Fresh raspberry phytochemical extract inhibits hepatic lesion in a Wistar rat model

Cancer chemopreventive potential of cooked glutinous purple rice on the early stages of hepatocarcinogenesis in rats

Cancer prevention using dietary phytochemicals holds great potential, particularly in the alternative treatment of liver cancer. Our previous study found that the methanol extract of cooked purple rice performed various biological functions including antioxidant, anti-inflammatory, and antimutagenic activities in in vitro assays. This study aimed to evaluate the chemopreventive effects of cooked glutinous purple rice extract (CRE) obtained from routine rice cooking method on diethylnitrosamine (DEN)-induced hepatic preneoplastic lesions in rats, along with its inhibitory mechanisms. CRE containing γ-oryzanols and high amounts of polyphenolic compounds, particularly cyanidin-3-glucoside, was fed to rats over a period 15 weeks. Additionally, injections of triple DEN at a concentration of 100 mg/kg BW were administered to rats once a week during the second, third, and fourth weeks of the experiment. The results revealed that CRE did not induce the formation of glutathione S-transferase placental form (GST-P) positive foci as a precancerous lesion during rat hepatocarcinogenesis, indicating non-carcinogenicity. Furthermore, CRE significantly reduced the number and size of GST-P positive foci in DEN-initiated rats. It also modulated microenvironment homeostasis by reducing the number of PCNA positive hepatocytes and by enhancing the number of apoptotic positive hepatocytes in the livers of DEN-initiated rats. Using RT-PCR analysis, CRE decreased the mRNA expression of some proinflammatory mediators, including interleukin-6, interleukin-1 beta, inducible nitric oxide synthase and cyclooxygenase 2, by attenuating the expression of cyclin E, the proliferation marker, while also inducing the expression of the apoptotic gene, Bcl2 associated X. The inhibitory mechanism at the early stages of hepatocarcinogenesis of CRE may be involved with the attenuation of cell proliferation, the enhancement of apoptosis, and the modulation of the proinflammatory system. Anthocyanins, flavonoids, and γ-oryzanol represent a group of promising chemopreventive agents in cooked glutinous purple rice extract. The outcomes of this study can provide an improved understanding of the potential role of the phytochemicals contained in cooked purple glutinous rice with regard to cancer alleviation.

The Effective Analysis for Blue Honeysuckle Extract in the Treatment of Hepatocellular Carcinoma

To further determine how BHE affected the growth of HCC cells, the proportion of each cell cycle phase was explored in HCC cells by flow cytometry. Blue honeysuckle (Lonicera caerulea L.) is a species of bush that grows in eastern Russia. Blue honeysuckle extract (BHE) is rich in bioactive phytochemicals which can inhibit the proliferation of tumor cells. The mechanism underlying the anticancer activity of BHE in primary liver cancer is poorly understood. The purpose of this study was to evaluate the growth inhibition mechanism of bioactive substances from blue honeysuckle on hepatocellular carcinoma (HCC) cells and to explore its protein and gene targets. The compounds in BHE were determined by high-performance liquid chromatography (HPLC) and liquid chromatography-mass spectrometry (LC-MS). Cell counting kit-8 (CCK8) assay was used to evaluate the effects of BHE on HCC cell proliferation, and flow cytometry assay (FCA) was used to determine how BHE arrested the proportion of each cell cycle phase in HCC cells. Western blot (WB) was performed to determine the expression of cell cycle-related proteins in HCC cells treated with different concentrations of BHE. The xenograft tumor animal models were established by HCC cell implantation. The results showed that cyanidin-3-o-glucoside and cyanidin-3-o-sophoroside which are the main biologically active components were detected in BHE. BHE is highly effective in inhibiting the proliferation of HCC cells by arresting the HCC cell cycle in the G2/M phase. BHE also downregulated the expression of conventional or classical dendritic cells-2 (cDC2) and cyclin B1 by promoting the expression of myelin transcription factor 1 (MyT1) in HCC cells. The weight and volume of xenografts were significantly decreased in the BHE treated groups when compared to the control group. BHE increased the expression of MyT1 in xenograft tissues. These findings showed that blue honeysuckle extract inhibits proliferation in vivo and in vitro by downregulating the expression of cDC2 and cyclin B1 and upregulating the expression of MyT1 in HCC cells.

