Combination anti-inflammatory therapy: synergism in rats of NSAIDs/corticosteroids with some herbal/animal products

Glabridin Plays Dual Action to Augment the Efficacy and Attenuate the Hepatotoxicity of Methotrexate in Arthritic Rats

Glabridin is chemically an isoflavane class of natural phenols and is found mainly in the roots of Glycyrrhiza glabra. It has several beneficial pharmacological actions for the management of inflammatory disorders as well as can counteract drug-induced toxic effects. On the other hand, methotrexate (MTX) is the first-line disease-modifying antirheumatic drug for the treatment of rheumatoid arthritis. However, its treatment is associated with major side effects like hepatotoxicity. In the quest to explore a suitable combination therapy that can improve the efficacy and reduce the hepatotoxicity of MTX, we hypothesized that glabridin might serve the purpose for which there is no literature precedent to date. We explored the antiarthritic efficacy of MTX in the presence or the absence of glabridin using Mycobacterium-induced arthritic model in rats. The results of reduction in paw swelling, inhibition of serum cytokines (TNF-α, IL-6, and IL-1β), and improvement in the bone joints from radiological and histopathological findings suggest that glabridin can substantially augment the antiarthritic efficacy of MTX. Further, results of concomitant glabridin treatment with MTX in the experimental time frame demonstrate that glabridin could considerably prevent the MTX-induced hepatic alteration in serum biochemical markers (SGPT and SGOT) and oxidative stress markers (malondialdehyde (MDA) and glutathione reduced (GSH)). Moreover, glabridin showed a marked effect in impeding the regulation of NF-κB/IκBα and Nrf2/Keap1 pathways in the hepatic tissues. The results of simultaneous administration of glabridin with MTX in the rat model indicate that glabridin had no pronounced effect of causing severe alteration in the pharmacokinetic behavior of MTX. In summary, glabridin can significantly potentiate the antiarthritic efficacy of MTX and can also minimize its hepatotoxicity via the inhibition of inflammation and oxidative stress. Further research should be performed to develop glabridin as a phytotherapeutics for the improved efficacy and better tolerability of MTX at the reduced dose level of MTX.

Reducing neuroinflammation via therapeutic compounds and lifestyle to prevent or delay progression of Parkinson's disease

Parkinson's disease (PD) is the second most common age-associated neurodegenerative disorder and is characterised by progressive loss of dopamine neurons in the substantia nigra. Peripheral immune cell infiltration and activation of microglia and astrocytes are observed in PD, a process called neuroinflammation. Neuroinflammation is a fundamental response to protect the brain but, when chronic, it triggers neuronal damage. In the last decade, central and peripheral inflammation were suggested to occur at the prodromal stage of PD, sustained throughout disease progression, and may play a significant role in the pathology. Understanding the pathological mechanisms of PD has been a high priority in research, primarily to find effective treatments once symptoms are present. Evidence indicates that early life exposure to neuroinflammation as a consequence of life events, environmental or behaviour factors such as exposure to infections, pollution or a high fat diet increase the risk of developing PD. Many studies show healthy habits and products that decrease neuroinflammation also reduce the risk of PD. Here, we aim to stimulate discussion about the role of neuroinflammation in PD onset and progression. We highlight that reducing neuroinflammation throughout the lifespan is critical for preventing idiopathic PD, and present epidemiological studies that detail risk and protective factors. It is possible that introducing lifestyle changes that reduce neuroinflammation at the time of PD diagnosis may slow symptom progression. Finally, we discuss compounds and therapeutics to treat the neuroinflammation associated with PD.

