Targeting angiogenic and proliferative mediators by montelukast & trimetazidine Ameliorates thioacetamide-induced liver fibrosis in rats

Liver fibrosis is a significant health complication with the potential to result in serious mortality and morbidity. However, there is no standard treatment due to its complex pathogenesis. The drug montelukast reversibly and selectively antagonizes the cysteinyl-leukotrienes-1 receptor and reduces inflammation; thus, it is used in the treatment of asthma. Trimetazidine, an anti-anginal agent, selectively inhibits the activity of mitochondrial long-chain 3-ketoacyl-CoA thiolase, inhibition of free fatty acid (FFA) oxidation. This study explores the efficacy of montelukast (5 and 10 mg/kg) and trimetazidine (10-20 mg/kg) against liver fibrosis induced by thioacetamide (TAA) in rats. Impaired liver function tests were significantly improved by montelukast and trimetazidine. The antioxidant and anti-inflammatory effects of montelukast and trimetazidine were proved by the inhibition of malondialdehyde (MDA) and nitric oxide (NO) accumulation, with elevation of glutathione (GSH) and superoxide dismutase activity, decreased heat shock protein (HSP-70) expression, and a decline in interleukin-6 (IL-6) and tumor necrosis factor (TNF-α) levels in liver tissue. Also, the antifibrotic effects were explored by reducing levels of hydroxyproline and alpha-smooth muscle actin (α-SMA) expression in liver tissue and attenuating hepatic expression of hepatic expression of angiogenic mediator vascular endothelium growth factor (VEGF) and proliferative mediator Antigen Kiel 67 (Ki-67).

MOntelukast as a potential CHondroprotective treatment following Anterior cruciate ligament reconstruction (MOCHA Trial): study protocol for a double-blind, randomized, placebo-controlled clinical trial

BACKGROUND

After anterior cruciate ligament (ACL) reconstruction, patient-reported outcomes are improved 10 years post-surgery; however, cytokine concentrations remain elevated years after surgery with over 80% of those with combined ACL and meniscus injuries having posttraumatic osteoarthritis (PTOA) within 10-15 years. The purpose of this multicenter, randomized, placebo-controlled trial is to assess whether a 6-month course of oral montelukast after ACL reconstruction reduces systemic markers of inflammation and biochemical and imaging biomarkers of cartilage degradation.

METHODS

We will enroll 30 individuals undergoing primary ACL reconstruction to participate in this IRB-approved multicenter clinical trial. This trial will target those at greatest risk of a more rapid PTOA onset (age range 25-50 with concomitant meniscus injury). Patients will be randomly assigned to a group instructed to take 10 mg of montelukast daily for 6 months following ACL reconstruction or placebo. Patients will be assessed prior to surgery and 1, 6, and 12 months following surgery. To determine if montelukast alters systemic inflammation following surgery, we will compare systemic concentrations of prostaglandin E2, monocyte chemoattractant protein-1, and pro-inflammatory cytokines between groups. We will also compare degradative changes on magnetic resonance imaging (MRI) collected 1 and 12 months following surgery between groups with reductions in early biomarkers of cartilage degradation assessed with urinary biomarkers of type II collagen breakdown and bony remodeling.

DISCUSSION

There is a complex interplay between the pro-inflammatory intra-articular environment, underlying bone remodeling, and progressive cartilage degradation. PTOA affects multiple tissues and appears to be more similar to rheumatoid arthritis than osteoarthritis with respect to inflammation. There is currently no treatment to delay or prevent PTOA after ACL injury. Since there is a larger and more persistent inflammatory response after ACL reconstruction than the initial insult of injury, treatment may need to be initiated after surgery, sustained over a period of time, and target multiple mechanisms in order to successfully alter the disease process. This study will assess whether a 6-month postoperative course of oral montelukast affects multiple PTOA mechanisms. Because montelukast administration can be safely sustained for long durations and offers a low-cost treatment option, should it be proven effective in the current trial, these results can be immediately incorporated into clinical practice.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04572256 . Registered on October 1, 2020.

