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Swain R, Nandi S, Swain SS, Pattanaik KP, Mohapatra S, Panigrahi D, Mallick S. Bentonite-in hypromellose-poloxamer sol-gel for corneal application of trimetazidine: Study of rheology and ocular anti inflammatory potential. Int J Biol Macromol 2023; 242:124628. [PMID: 37119900 DOI: 10.1016/j.ijbiomac.2023.124628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
Bentonite is reported to be used for extending ocular drug delivery safely in a controlled manner. Bentonite combined hydroxypropyl methylcellulose (HPMC)-poloxamer based sol-to-gel formulation has been developed for the prophylactic ocular anti-inflammatory effect of trimetazidine after corneal application. HPMC-poloxamer sol formulation was prepared incorporating trimetazidine to bentonite at 1: 2*10-5 to 1:5*10-6 ratios using cold method, and investigations were carried out in carrageenan-induced rabbit eye model. Pseudoplastic shear thinning behavior without any yield value and high viscosity at low shear rate were the positive attribute of the tolerability of the sol formulation after ocular instillation. Presence of bentonite nanoplatelets revealed more sustained in vitro release (~79-97 %) and corneal permeation (~79-83 %) over a period of 6 h in comparison to its absence. Prominent acute inflammation has been produced in the carrageenan-induced untreated eye, whereas the absence of ocular inflammation has been noticed in the previously sol-treated eye even after carrageenan injection. HPMC-poloxamer-based formulation exhibited stronger binding affinity (5.13 kcal/mol) in the presence of bentonite rather than its absence (3.99 kcal/mol), resulting in a stable and sustained effect. HPMC-poloxamer in-situ gel of trimetazidine containing bentonite could be utilized for sustained ocular delivery and the control of ophthalmic inflammation prophylactically.
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Affiliation(s)
- Rakesh Swain
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar 751003, Odisha, India
| | - Souvik Nandi
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar 751003, Odisha, India
| | - Shasank Sekhar Swain
- Division of Microbiology & NCDs, ICMR Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar 751023, Odisha, India
| | - Krushna Prasad Pattanaik
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar 751003, Odisha, India
| | - Sujata Mohapatra
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar 751003, Odisha, India
| | - Dhananjay Panigrahi
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar 751003, Odisha, India
| | - Subrata Mallick
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar 751003, Odisha, India.
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Dai ZL, Song YF, Tian Y, Li Y, Lin M, Lin J, Wang Q, Wang P, Gao WL. Trimetazidine offers myocardial protection in elderly coronary artery disease patients undergoing non-cardiac surgery: a randomized, double-blind, placebo-controlled trial. BMC Cardiovasc Disord 2021; 21:473. [PMID: 34598676 PMCID: PMC8485575 DOI: 10.1186/s12872-021-02287-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/24/2021] [Indexed: 11/21/2022] Open
Abstract
Background Trimetazidine (TMZ) pretreatment protects cardiomyocytes during cardiac surgery. TMZ may protect elderly patients with ischaemic heart disease (IHD) undergoing non-cardiac surgery. Methods This was a randomized, double-blind, placebo-controlled trial (registration #ChiCTR1900025018) of patients with IHD scheduled to undergo non-cardiac surgery at Shenzhen People’s Hospital (Shenzhen, Guangdong Province, China) between June 2014 and September 2015, randomized to 60 mg TMZ or placebo 12 h before surgery. The primary endpoint was the occurrence of in-hospital cardiovascular events. The secondary endpoints were myocardial ischaemia on five-lead electrocardiogram (cECG), cardiac troponin I (cTnI) elevation, cardiac death, acute coronary events, heart failure, and arrhythmia requiring treatments. Results Compared with the placebo group, the TMZ group showed a lower occurrence of in-hospital cardiovascular events (primary endpoint, 20.0% vs. 37.5%, P = 0.02), myocardial ischaemia (15.0% vs. 32.5%, P < 0.01), cTnI elevation (2.5% vs. 10%, P < 0.01), acute coronary events (10.0% vs. 20.0%, P < 0.05), heart failure (0% vs. 2.5%, P < 0.05), and arrhythmia requiring treatment (17.5% vs. 35.0%, P < 0.05). There was no acute myocardial infarction during the 30-day postoperative period. Conclusions In elderly patients with IHD undergoing non-cardiac surgery, TMZ pretreatment was associated with myocardial protective effects. Trial registration The trial was prospectively registered at http://www.chictr.org.cn/showproj.aspx?proj=41909 with registration number [ChiCTR1900025018] (7/8/2019).
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Affiliation(s)
- Zhong-Liang Dai
- Department of Anesthesiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China. .,Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020, Guangdong, China.
| | - Yi-Feng Song
- Department of Anesthesiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.,Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020, Guangdong, China
| | - Ya Tian
- Department of Anesthesiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.,Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020, Guangdong, China
| | - Yin Li
- Department of Anesthesiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.,Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020, Guangdong, China
| | - Miao Lin
- Department of Anesthesiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.,Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020, Guangdong, China
| | - Juan Lin
- Department of Anesthesiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.,Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020, Guangdong, China
| | - Qi Wang
- Department of Anesthesiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.,Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020, Guangdong, China
| | - Ping Wang
- Department of Anesthesiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.,Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020, Guangdong, China
| | - Wen-Li Gao
- Department of Anesthesiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China. .,Shenzhen Engineering Research Center of Anesthesiology, No. 1017 Dongmen North Road, Shenzhen, 518020, Guangdong, China.