Perna canaliculus and the Intestinal Microbiome

Natural medicines are often an attractive option for patients diagnosed with chronic conditions. Three main classes of bioactives that have been reported from marine mussel extracts include proteins, lipids and carbohydrates. Commercially, the most relevant species of marine mollusks belong to two genera, Perna and Mytilus. Specifically, the Perna canaliculus species has been repeatedly demonstrated to harbor anti-inflammatory compounds such as omega-3 polyunsaturated fatty acids (ω-3 PUFAs) that can ameliorate pro-inflammatory conditions, or proteins that can promote thrombin inhibitory activity. Recent clinical studies have posited that extracts from green-lipped mussels may lead to prebiotic activity in the intestinal microbiome that in turn has been reported to improve symptoms of osteoarthritis of the knee. Prebiotics have been reported to favorably interact with the intestinal microbiome through the proliferation of beneficial bacteria in the gut, suppressing exogenous and endogenous intestinal infections and promoting homeostasis by balancing local pro- and anti-inflammatory actions. Bioactive compounds from Perna canaliculus are functional foods and, in this regard, may positively interact with the intestinal microbiome and provide novel therapeutic solutions for intra-intestinal and extra-intestinal inflammatory conditions.

Celery Seed and Related Extracts with Antiarthritic, Antiulcer, and Antimicrobial Activities

Celery preparations have been used extensively for several millennia as natural therapies for acute and chronic painful or inflammatory conditions. This chapter reviews some of the biological and chemical properties of various celery preparations that have been used as natural remedies. Many of these have varying activities and product qualities. A fully standardized celery preparation has been prepared known as an alcoholic extract of the seeds of a plant source derived from northern India. This is termed, Celery Seed Extract (CSE) and has been found to be at least as effective as aspirin, ibuprofen, and naproxen in suppressing arthritis in a model of polyarthritis. CSE can also reduce existing inflammation in rats. CSE has also been shown to provide analgesia in two model systems. CSE, in addition to acting as an analgesic and inflammatory agent, has been shown to protect against and/or reduce gastric irritation caused by NSAIDs, as well as act synergistically with them to reduce inflammation. The CSE was fractionated by organic solvent extractions, then subjected to column chromatography followed by HPLC and was characterized by mass spectrometry. This yielded a purified component that had specific inhibitory effects on Helicobacter pylori but was not active against Campylobacter jejuni or Escherichia coli. Additionally, toxicology studies did not reveal any clear signs of toxicity at doses relevant to human use. Also, unlike many dietary supplements, the available data suggest that CSE does not significantly affect the p450 enzyme systems and thus is less likely to alter the metabolism of drugs the individual may be taking. CSE may be a prototype of a natural product that can be used therapeutically to treat arthritis and other inflammatory diseases.

Capture and identification of the volatile components in crude and processed herbal medicines through on-line purge and trap technique coupled with GC × GC-TOF MS

This work aimed to investigate the volatile components in crude and processed herbal medicines (HMs). Using Atractylodis Macrocephalae Rhizoma (AMR) as a model HM, the volatile components were captured through on-line purge and trap technique and identified by using comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry (GC × GC-TOF MS) system. A total of 224 and 171 volatile compounds were identified in crude and processed AMR samples, respectively. After frying with honey-bran, 52 compounds which were found in crude AMR samples disappeared in processed AMR samples, and 15 compounds were newly generated in processed AMR. The established method can be applied in different research areas such as HM and food processing.

The future of osteoarthritis therapeutics: targeted pharmacological therapy

Osteoarthritis (OA) is one of the most common forms of degenerative joint disease and a major cause of pain and disability affecting the aging population. It is estimated that more than 20 million Americans and 35 to 40 million Europeans suffer from OA. Analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) are the only therapeutic treatment options for OA. Effective pharmacotherapy for OA, capable of restoring the original structure and function of damaged cartilage and other synovial tissue, is urgently needed, and research into such disease-modifying osteoarthritis drugs (DMOADs) is in progress. This is the first of three reviews focusing on OA therapeutics. This paper provides an overview of current research into potential structure-modifying drugs and more appropriately targeted pharmacological therapy. The challenges and opportunities in this area of research and development are reviewed, covering the most up-to-date initiatives, trends, and topics.