Chemopreventive effects of Costus comosus Linn against diethylnitrosamine-induced hepatocellular carcinoma in rats

Introduction: Costus comosus is a potential medicinal plant used traditionally to treat various ailments. The present study aimed to evaluate antioxidant status, lipid peroxidation, and the ameliorative effect of its ethanolic leaf extract against diethylnitrosamine (DEN)-induced hepatocellular carcinoma (HCC) in rats. Methods: HCC was induced by 0.01 % v/v DEN through the drinking water for 16 weeks. The animals were treated with ethanolic leaf extract of C. comosus (EECC) at 200 and 400 mg/kg for 16 weeks. In this study, tumour incidence, tumour volume, tumour burden, lipid peroxidation, antioxidant activity, liver marker enzymes, and histological responses were measured in the animals. At the end of the study, rats were sacrificed, their livers were removed and the levels of antioxidant enzymes were measured in the liver homogenate. Results: In DEN-treated animals, there were 100% tumour occurrences probably due to an imbalance in carcinogen metabolizing enzymes and cellular redox state. The oral administration of ethanolic leaf extract of C. comosus therapy at a dose of 200 and 400 mg/kg reduced lipid peroxide levels and restored the increased activities of liver marker enzymes and antioxidant status to near normal. The biochemical findings corroborate histological findings, indicating that the leaf extract has a significant hepatoprotective impact in a dose-dependent manner. Conclusion: The results of the present study showed the promising anti-carcinogenic effects of ethanolic leaf extract of C. comosus against the DEN-induced HCC in rats.

Ameliorative potential of manganese nanoparticles with low-level ionizing radiation against experimentally induced hepatocarcinogenesis

Nanotechnology is a rich field with infinite possibilities of drug designs for cancer treatment. We aimed to biosynthesize manganese nanoparticles (Mn NPs) using Lactobacillus helveticus to investigate its anticancer synergistic effect with low-dose gamma radiation on HCC-induced rats. Diethylnitrosamine (DEN) (20 mg/kg BW, 5 times a week for 6 weeks) induced HCC in rats. Rats received Mn NPs (5 mg/kg BW/day) by gastric gavage over 4 weeks concomitant with single dose of gamma radiation (γ-R) (0.25 Gy). Characterization, cytotoxicity, and anticancer activity of Mn NPs were evaluated. DEN-induced significant liver dysfunction (alanine transaminase activity ALT, total proteins, and albumin levels) associated with significant increase in lipid peroxidation levels with reduction in super oxide dismutase activity. Furthermore, DEN intoxication is sponsored for remarkable increase in levels of Alfa-fetoprotein, tumor necrosis factor α, vascular endothelial growth factor, and transforming growth factor beta with remarkable decrease in caspase 3 and cytochrome c. Treatment with Mn NPs (4.98-11.58 nm) and single dose gamma radiation evoked significant repair in ALT, total protein, and albumin accompanied with balanced oxidative status, diminished inflammatory biomarkers, angiogenic factor, and growth factor with restoration in apoptotic factors. Mn NPs revealed obvious in vitro cytotoxic activity against HepG2 cell line in a dose-dependent manner. Our findings were well appreciated with the histopathological study. In conclusion, a new approach of the single or combined use of Mn NPs with low-dose γ-radiation regimens as promising paradigm for HCC treatment is recommended.

The comparison of biochemical composition of Actinidia kolomikta and Actinidia polygama fruits