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Wang C, Chen W, Yu M, Yang P. Efficacy of Trimetazidine in Limiting Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis. Angiology 2021; 72:511-523. [PMID: 33472383 DOI: 10.1177/0003319720987745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We systematically searched the literature to assess the efficacy of trimetazidine in reducing periprocedural myocardial injury and improving postoperative left ventricular ejection fraction (LVEF) in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). An electronic search was conducted based on the PubMed, Ovid, Scopus, Springer, CENTRAL, and Google Scholar databases; 14 randomized controlled trials (RCTs) were included. Our meta-analysis showed a significant reduction in cardiac troponin I (cTnI) levels with trimetazidine compared with controls (P < .00001) but not in serum creatine kinase-myocardial band levels (P = .49). There were significantly reduced odds of ischemic ST-T segment changes with trimetazidine (P = .0.03) but lack of significant difference in the incidence of anginal attacks between the 2 groups (P = .10). Results also suggest significantly higher LVEF with trimetazidine compared with controls (P < .00001). Meta-regression analysis indicated no influence of duration of trimetazidine therapy on cTnI levels. The administration of preprocedure trimetazidine may have a role in reducing periprocedural myocardial injury in patients with CAD undergoing PCI. Evidence also suggests that postoperative trimetazidine may improve LVEF in the short term. Lack of high-quality trials and the heterogeneity of studies limit the ability of our analysis to draw strong conclusions. Further well-designed RCTs are required to supplement current evidence.
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Affiliation(s)
- Chang Wang
- Department of Cardiology, 74569China-Japan Union Hospital of Jilin University, Changchun, Jilin, P. R. China.,Jilin Provincial Precision Medicine Key Laboratory for Cardiovascular Genetic Diagnosis, Jilin, P. R. China.,Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Jilin, P. R. China
| | - Weiwei Chen
- Department of Cardiology, 74569China-Japan Union Hospital of Jilin University, Changchun, Jilin, P. R. China.,Jilin Provincial Precision Medicine Key Laboratory for Cardiovascular Genetic Diagnosis, Jilin, P. R. China.,Jilin Provincial Cardiovascular Research Institute, Jilin, P. R. China
| | - Ming Yu
- Department of Cardiology, 74569China-Japan Union Hospital of Jilin University, Changchun, Jilin, P. R. China.,Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Jilin, P. R. China.,Jilin Provincial Cardiovascular Research Institute, Jilin, P. R. China
| | - Ping Yang
- Department of Cardiology, 74569China-Japan Union Hospital of Jilin University, Changchun, Jilin, P. R. China.,Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Jilin, P. R. China.,Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Jilin, P. R. China
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Zhang Q, Lian Z, Zhang W, Cui Y, Wang W, Wu J, Chen Z, Wang W. Association between interleukin-8 gene -251 A/T polymorphism and the risk of coronary artery disease: A meta-analysis. Medicine (Baltimore) 2019; 98:e17866. [PMID: 31770200 PMCID: PMC6890313 DOI: 10.1097/md.0000000000017866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The association between interleukin-8 (IL-8) gene polymorphism -251 A>T and susceptibility to coronary artery disease (CAD) has been investigated previously; however, results remain controversial. Thus, a meta-analysis was conducted to reassess the effects of this polymorphism on CAD risks. METHODS The PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched for relevant studies published up to December, 2018. The pooled odds ratios (OR) were calculated using STATA 13.0 software for allelic (A vs T) as well as homozygote (AA vs TT), heterozygote (AT vs TT), recessive (AA vs AT + TT), and dominant (AA + AT vs TT) genotype models, respectively. RESULTS Ten case-control studies (3744 cases and 3660 controls) were included. Overall, a significant association of IL-8 gene -251 A > T polymorphism with an increased risk of CAD was only observed in the dominant genotype model (OR = 1.48), but not others. In the subgroup analysis, significantly increased risks were also found for Chinese (OR = 1.64), polymerase chain reaction-restriction fragment length polymorphism genotyping (OR = 1.61), acute coronary syndrome (ACS) type (OR = 1.92 for 3 datasets; OR = 1.88 for 4 datasets), high quality (OR = 1.64), and age/gender matching status (OR = 1.55) under the dominant model. Furthermore, significantly increased risks were also found for ACS type under allelic (OR = 1.32 for 3 datasets; OR = 127 for 4 datasets), homozygote (OR = 1.64 for 3 datasets; OR = 1.50 for 4 datasets), heterozygote (OR = 1.32 for 3 datasets; OR = 1.30 for 4 datasets), and recessive (OR = 1.40 for 3 datasets; OR = 1.28 for 4 datasets) models. CONCLUSION This meta-analysis suggests that Chinese patients carrying -251A allele of IL-8 may have an increased risk for the development of CAD, especially ACS.
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Affiliation(s)
| | | | | | | | | | - Jun Wu
- Department of Gastroenterology
| | | | - Wei Wang
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
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