Intersection of inflammation and herbal medicine in the treatment of osteoarthritis

Herbal remedies and dietary supplements have become an important area of research and clinical practice in orthopaedics and rheumatology. Understanding the risks and benefits of using herbal medicines in the treatment of arthritis, rheumatic diseases, and musculoskeletal complaints is a key priority of physicians and their patients. This review discusses the latest advances in the use of herbal medicines for treating osteoarthritis (OA) by focusing on the most significant trends and developments. This paper sets the scene by providing a brief introduction to ethnopharmacology, Ayurvedic medicine, and nutrigenomics before discussing the scientific and mechanistic rationale for targeting inflammatory signalling pathways in OA by use of herbal medicines. Special attention is drawn to the conceptual and practical difficulties associated with translating data from in-vitro experiments to in-vivo studies. Issues relating to the low bioavailability of active ingredients in herbal medicines are discussed, as also is the need for large-scale, randomized clinical trials.

Lyprinol-is it a useful anti-inflammatory agent?

The New Zealand green lipped mussel preparation Lyprinol is available without a prescription from a supermarket, pharmacy or Web. The Food and Drug Administration have recently warned Lyprinol USA about their extravagant anti-inflammatory claims for Lyprinol appearing on the web. These claims are put to thorough review. Lyprinol does have anti-inflammatory mechanisms, and has anti-inflammatory effects in some animal models of inflammation. Lyprinol may have benefits in dogs with arthritis. There are design problems with the clinical trials of Lyprinol in humans as an anti-inflammatory agent in osteoarthritis and rheumatoid arthritis, making it difficult to give a definite answer to how effective Lyprinol is in these conditions, but any benefit is small. Lyprinol also has a small benefit in atopic allergy. As anti-inflammatory agents, there is little to choose between Lyprinol and fish oil. No adverse effects have been reported with Lyprinol. Thus, although it is difficult to conclude whether Lyprinol does much good, it can be concluded that Lyprinol probably does no major harm.

Anti-inflammatory glucocorticoid drugs: reflections after 60 years

This review considers the problem of the serious concomitant side effects of powerful anti-inflammatory drugs modelled upon the principal human glucocorticoid hormone, cortisol. The very nature of the original bio-assays to validate their cortisol-like hormonal and anti-inflammatory activities ensured that pleiotropic toxins were selected for clinical studies. Other complicating factors have been (1) considerable reliance on bio-assays conducted in laboratory animals that primarily secrete corticosterone, not cortisol, as their principal anti-inflammatory adrenal hormone; (2) some differences in the binding of xenobiotic cortisol analogues (vis á vis cortisol) to transport proteins, detoxifying enzymes and even some intra-cellular receptors; (3) the "rogue" properties of these hormonal xenobiotics, acting independently of--but still able to suppress--hormonal mechanisms regulating endogenous cortisol; and (4) problems of intrinsic/acquired "steroid resistance", diminishing their clinical efficacy, but not necessarily all their toxicities. The rather gloomy conclusion is that devising new drugs to reproduce the effect of multi-potent hormones may be a recipe for disaster, in contexts other than simply remedying an endocrine deficiency. Promising new developments include "designed" combination therapies that allow some reduction in total steroid doses (and hopefully their side effects); sharpening strategies to limit the actual duration of steroid administration; and resurgent interest in searching for more selective analogues (both steroidal and non-steroid) with less harmful side effects. Some oversights and neglected areas of research are also considered. Overall, it now seems timely to engage in some drastic rethinking about (retaining?) these "licensed toxins" as fundamental therapies for chronic inflammation.