The demand for natural products, which are rich in biologically active compositions, grows constantly. The choice and production of such products can minimize the deficit of importance for human organism components, which are contained only in plant food. The paper contains the laboratory studying results of the chemical composition of the fruits of two Actinidia Lindl. cultivars of Federal State Budgetary Scientific Institution Federal Horticultural Research Center for Breeding, Agrotechnology, and Nursery (FSBSI FSC for Horticulture) genetic collection: Actinidia kolomikta (Rupr. et Maxim.) Maxim. and Actinidia polygama (Siebold et Zucc.) Maxim. All the presented samples are grown in field conditions. The fruits were picked up in the phase of harvest maturity while ripening. The data on antioxidant activity of water and methanol extracts, the content of phenolic compounds sum, soluble solids, and titratable acids in the fruits, and on qualitative composition of secondary metabolites (organic acids, fatty acids, mono-, di- and polysaccharides) are given in the paper. The variation limits of the parameters under study depending on the sample are presented. As a result of the laboratory studies, it was stated that A. kolomikta fruits 10 times exceed A. polygama fruits on all the stated parameters. Only the results on the soluble solids content in the fruits of both cultivars are approximately at the same level (A. kolomikta > A. polygama on 1.16%). The positive correlation between antioxidant activity and the general content of polyphenols is confirmed at both cultivars. Actinidia kolomikta genotypes Chempion and Lakomka and Actinidia polygama ones Tselebnaya and Uzorchataya showed the best results. The correct individual choice of actinidia fruits that are the best ones at the biochemical composition and the content of micronutrients allows supplying the consumers with food products.

Suppression of isoproterenol-induced cardiotoxicity in rats by raspberry ketone via activation of peroxisome proliferator activated receptor-α

The peroxisome proliferator-activated receptor-α (PPAR-α) controls the lipid and glucose metabolism and also affects inflammation, cell proliferation and apoptosis during cardiovascular disease. Raspberry ketone (RK) is a red raspberry (Rubusidaeus, Family-Rosaceae) plant constituent, which activates PPAR-α. This study was conducted to assess the cardioprotective action of RK against isoproterenol (ISO)-induced cardiotoxicity. Wistar rats were randomly divided into six groups (six rats/group). Rats were orally administered with RK (50, 100 and 200 mg/kg, respectively) and fenofibrate (standard, 80 mg/kg) for 28 days and ISO was administered (85 mg/kg, subcutaneously) on 27th and 28th day. Administration of ISO in rats significantly altered hemodynamic and electrocardiogram patterns, total antioxidant capacity, PPAR-α, and apolipoprotein C-III levels. These myocardial aberrations were further confirmed during infarct size, heart weight to body weight ratio and immunohistochemical assessments (caspase-3 and nuclear factor-κB). RK pretreatment (100 and 200 mg/kg) significantly protected rats against oxidative stress, inflammation, and dyslipidemia caused by ISO as demonstrated by change in hemodynamic, biochemical and histological parameters. The results so obtained were quite comparable with fenofibrate. Moreover, RK was found to have binding affinity with PPAR-α, as confirmed by docking analysis. PPAR-α expression and concentration was also found increased in presence of RK which gave impression that RK probably showed cardioprotection via PPAR-α activation, however direct binding study of RK with PPAR-α is needed to confirm this assumption.

Attenuation of diethylnitrosamine (DEN) - Induced hepatic cancer in experimental model of Wistar rats by Carissa carandas embedded silver nanoparticles

OBJECTIVE

Hepatic cancer is well known, and leading cancer around the world and remain asymptomatic diseases. Carissa carandas possess anti-proliferative, antioxidant, hepatoprotective property and used in hepatic cancer. The current study deals to evaluate the chemoprotective and therapeutic property of Carissa carandas embedded silver nanoparticles (CCAgNPs) against diethylnitrosamine (DEN) -induced hepatic cancer.

MATERIAL AND METHOD

Wistar rats were divided into six groups and hepatic cancer was induced with diethylnitrosamine at the dose of 200 mg/kg BW. The animals were gastrogavaged with standard drug and CCAgNPs for 16 weeks. Serum biomarkers, haematological profile, antioxidants enzymes, inflammatory markers and membrane bound enzymes were assessed to find the anti-proliferative potential of silver nanoparticles. Histological evaluation and microscopic characterizations were also performed to authenticate the outcomes of the present work.

RESULTS

Biosynthesized CCAgNPs significantly down-regulated the serum marker enzymes of hepatic and non-hepatic parameter, elevated the levels of enzymatic and non-enzymatic antioxidant profile, elevation in membrane bound enzymes and diminish the levels of inflammatory markers (IL-6, TNF-α, and IL-1β) via NF-κB pathway. Histopathological features also showed recovery of a hepatic architecture in cancer-induced rats in a dose-dependent manner.

CONCLUSION

Our consequences established that such plant mediated silver nanoparticles shown a defensive impact against DEN-induced hepatocarcinogenesis, and serves as a better option to ameliorate the clinical results against hepatocellular carcinoma.