Colonic anastomosis can be protected from ischemia reperfusion injury with intra-peritoneal Montelukast treatment

BACKGROUND

Ischemia reperfusion injury is unavoidable in the setting of transplantation and may lead to primary dysfunction of the transplanted organ. Similarly, intestinal ischemia reperfusion injury may have deleterious effects causing intestinal failure. Montelukast is a selective reversible cysteinyl-leukotriene type 1 receptor antagonist used in clinical practice for its anti-inflammatory effects. In this study, we investigated the effects of Montelukast on colon anastomosis performed after intestinal ischemia reperfusion injury.

METHODS

40 adult male Wistar Albino rats were used. All rats underwent intestinal ischemia reperfusion injury. Afterwards, the entire group was divided into two for either right or left colonic resection and anastomosis. Rats in the control groups were given intra-peritoneal normal saline for 1 week while the animals in the treatment groups were given intra-peritoneal Montelukast (10 mg/kg; 1 ml). All animals were subjected to ischemia reperfusion injury followed by either right or left colonic segmental resection and anastomosis in the first day of the experiment. On postoperative day 7 adhesion scoring, anastomotic bursting pressure, anastomotic tissue hydroxyproline content were assessed for all groups.

RESULTS

Significant differences were detected in adhesion scores between the treatment and control groups regardless of the colonic resection site. Anastomotic bursting pressures and hydroxyproline content of the anastomotic sites were significantly higher in the treatment groups when compared with the control groups. Anastomotic tissues treated with Montelukast showed more prominent vascularization in histopathological examinations.

CONCLUSION

Montelukast has a potential to attenuate the detrimental effects of ischemia reperfusion injury on intestinal anastomosis.

Beneficial effects montelukast, cysteinyl-leukotriene receptor antagonist, on renal damage after unilateral ureteral obstruction in rats

Introductıon

Ureteral obstruction is a common pathology and caused kidney fibrosis and dysfunction at late period. In this present, we investigated the antifibrotic and antiinflammatory effects of montelukast which is cysteinyl leukotriene receptor antagonist, on kidney damage after unilateral ureteral obstruction(UUO) in rats.

Mateirıals and Methods

32 rats divided four groups. Group 1 was control, group 2 was sham, group 3 was rats with UUO and group 4 was rats with UUO which were given montelukast sodium (oral 10 mg/kg/day). After 14 days, rats were killed and their kidneys were taken and blood analysis was performed. Tubular necrosis, mononuclear cell infiltration and interstitial fibrosis scoring were determined histopathologically in a part of kidneys; nitric oxide(NO), malondialdehyde(MDA) and reduced glutathione(GSH) levels were determined in the other part of kidneys. Urea-creatinine levels were investigated at blood analysis. Statistical analyses were made by the Chi-square test and one-way analysis of variance (ANOVA).

Results

There was no difference significantly for urea-creatinine levels between groups. Pathologically, there was serious tubular necrosis and fibrosis in group 3 and there was significantly decreasing for tubular necrosis and fibrosis in group 4(p<0.005). Also, there was significantly increasing for NO and MDA levels; decreasing for GSH levels in group 3 compared the other groups(p<0.005).

Conclusıon

We can say that montelukast prevent kidney damage with antioxidant effect, independently of NO.

Effect of Ozone Therapy (OT) on Healing of Colonic Anastomosis in a Rat Model of Peritonitis

BACKGROUND

Ozone is a three-oxygen molecule (O3). Ozone therapy (OT) is systematically effective when pathological inflammatory and immunologic processes are activated. Among of these conditions are wound healing, macular degeneration related to aging, and conditions that are ischemic or infectious.

AIMS

The aim of this study was to determine the effects of OT on wound healing of intestinal anastomosis in the presence of peritonitis in a rat model.

STUDY DESIGN

Animal experimentation.