Beyond conventional DMARDs: extending TNF-regulant therapies to the vast majority/less privileged who do need them

This article is a plea to find (better) ways to extend the benefits of anti-cytokine therapies to ensure they will become available as widely as possible. Pessimistically, this will probably involve substituting more affordable, although somewhat less specific, non-biological agents for present target-specific bio-DMARDs (disease-modifying antirheumatic drugs) to ensure far wider distribution of benefits. Optimistically, new developments in technology and bio-engineering might dramatically reduce costs of present 'biological' therapies. (The antibiotics we now take for granted were once also horrendously expensive.). Pragmatically, one goal for this mission should include seriously pursuing more research and pilot clinical trials of non-protein combination therapies able to control: (i) TNF or other pro-inflammatory cytokines; and also (ii) other mediators sustaining chronic inflammation (-->pain, effusion, fibrosis, porosis, etc.). This can be immediately facilitated by drawing upon the immense resources of non-prescription Asia-Pacific traditional therapies--particularly when these have already been shown to either reduce TNF synthesis or control TNF-induced responses in preclinical studies. Could this be a major goal for the next decade, helping rectify some of the omissions of the current Bone & Joint Decade 2000-2010?

Comparison of the antioxidant properties of emu oil with other avian oils

The antioxidant properties of emu oil were compared with oils derived from the fat of other avian species. We first examined their free radical scavenging activity against the 2,2-diphenyl-1-picryl hydracyl radical. The concentration of emu oil in the test solution that caused 50% neutralisation (IC50) was variable (24.5 ± 5.9 mg/mL, range 5.3–55.4 mg/mL), but similar to values obtained for other ratites (10.7 ± 5.9 mg/mL). In contrast, the IC50 values for duck and chicken oil were much higher (118.0 ± 8.1 mg/mL). The variability in the radical scavenging activity of emu oil preparations may reflect variations in the diets of the birds, the processing protocol and/or the storage age of the oil. We also evaluated some of the ratite oils for their inhibitory capacity on human erythrocyte membrane oxidation, by measuring the reduction of the thiobarbituric acid-reactive substance (TBAR) production. Emu oil had a greater effect in decreasing TBAR production than either the ostrich or rhea oil, suggesting that it offers more protection than the other ratite oils against oxidative damage. In conclusion, we demonstrated that emu oil has both antioxidant properties in vitro and a protective role against oxidative damage in a model biological membrane system. The antioxidant or radical scavenging properties of emu oil appear to be due to minor constituents in the non-triglyceride fraction of the oil, while its high ratio of unsaturated to saturated fatty acids (UFA : SFA) offers protection against oxidative damage.

Systematic review of a marine nutriceutical supplement in clinical trials for arthritis: the effectiveness of the New Zealand green-lipped mussel Perna canaliculus

BACKGROUND

Nutritional supplements, such as Seatone, which contain freeze-dried tissue from the New Zealand green-lipped mussel Perna canaliculus, are sold in many countries to relieve arthritic symptoms and to aid in the regeneration of arthritic and injured joints.

METHODS

Searches for all published controlled trials on the clinical effectiveness of green-lipped mussel, as a nutritional supplement with potential health benefits for arthritis, were carried out from four independent databases. No language restrictions were imposed, and the review was undertaken from extracted data and was assessed critically according to predefined criteria by the authors.

RESULTS

Reports of clinical studies, using freeze-dried mussel powder, show mixed outcome measures and are not conclusive, with only two of five randomized controlled trials attesting benefits for rheumatoid and osteoarthritis patients. Similarly, animal studies have likewise yielded mixed findings. In both these cases possibly due to the lack of stabilization of the omega-3 polyunsaturated fatty acids, now known to be the basis of anti-inflammatory activity.

CONCLUSION

There is little consistent and compelling evidence, to date, in the therapeutic use of freeze-dried green-lipped mussel powder products for rheumatoid or osteoarthritis treatment, particularly in comparison to other cheaper alternative nutriceutical supplements of proven efficacy. However, further investigations are necessary to determine whether green-lipped mussel supplements, such as Seatone, are therapeutic options in the management of arthritis.