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Kontoghiorghes GJ. The Puzzle of Aspirin and Iron Deficiency: The Vital Missing Link of the Iron-Chelating Metabolites. Int J Mol Sci 2024; 25:5150. [PMID: 38791185 PMCID: PMC11121054 DOI: 10.3390/ijms25105150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Acetylsalicylic acid or aspirin is the most commonly used drug in the world and is taken daily by millions of people. There is increasing evidence that chronic administration of low-dose aspirin of about 75-100 mg/day can cause iron deficiency anaemia (IDA) in the absence of major gastric bleeding; this is found in a large number of about 20% otherwise healthy elderly (>65 years) individuals. The mechanisms of the cause of IDA in this category of individuals are still largely unknown. Evidence is presented suggesting that a likely cause of IDA in this category of aspirin users is the chelation activity and increased excretion of iron caused by aspirin chelating metabolites (ACMs). It is estimated that 90% of oral aspirin is metabolized into about 70% of the ACMs salicyluric acid, salicylic acid, 2,5-dihydroxybenzoic acid, and 2,3-dihydroxybenzoic acid. All ACMs have a high affinity for binding iron and ability to mobilize iron from different iron pools, causing an overall net increase in iron excretion and altering iron balance. Interestingly, 2,3-dihydroxybenzoic acid has been previously tested in iron-loaded thalassaemia patients, leading to substantial increases in iron excretion. The daily administration of low-dose aspirin for long-term periods is likely to enhance the overall iron excretion in small increments each time due to the combined iron mobilization effect of the ACM. In particular, IDA is likely to occur mainly in populations such as elderly vegetarian adults with meals low in iron content. Furthermore, IDA may be exacerbated by the combinations of ACM with other dietary components, which can prevent iron absorption and enhance iron excretion. Overall, aspirin is acting as a chelating pro-drug similar to dexrazoxane, and the ACM as combination chelation therapy. Iron balance, pharmacological, and other studies on the interaction of iron and aspirin, as well as ACM, are likely to shed more light on the mechanism of IDA. Similar mechanisms of iron chelation through ACM may also be implicated in patient improvements observed in cancer, neurodegenerative, and other disease categories when treated long-term with daily aspirin. In particular, the role of aspirin and ACM in iron metabolism and free radical pathology includes ferroptosis, and may identify other missing links in the therapeutic effects of aspirin in many more diseases. It is suggested that aspirin is the first non-chelating drug described to cause IDA through its ACM metabolites. The therapeutic, pharmacological, toxicological and other implications of aspirin are incomplete without taking into consideration the iron binding and other effects of the ACM.
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Affiliation(s)
- George J Kontoghiorghes
- Postgraduate Research Institute of Science, Technology, Environment and Medicine, Limassol 3021, Cyprus
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Tükel HC, Alptekin Ö, Turan B, Delilbaşı E. Effects of metabolic syndrome on masseter muscle of male Wistar rats. Eur J Oral Sci 2015; 123:432-8. [DOI: 10.1111/eos.12226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 01/21/2023]
Affiliation(s)
- H. Can Tükel
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; University of Cukurova; Adana Turkey
| | - Özlem Alptekin
- Department of Biochemistry; Faculty of Pharmacy; University of Cukurova; Adana Turkey
| | - Belma Turan
- Department of Biophysics; Faculty of Medicine; University of Ankara; Ankara Turkey
| | - Ertan Delilbaşı
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; University of Gazi; Ankara Turkey
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Efficacy of hyaluronic acid injections in patients with osteoarthritis of the temporomandibular joint. A comparative study. J Craniofac Surg 2015; 24:2006-9. [PMID: 24220392 DOI: 10.1097/scs.0b013e3182a30566] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of the present study was to report the 1-year therapeutic outcome of intra-articular injections of high-molecular-weight hyaluronic acid (HA) without arthrocentesis in a group of 25 patients with osteoarthritis (OA) of the temporomandibular joint (TMJ). The results were compared with those of a group of 10 patients with OA of the TMJ, treated with nonsteroidal anti-inflammatory drugs.Twenty-five patients (group A) underwent a cycle of 5 injections of HA into the TMJ. Ten patients (group B) underwent a therapy with nonsteroidal anti-inflammatory drugs for 1 month. The follow-up assessments after the end of treatment were at 1, 3, 6, and 12 months.Regarding the first follow-up (1 month), statistical analysis for all clinical parameters showed no significant differences (ie, beneficial effect for 2 groups) between groups A and B (P > 0.001). Significant statistical differences (ie, encouraging effect for group A) for all clinical parameters were recorded 1 year after the end of treatment between groups A and B (P < 0.001).A cycle of 5 intra-articular injections of HA without arthrocentesis for patients with OA of the TMJ is considered successful at 1-year follow-up period.
