Effects of edaravone on human neutrophil function

Oxidative/nitrative stress in the pathogenesis of systemic sclerosis: are antioxidants beneficial?

Systemic sclerosis (SSc) is a multisystem autoimmune disease: characterised from the clinical side by progressive vasculopathy and fibrosis of the skin and different organs and from the biochemical side by fibroblast deregulation with excessive production of collagen and increased expression of nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4). The latter contributes to an overproduction of reactive oxygen species that through an autocrine loop maintains NOX4 in a state of activation. Reactive oxygen and nitrogen species are implicated in the origin and perpetuation of several clinical manifestations of SSc having vascular damage in common; attempts to dampen oxidative and nitrative stress through different agents with antioxidant properties have not translated into a sustained clinical benefit. Objective of this narrative review is to describe the origin and clinical implications of oxidative and nitrative stress in SSc, with particular focus on the central role of NOX4 and its interactions, to re-evaluate the antioxidant approaches so far used to limit disease progression, to appraise the complexity of antioxidant treatment and to touch on novel pathways elements of which may represent specific treatment targets in the not so distant future.

Effect of free radical scavenger, edaravone, for patients with carbon monoxide poisoning

OBJECTIVE

Chronic neurological symptoms after carbon monoxide (CO) poisoning are caused by various biological processes in the damaged brain, with free radicals playing roles as mediators in establishing pathological processes leading to chronic neurological symptoms under CO poisoning. This study aimed to clarify the effects of a free radical scavenger, edaravone, in patients with CO poisoning.

METHODS

We retrospectively compared two groups comprising patients treated with hyperbaric oxygenation alone (Group A, n=25) or edaravone in addition to hyperbaric oxygenation (Group B, n=25). Edaravone was administrated intravenously at 30 mg every 12h for 7 days. Patient characteristics, general conditions on admission, and frequency of chronic neurological symptoms were compared between groups. Among patients showing chronic neurological symptoms, cognitive function and daily activity were also compared between groups.

RESULTS

No significant differences in characteristics or general conditions on admission were identified between groups. In Group B, no patients presented with marked complications caused by edaravone. Although chronic persisting symptoms were less frequent in Group B (n=1, 0.04%) than in Group A (n=5, 20%), this difference was not significant. In the 11 patients showing chronic symptoms, scores for cognitive function and daily activity in the chronic phase were better in Group B than in Group A, but no significant differences were apparent.

CONCLUSIONS

The present results suggest that edaravone represents a tolerable and feasible treatment for CO-poisoned patients. Further studies are needed to clarify whether edaravone can favorably influence chronic neurological symptoms caused by CO poisoning.

Effects of edaravone on amyloid-β precursor protein processing in SY5Y-APP695 cells

Previous reports have revealed that reactive oxygen species (ROS) is involved in the development of Alzheimer's disease (AD), and recent studies indicate that free radical-generating systems can regulate amyloid-β precursor protein (APP) processing. Edaravone is a novel free radical scavenger currently used to reduce cerebral damages after acute cerebral infarction. In the present study, we used SH-SY5Y cells stably transfected with the human "Swedish" APP mutation APP695 (SY5Y-APP695swe) as an in vitro model to investigate the effect of edaravone on APP processing. The result showed that edaravone treatment for 24 h down-regulated β-amyloid (Aβ) production in a dose-dependent manner. Moreover, edaravone modulated APP processing by increasing α-secretase-derived APP fragments and decreasing β-secretase-derived APP fragments. In addition, the mRNA and protein levels of insulin degrading enzyme (IDE) and neprilysin (NEP), two key Aβ degrading enzymes, were not changed after edaravone administration. Taken together, our data suggested that edaravone played an important role in regulating Aβ production by enhancing the non-amyloidogenic pathway and inhibiting the amyloidogenic pathway. Thus, edaravone may be potentially useful for treating Alzheimer's disease (AD).

Edaravone directly reacts with singlet oxygen and protects cells from attack

AIMS

Protective effects of edaravone, an approved medicine for acute brain infarction in Japan, on cell death induced by singlet oxygen (1O2) were examined.

MAIN METHOD

The 1O2 scavenging activity was examined by direct analysis of near-infrared luminescence in a cell-free system and by fluorospectrometry in the presence of cells. The protective effects of edaravone on 1O2-induced cell death were examined, using rat neuronal B50 cells. Cell death was evaluated by mitochondrial respiration (MTT assay), confocal microscopy and time-lapse imaging. The chemical reaction of edaravone with 1O2 was examined by production analysis using high performance liquid chromatography (HPLC).

