Tixocortol pivalate and beclomethasone dipropionate in seasonal allergic rhinitis: a double-blind study

Direct inhibition of cyclooxygenase pathway in platelets by tixocortol 21-pivalate: comparison with related structures, steroidal and non steroidal anti-inflammatory drugs

Direct activity of the local anti-inflammatory steroid, tixocortol 21-pivalate (21 thioester derivative of cortisol) on metabolism of exogenous arachidonate by rabbit platelets was investigated in vitro. Tixocortol 21-pivalate inhibited generation of prostanoids from cyclooxygenase with an IC50 value of 19.6 microM without affecting the 12-lipoxygenase pathway. In this model, reference anti-inflammatory glucosteroids were ineffective, whereas indomethacin and aspirin inhibited the cyclooxygenase activity. Among tixocortol 21-pivalate related structures, tixocortol and its disulfide dimere or several other tixocortol esters exhibited a quite similar efficacy while S-methylation and subsequent S-oxydations of tixocortol abolished inhibitory activity. These results indicate that tixocortol 21-pivalate in contrast to other glucosteroids is able to act directly on cyclooxygenase pathway and that some specific chemical environment of the 21 thiol side chain are required for this inhibition.

Local anti-inflammatory activities of tixocortol 21-pivalate, inhibition of prostaglandins and leukotrienes synthesis, in carrageenin-induced pleurisy. Reversion of effects by RU 486

Since a direct effect of tixocortol pivalate (TP) has been described on cyclooxygenase pathway, local anti-inflammatory activities of some 21 thiol derivatives of steroids were investigated on the carrageenin-induced pleurisy model in comparison with dexamethasone (Dex) or other anti-inflammatory drugs. LTC4/D4 contents in pleural fluid were assayed by RIA as well as PGE2 levels to characterize the effects on arachidonate pathways. After oral administration, TP was inactive up to 1 g/kg on exudate volume and leukocyte migration as expected for this strict local anti-inflammatory steroid contrary to Dex (ID50 = 0.05-0.41 mg/kg). When administered locally, TP and tixocortol (T) exerted a dose dependent inhibitory activity on exudate volume (ID30 = 12.4 micrograms or 13.1 micrograms/pleural cavity) and leukocyte count (ID30 = 83 or 230 micrograms); in the same conditions. Dex was more active (ID30 = 0.7 and 2.6 micrograms). All these steroids decreased PGE2 and LTC4/D4 contents in exudate fluids, respectively TP (50 micrograms/pleural cavity) by 28 and 63%; T (100 micrograms) by 33 and 31%; Dex (5 micrograms) by 43 and 40%. Local co-administration of RU 486 (50 micrograms) with either TP, T or Dex reversed the anti-inflammatory effects of all steroids, indicating in these conditions a local activity through glucosteroid receptor occupancy.