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Bhat SS, Hegde KS, Chandrashekhar S, Rao SN, Manikkoth S. Preclinical screening of phyllanthus amarus ethanolic extract for its analgesic and antimicrobial activity. Pharmacognosy Res 2014; 7:378-84. [PMID: 26692753 PMCID: PMC4660518 DOI: 10.4103/0974-8490.159577] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 01/08/2015] [Accepted: 10/21/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND To discover a new agent which possesses dual property of analgesic and antimicrobial activity, thereby reducing the burden of polypharmacy. Phyllanthus amarus was screened for its analgesic and antimicrobial activities. OBJECTIVES The objective was to evaluate the analgesic and antimicrobial activity, of P. amarus ethanolic extract (PAEE). MATERIALS AND METHODS The ethanolic extract of P. amarus was prepared using Soxhlet apparatus. An in vivo study using Swiss albino mice was done to screen the central and peripheral analgesic activity of P. amarus extract. The extract was administered at a dose of 100 mg/kg body weight orally. The peripheral analgesic activity was assessed using acetic acid induced writhing test. The central analgesic activity was assessed using Eddy's hot plate apparatus. An in vitro study was carried out to study the antimicrobial activity of the above extract using selected species of Streptococcus mutans, and S. salivarius. The antimicrobial activities were determined using the agar well method. RESULTS The ethanolic extract of P. amarus showed significant (P < 0.05) peripheral and central analgesic activity. In vitro antimicrobial screening indicated that the ethanolic extract had shown a zone of inhibition against S. mutans and S. salivarius in the agar wells. CONCLUSION This study showed that PAEE exhibited significant analgesic and antimicrobial activities.
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Affiliation(s)
- S. Sham Bhat
- Department of Paedodontics and Preventive Dentistry, Yenepoya University, Mangalore, Karnataka, India
| | - K. Sundeep Hegde
- Department of Paedodontics and Preventive Dentistry, Yenepoya University, Mangalore, Karnataka, India
| | - Sharath Chandrashekhar
- Department of Paedodontics and Preventive Dentistry, Yenepoya University, Mangalore, Karnataka, India
| | - S. N. Rao
- Department of Pharmacology, Yenepoya University, Mangalore, Karnataka, India
| | - Shyamjith Manikkoth
- Department of Pharmacology, Yenepoya University, Mangalore, Karnataka, India
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Quintans-Júnior L, da Rocha RF, Caregnato FF, Moreira JCF, da Silva FA, Araújo AADS, dos Santos JPA, Melo MS, de Sousa DP, Bonjardim LR, Gelain DP. Antinociceptive action and redox properties of citronellal, an essential oil present in lemongrass. J Med Food 2011; 14:630-9. [PMID: 21480794 DOI: 10.1089/jmf.2010.0125] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Citronellal (CT) is a monoterpenoid and the major constituent of the mixture of terpenoids that give the citronella oil its lemon scent. Citronella oil is widely used around the world for various purposes and is mainly obtained from plants of the Cymbopogon genus, which are known as "lemongrass." Considering these plants have been used worldwide for various medicinal purposes, the interest of researchers to understand the biological activities of monoterpenoids related to the Cymbopogon genus has been increasing. In the present work, we investigated the antinociceptive action and the redox properties of CT. Our results indicate that intraperitoneal injection of CT was effective in reducing nociceptive face-rubbing behavior in both phases of the formalin test, which was also naloxone-sensitive. CT also evoked antinociceptive response in the capsaicin and glutamate tests. The total radical-trapping antioxidant parameter and total antioxidant reactivity assays indicate that CT at doses of 0.1 and 1 mg/mL exerts a significant antioxidant activity, which is probably related to its ability to scavenge superoxide and nitric oxide, but not H(2)O(2) or hydroxyl radicals, as evaluated separately by specific in vitro tests. These results show for the first time the antinociceptive potential of CT and indicate that the antioxidant properties of this compound may rely on its mechanism of biological actions because CT-containing natural products are used to treat various diseases related to oxidative stress and reactive species.