Fresh red raspberry phytochemicals suppress the growth of hepatocellular carcinoma cells by PTEN/AKT pathway

The red raspberry (Rubus idaeus L.) is a common fruit worldwide and its extract has been found to inhibit the growth of many types of tumors, mainly because it is rich in bioactive phytochemicals. However, the mechanism underlying its anticancer activity in hepatocellular carcinoma (HCC) is not well understood. Herein, the aim of this study was to determine the effects of red raspberry phytochemicals on the proliferation of hepatocellular carcinoma cells and to elucidate its biochemical and molecular targets. CCK8 and colony formation, as well as flow cytometry assays, were employed to determine the effects of red raspberry extract (RRE) on cell proliferation and cell cycle distribution in HCC cells. Our results showed that RRE significantly inhibited cell proliferation and arrested cell cycle progression at the S phase in HCC cells. RRE increased the expression of phosphatase and tensin homologue deleted on chromosome 10 (PTEN) by reducing the methylation status of the PTEN gene promoter and inhibiting DNMT1 expression and regulated AKT signaling pathway. These findings show that red raspberry phytochemicals inhibit the proliferation of HCC cells by regulating PTEN/AKT signaling pathway, providing evidence that RRE may be used as a potential auxiliary therapy for patients with HCC.

Implication of nano-antioxidant therapy for treatment of hepatocellular carcinoma using PLGA nanoparticles of rutin

Aim: The present work describes the development of poly(lactic co-glycolic acid) (PLGA) nanoparticles (NPs) of rutin (RT) for the treatment of hepatocellular carcinoma in rats. Materials & methods: RT-loaded PLGA NPs (RT-PLGA-NPs) were prepared by double emulsion evaporation method. Further these are optimized by Box–Behnken design. PLGA NPs were evaluated for size, polydispersity index, drug-loading capacity, entrapment, gastric stability, in vitro drug release, in vivo preclinical studies and biochemical studies. Results: Preclinical evaluation of RT-PLGA-NPs for anticancer activity through oral route exhibited significant improvement in hepatic, hematologic and renal biochemical parameters. Highly superior activity was observed in regulating oxidative stress and inflammatory markers, antioxidant enzymes, cytokines and inflammatory mediators and their role on plasma membrane ATPases responsible for destruction in liver tissues. Conclusion: Histopathological evaluation indicated reduced incidence of hepatic nodules, necrosis formation, infiltration of inflammatory cells, blood vessel inflammation and cell swelling with RT-PLGA-NP treatment along with considerable downregulation in the levels of proinflammatory cytokines.

Raspberry ketone protects against isoproterenol-induced myocardial infarction in rats

AIM

The cardioprotective role of raspberry ketone (RK) against isoproterenol (ISO)-induced myocardial infarction (MI) in rats was assessed.

MATERIALS AND METHODS

Rats were randomly divided into Group I - Vehicle control; Group II - Toxic control ISO (85mg/kg, s.c.); Group III, IV and V - RK (50, 100 and 200mg/kg, respectively) with ISO; Group VI- RK (200mg/kg) alone; Group VII - Propranolol (10mg/kg) with ISO; and Group VIII - Propranolol (10mg/kg) alone. After twenty-four hours of the last dose, animals were sacrificed and creatine kinase-MB, lactate dehydrogenase, total cholesterol, triglycerides, high-density-lipoprotein, low-density-lipoprotein, very-low-density-lipoprotein, malondialdehyde, reduced glutathione, superoxide dismutase, catalase, Na⁺, K⁺-ATPase, nitric oxide, histopathological and immunohistochemical analysis (tumor necrosis factor-α and inducible nitric oxide synthase) were performed.

KEY FINDINGS

Treatment with ISO significantly deviated the biochemical parameters from the normal levels, which were considerably restored by RK at 100 and 200mg/kg doses. 50mg/kg dose, however, did not demonstrate any significant cardioprotective action. The histopathological and immunohistochemical analysis further substantiated these findings.

SIGNIFICANCE

Our study showed a dose-dependent reduction in oxidative stress, inflammation and dyslipidemia by RK in ISO-intoxicated rats, which signifies that RK from the European red raspberry plant might be a valuable entity for the management of MI.