METHODS

A total of 40 Wistar albino rats were randomized into four groups (n=10) including: sham (S), peritonitis (P), ozone 0 (O0), and ozone 24 (O24). In group S, only cecal dissection was carried out. The S group had only a cecal dissection and intestinal anastomosis performed, but no peritonitis. In all other groups, cecal ligation and puncture (CLP) followed the cecal dissection to induce bacterial peritonitis. 24 h after puncture, a cecal resection and ileocolic anastomosis were performed. In group P, 24 h after CLP, a cecal resection and ileocolic anastomosis were performed and no ozone was administered. In group O0, immediately after the anastomosis, and in group O24, starting 24 hours after the anastomosis, an intraperitoneal 1 mg/kg/day ozone administration was applied for seven days. On the seventh day the animals were sacrificed, the anastomotic bursting pressures (BP) and the hydroxyproline values of the anastomotic tissues were measured, and histopathologic examination of the anastomotic segment was carried out.

RESULTS

The highest BP was in group S, with 211±23.13 mmHg. The mean BP of group P was 141±56.25 mmHg, which was significantly lower than in the other two peritonitis groups that received ozone therapy, group O0 and O24, where it was 192±22 and 166±45 mmHg, respectively (p<0.05). The difference in the BP between groups O0 and O24 was not statistically significant (p>0.05). Histopathologic analyses of the anastomotic segments determined there was significantly more oedema and necrosis in the control group rats, and collagen deposition in the anastomotic tissue was significantly higher in the ozone-treated groups on postoperative day 7. Hydroxyproline levels were significantly higher in groups O0 and O24 compared to the peritonitis group (P).

CONCLUSION

Ozone therapy has a beneficial effect on anastomotic healing of the colon in the presence of peritonitis.

Anti-inflammatory Montelukast prevents toxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin: Oxidative stress, histological alterations in liver, and serum cytokine levels

This study aimed to investigate the potential beneficial effects of the montelukast (ML) on oxidative stress and histological alterations in liver tissues and cytokine levels in rats intoxicated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Rats were divided randomly into four equal groups (control, TCDD, ML, TCDD + ML). TCDD were administered by gavages dissolved in corn oil at the doses of 2 µg/kg/week, and ML was given intraperitoneally at the dose of 10 mg/kg/day. Oxidative status, histological alterations, and cytokine levels were analyzed on day 60. The results showed that although TCDD induced oxidative stress via significant increase in formation of thiobarbituric acid reactive substance, it caused a significant decline in glutathione (GSH), catalase (CAT), and superoxide dismutase (SOD) levels in liver. Besides, TCDD led to significant histopathological damage in liver and serum cytokine levels alterations (increase in tumor necrosis factor α and interleukin 1β levels). In contrast, ML treatment reversed oxidative effects of TCDD by increasing the levels of GSH, CAT, and SOD and decreasing the formation of TBARS. Also, it can normalize the levels of histological and cytokine alterations induced by TCDD. In conclusion, it was determined that TCDD exposure caused adverse effects on cytokine levels, histological alterations, and oxidative stress in rats. However, ML treatment partially eliminated toxic effects of TCDD. Thus, it was judged that coadministration of ML with TCDD may be useful to attenuate the negative effects of TCDD.

Effects of montelukast on the healing of ischemic colon anastomoses

BACKGROUND

The aim of this study was to examine whether treatment with montelukast, a selective leukotriene antagonist, would affect anastomotic healing in a reperfused colon rat model with remote ischemia/reperfusion injury.

METHODS

Rats (n = 12 per group) were intraperitoneally administered normal saline or 10 mg/kg montelukast sodium 60 minutes before and for 5 days after surgery. Ischemia was induced for 45 minutes through superior mesenteric artery occlusion. A left colon anastomosis was made. Blood and perianastomotic tissue samples were obtained on postoperative day 5.

RESULTS

Mean anastomotic bursting pressures of the control and montelukast groups were 159.17 ± 29.99 and 216.67 ± 26.40, respectively (P < .001). Compared with saline, montelukast treatment increased the mean tissue hydroxyproline level (2.46 ± .30 vs 3.61 ± .33 μmol/L) and decreased tissue caspase-3 activity (36.06 ± 5.72 vs 21.78 ± 3.87) and malondialdehyde levels (3.43 ± .34 vs 2.29 ± .34 nmol/g) (P < .001 for all). Other plasma markers of injury also showed differences.

CONCLUSIONS

Montelukast prevented ischemia/reperfusion-induced damage in a rat model of colonic anastomotic wound healing.