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Temporomandibular joint pain and synovial fluid analysis: a review of the literature. J Oral Maxillofac Surg 2009; 67:2497-504. [PMID: 19837323 DOI: 10.1016/j.joms.2009.04.103] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Accepted: 04/23/2009] [Indexed: 02/06/2023]
Abstract
The pathophysiology of temporomandibular joint pain is not well understood. A significant amount of research has been conducted to evaluate synovial fluid in these patients and in healthy controls. Qualitative and quantitative analyses of the synovial fluid have shown a significant difference between these groups. A multitude of inflammatory mediators and degradation products have been identified. The concentration of these products has been shown to correlate with several clinical parameters including pain, chronicity, severity of degenerative change, and response to treatment. A common inflammatory pathway would appear to be involved in most patients. At the present time, synovial fluid analysis does not have the sensitivity or specificity to allow specific diagnoses and targeted treatment. Continued research with the specific aim of establishing more appropriate therapeutic modalities based on the biochemical pathways is warranted.
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Etoz OA, Ataoglu H, Erel O, Celik H, Herken EN, Bayazit YA. Association of Serum Total Antioxidant Capacity and Total Oxidant Status with Pain Perception in Patients with Myofacial pain Dysfunction. Int J Neurosci 2009; 119:1282-91. [DOI: 10.1080/00207450902907482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Shinoda C, Takaku S. Oral and Maxillofacial Pathology: Interleukin-1 β, interleukin-6, and tissue inhibitor of metalloproteinase-1 in the synovial fluid of the temporomandibular joint with respect to cartilage destruction. Oral Dis 2008; 6:383-90. [PMID: 11355271 DOI: 10.1111/j.1601-0825.2000.tb00131.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The distribution and biological roles of interleukin (IL)-1 beta, IL-6, and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the synovial fluid of patients with non-inflammatory chronic temporomandibular joint (TMJ) disorders were evaluated in relation to pain upon joint movements and X-ray and magnetic resonance imaging (MRI) findings. MATERIALS AND METHODS TMJ aspirates were obtained from 48 patients (48 joints) with chronic TMJ disorders and from 18 controls (18 joints). The IL-1 beta and IL-6 levels in the aspirates were determined by using an enzyme-linked immunosorbent assay and the TIMP-1 level was measured by an enzyme immunoassay. Following examinations for pain upon joint movements and X-ray and MRI observations, the IL-1 beta, IL-6, and TIMP-1 levels and frequencies of their detection were compared. RESULTS The IL-1 beta level and frequency of detection showed no correlation with pain upon joint movements or with the X-ray and MRI findings. In the frequency of detection of IL-6, there were significant differences between control (no detection) and all chronic TMJ disorder groups that were classified by imaging diagnosis (P < 0.001). A correlation was also noted between the presence of IL-6 and pain upon joint movements. The IL-6 level was correlated with the TIMP-1 level and with pain upon joint movements. TIMP-1 level was correlated with pain upon joint movements. The TIMP-1 was present in higher level from patients with chronic TMJ disorders who exhibited osseous changes on the X-ray images. CONCLUSION The results indicated that the IL-6 and TIMP-1 levels in the TMJ aspirates of patients with chronic TMJ disorders have been raised. The former was not detected in the TMJ aspirates of the control. These findings suggest that IL-6 and TIMP-1 might play a role in the etiology of chronic TMJ disorders, but further studies are needed to validate this.