KEY FINDINGS

When rose Bengal (RB) in D2O was irradiated by a 514nm laser beam, the signal of 1O2 was observed. Edaravone suppressed the 1O2 signal more potently than azide, a 1O2 scavenger. When B50 cells were irradiated by 525nm green light in the RB solution, production of 1O2 and induction of cell death were observed. The fluorospectrometric study and the MTT assay revealed that 100-400microM edaravone suppressed the 1O2 production and attenuated cell death in a concentration-dependent manner. Confocal microscopy and the time-lapse imaging revealed that edaravone prevented the impairment of membrane integrity and the progression of cell death induced by 1O2. The HPLC study revealed that edaravone chemically reacted with 1O2 and changed another compound.

SIGNIFICANCE

Since 1O2 is possibly involved in post-ischemic neuronal damage, the clinically approved curative effects of edaravone on acute brain infarction might be attributed to its potent 1O2 scavenging activity.

Reactive oxygen species modulate growth of cerebral aneurysms: a study using the free radical scavenger edaravone and p47phox(-/-) mice

Cerebral aneurysm (CA) is a relatively common disease and can cause a catastrophic subarachnoid hemorrhage with a high mortality and morbidity rate. Despite its clinical and social importance, the detailed mechanism of CA formation remains to be elucidated, resulting in the absence of effective medical treatment against CAs. Recent studies revealed that chronic inflammation in arterial walls by hemodynamic force is implicated in CA formation. Reactive oxygen species (ROS) are a major mediator of inflammation and actively participate in the pathogenesis of various vascular diseases. In the present study, we first assessed the expression of ROS-producing and -eliminating genes in CA walls by immunohistochemistry and RT-PCR analysis. The ROS-producing gene, p47phox, was upregulated in infiltrating macrophages and medial smooth muscle cells in arterial walls. Upregulated ROS-producing genes and suppressed ROS-eliminating genes suggested that ROS overproduction occurred in aneurysmal walls. In situ superoxide imaging by dihydroethidium, which showed ROS overproduction in aneurysmal walls, confirmed this hypothesis. Edaravone, a powerful free radical scavenger, effectively inhibited CA formation by suppressing inflammation-related gene expression in aneurysmal walls. Furthermore, CA formation was markedly inhibited by p47phox deletion in mice and was accompanied by decreased inflammation in aneurysmal walls. These data suggested the active participation of ROS and p47phox in CA formation and the therapeutic potential of an ROS-eliminating agent against CA formation.

The novel antioxidant edaravone: from bench to bedside

Over the last decade, important advances have been made to support the fact that reactive oxygen species (ROS) are generated and play a harmful role during the acute and late stages of cerebral ischemia. Several drugs, such as radical scavengers and antioxidants, have been evaluated in preclinical and clinical studies. Edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one; Radicut, Mitsubishi Tanabe Pharma Corporation) is a novel antioxidant that is currently used in Japan for the treatment of patients in the acute stage of cerebral infarction. Edaravone scavenges ROS and inhibits proinflammatory responses after brain ischemia in animals and humans. In particular, postischemic inflammation, leading to brain edema and infarction due to neuronal damage and endothelial cell death, can be ameliorated by edaravone. In addition to these antistroke effects, edaravone has also been shown to prevent oxidative damage to various extracerebral organs. Therefore, in addition to its usefulness in the treatment of stroke, edaravone is expected to play an integral role in the treatment of many oxidative stress-related diseases.

Effects of Edaravone on Singlet Oxygen Released From Activated Human Neutrophils

The effects of edaravone, a curative agent for acute brain infarction, on singlet oxygen ((1)O2) released from activated human neutrophils were examined, and the effects were compared to those of histidine, a (1)O2 singlet oxygen scavenger. The neutrophils, stimulated with opsonized zymosan, released (1)O2 that was detected by chemiluminescence using a (1)O2 specific probe, trans-1-(2'-methoxyvinyl)pyrene. Edaravone dose-dependently suppressed the (1)O2 release with an IC(50) of approximately 0.3 microM, while the IC(50) of histidine was approximately 1 mM. This (1)O2 scavenging activity of edaravone might be involved in its curative effects on acute brain infarction.