Time course pathogenesis of sulphur mustard-induced skin lesions in mouse model

Sulphur mustard (SM) is a bifunctional alkylating agent that causes cutaneous blistering in humans and animals. In this study, we have presented closer views on pathogenesis of SM-induced skin injury in a mouse model. SM diluted in acetone was applied once dermally at a dose of 5 or 10 mg/kg to Swiss albino mice. Skin was dissected out at 0, 1, 3, 6, 12, 24, 48, 72 and 168 hours, post-SM exposure for studying histopathological changes and immunohistochemistry of inflammatory-reparative biomarkers, namely, transforming growth factor alpha (TGF-α), fibroblast growth factor (FGF), endothelial nitric oxide synthase (eNOS) and interlukin 6 (IL-6). Histopathological changes were similar to other mammalian species and basal cell damage resembled the histopathological signs observed with vesication in human skin. Inflammatory cell recruitment at the site of injury was supported by differential expressions of IL-6 at various stages. Time-dependent expressions of eNOS played pivotal roles in all the events of wound healing of SM-induced skin lesions. TGF-α and FGF were strongly associated with keratinocyte migration, re-epithelialisation, angiogenesis, fibroblast proliferation and cell differentiation. Furthermore, quantification of the tissue leukocytosis and DNA damage along with semiquantitative estimation of re-epithelialisation, fibroplasia and neovascularisation on histomorphologic scale could be efficiently used for screening the efficacy of orphan drugs against SM-induced skin injury.

Beneficial effects of montelukast against methotrexate-induced liver toxicity: a biochemical and histological study

The effects of montelukast against methotrexate-induced liver damage were investigated. 35 Wistar albino female rats were divided into 5 groups as follows: group I: control; group II: montelukast (ML); group III: methotrexate (Mtx); group IV: montelukast treatment after methotrexate application (Mtx + ML); group V: montelukast treatment before methotrexate application (ML + Mtx). At the end of the experiment, the liver tissues of rats were removed. Malondialdehyde (MDA), myeloperoxidase (MPO), and reduced glutathione levels were determined from liver tissues. In addition, the liver tissues were examined histologically. MDA and MPO levels of Mtx group were significantly increased when compared to control group. In Mtx + ML group, these parameters were decreased as compared to Mtx group. Mtx injection exhibited major histological alterations such as eosinophilic staining and swelling of hepatocytes. The glycogen storage in hepatocytes was observed as decreased by periodic acid schiff staining in Mtx group as compared to controls. ML treatment did not completely ameliorate the lesions and milder degenerative alterations as loss of the glycogen content was still present. It was showed that montelukast treatment after methotrexate application could reduce methotrexate-induced experimental liver damage.

Beneficial effects of montelukast against cisplatin-induced acute renal damage in rats

OBJECTIVE

In this study, the therapeutic and protective effects of montelukast against cisplatin (CP)-induced acute renal damage were investigated.

MATERIALS AND METHODS

Thirty-five female rats were divided into five groups as follows: (1) control, (2) montelukast (10 mg/kg daily for 10 days per-oral (p.o.), (3) CP (single dose 7 mg/kg intraperitoneally (i.p.)), (4) CP + montelukast (10 mg/kg daily for 10 days p.o., after 3 days of the injection of CP), (5) montelukast (10 mg/kg daily for 10 days p.o.) + CP (single dose 7 mg/kg i.p., after the last dose of montelukast). At the end of the experiment, malondialdehyde (MDA), a lipid peroxidation product, myeloperoxidase (MPO), and reduced glutathione (GSH) levels were determined in the renal tissue. Also, blood urea nitrogen (BUN) and creatinine (Cr) levels were assayed from the trunk blood samples.

RESULTS

CP treatment caused a significant elevation of MDA, MPO, BUN, and Cr levels when compared with the control group. Also, GSH levels were found to be reduced due to the CP treatment. Montelukast administration after CP injection ameliorated all of these parameters. Our histopathological findings (marked swelling of epithelial cells, tubular dilatation, tubular desquamation, and loss of brush border in the kidney) were consistent with the biochemical results.

CONCLUSION

Montelukast treatment after CP injection exerted therapeutic effects against CP-induced acute kidney damage.