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Affiliation(s)
- C Shinoda
- Department of Oral and Maxillofacial Surgery, Saitama Medical School, Morohongo 38, Moroyama Irumagun, Saitama 350-0495, Japan
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Milam SB. Pathogenesis of degenerative temporomandibular joint arthritides. Odontology 2006; 93:7-15. [PMID: 16170470 DOI: 10.1007/s10266-005-0056-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2005] [Accepted: 07/14/2005] [Indexed: 12/15/2022]
Abstract
Over the past decade, remarkable progress has been made in the study of molecular mechanisms involved in degenerative temporomandibular joint arthritides. Based on recent findings, models of degenerative temporomandibular joint disease predict that mechanical loads trigger a cascade of molecular events leading to disease in susceptible individuals. These events involve the production or release of free radicals, cytokines, fatty acid catabolites, neuropeptides, and matrix-degrading enzymes. Under normal circumstances, these molecules may be involved in the remodeling of articular tissues in response to changing functional demands. However, if functional demands exceed the adaptive capacity of the temporomandibular joint or if the affected individual is susceptible to maladaptive responses, then a disease state will ensue. An individual's susceptibility to degenerative temporomandibular joint disease may be determined by several factors, including genetic backdrop, sex, age, and nutritional status. It is hoped that, by furthering our understanding of the molecular events that underlie degenerative temporomandibular joint diseases, improved diagnostics and effective therapies for these debilitating conditions will be developed.
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Affiliation(s)
- Stephen B Milam
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.
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Takahashi T, Homma H, Nagai H, Seki H, Kondoh T, Yamazaki Y, Fukuda M. Specific expression of inducible nitric oxide synthase in the synovium of the diseased temporomandibular joint. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 95:174-81. [PMID: 12582357 DOI: 10.1067/moe.2003.45] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The expression of inducible nitric oxide synthase (iNOS) in temporomandibular joint (TMJ) specimens obtained arthroscopically from diseased TMJs was investigated by using immunohistochemistry and compared with clinical, arthroscopic, and histologic findings. STUDY DESIGN Synovial biopsies were obtained arthroscopically from 18 TMJs in 15 patients with symptomatic internal derangement (ID) or osteoarthritis (OA). We also obtained arthroscopic biopsies from 8 control TMJs (3 with habitual luxation of the mandible, one with ID with clicking, and 4 with mandibular condyle fractures). The expression of iNOS was examined by immunohistochemistry and was compared with clinical, arthroscopic, and histologic findings. RESULTS Definite or intense iNOS immunoreactivity was observed in both the synovial lining cells and the endothelial cells of TMJs with symptomatic ID or OA. Weaker immunoreactivity was present in synovial fibroblasts. In contrast, in TMJs without synovitis (eg, those with habitual luxation of the mandible) the expression of iNOS was weak or marginal. The expression of iNOS correlated significantly with arthroscopic evidence of synovitis (r = 0.406, P <.05) but not with cartilaginous degeneration (P >.05). The expression of iNOS also correlated with the histologic grade of the synovial lining cell layers (r = 0.530, P <.05). However, in patients with ID or OA of the TMJ, there was no statistically significant correlation between the intensity of iNOS immunoreactivity and clinical, arthroscopic, or histologic findings (P >.05). CONCLUSION These data clearly suggest that nitric oxide is locally produced in the synovial lining of the TMJ in ID and OA.
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Affiliation(s)
- Tetsu Takahashi
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, Japan.
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Gynther GW. Relationship between joint effusion, joint pain, and protein levels in joint lavage fluid of patients with internal derangement and osteoarthritis of the temporomandibular joint. J Oral Maxillofac Surg 1999. [DOI: 10.1016/s0278-2391(99)90484-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jendresen MD, Allen EP, Bayne SC, Donovan TE, Goldman S, Hume R, Kois JC. Annual review of selected dental literature: report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 1998; 80:81-120. [PMID: 9656182 DOI: 10.1016/s0022-3913(98)70095-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Harris M. The surgical management of idiopathic facial pain produces intractable iatrogenic pain? Br J Oral Maxillofac Surg 1996; 34:1-3. [PMID: 8645659 DOI: 10.1016/s0266-4356(96)90127-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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