Metabolomic study of the intervention effects of Shuihonghuazi Formula, a Traditional Chinese Medicinal formulae, on hepatocellular carcinoma (HCC) rats using performance HPLC/ESI-TOF-MS

ETHNOPHARMACOLOGICAL RELEVANCE

Metabolomics is the comprehensive assessment of endogenous metabolites of a biological system in a holistic context, and its property consists with the global view of Traditional Chinese Medicine (TCM). Shuihonghuazi Formula (SHHZF) has been used for liver cancer early treatment in clinical for more than thirty years, but its mechanism remains unclear completely. This paper was designed to explore the therapeutic effects of SHHZF on liver cancer and its metabolomic characters.

MATERIALS AND METHODS

All the rats were given diethylnitrosamine (DEN) at the dosage of 70mg/kg for 14 weeks. From the 7th weeks, SHHZF was given to the rats which lasted for 10 weeks. Therapeutic effects of SHHZF was compared with that of cyclophosphamide (CTX). High performance liquid-chromatography/electrospray-ionization time of flight mass spectrometer (HPLC/ESI-TOF-MS) combined with pattern recognition approaches including principal component analysis (PCA), partial least squares-discriminant analysis (PLS-DA), was integrated to approximate the comprehensive metabolic signature and discover differentiating metabolites by Agilent MPP 12.1. The changes in metabolic profiling in plasma were restored to their baseline values after SHHZF treatment according to the PLS-DA score plots.

RESULTS

The results indicated that 23 ions as "differentiating metabolites". The alterations in those metabolites were associated with perturbations in fatty acid and bile acid metabolism, in response to liver cancer through immune and nervous system. And SHHZF could increase the uptake and utilization of linoleic acid and oleic acid, increase arachidonic acid-like substance content and enhance organism immunity of liver cancer rats. And it also could increase the translation from phosphatidylethanolamine (PE) to phosphatidylcholine (PC), linoleic acid metabolism and inhibits abnormal metabolism of bile acid.

CONCLUSIONS

The mechanism of therapeutic effects of SHHZF on liver cancer by adjusting the activities of PE N-methyl transferase (PEMT), Lysophospholipase D, methylenetetrahydrofolate reductase (MTHFR) and lysophospholipase was elucidated by the method of metabonomics for the first time.

Transfer and Mass Balance of Ellagitannins, Anthocyanins, Flavan-3-ols, and Flavonols during the Processing of Red Raspberries (Rubus idaeus L.) to Juice

The putative health benefits of raspberries and raspberry-based products are potentially attributable to the presence of polyphenolic compounds, such as ellagitannins, anthocyanins, flavanols, and flavonols. Their content in the products of raspberry processing into juice may be affected by the fruit cultivar, technological process parameters, and the properties of the polyphenolics themselves. The objective of the study was to investigate the composition and quantity of the above polyphenolics in raspberries and the products of their processing (that is, juice and press cake, including its seed and seedless fractions). The study also examined the relationship between the molecular mass of ellagitannins and their transfer to juice. The average percentage contributions of ellagitannins, anthocyanins, flavanols, and flavonols to total polyphenolics in the fruits were 64.2%, 17.1%, 16.9%, and 1.8%, respectively. Analysis of raspberry products showed that the dominant compounds in juice were anthocyanins, with 65.1% contribution to total polyphenolics, while in raspberry press cake, they were tannins (98.0%, mainly ellagitannin including lambertianin C and sanguiin H-6). As shown by our mass-balance calculations, on average, 68.1% of ellagitannins and 87.7% of flavanols were retained in press cake, especially in its seedless fraction. In addition, a significant negative correlation was found between the molecular mass of ellagitannins and their transfer to juice. An increase in molecular mass from 1568 to 2805 Da resulted in a more than 10-fold decrease in ellagitannin transfer.

The impact of diet and nutrition in the prevention and progression of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide. There is growing evidence for a chemopreventive role of nutrition in the development of HCC in at risk populations. Bibliographical searches were performed in PubMed for the terms 'nutrition and hepatocellular carcinoma', 'nutrition and liver cancer', 'nutrition and hepatic cancer', 'diet and hepatocellular carcinoma', 'diet and liver cancer'. High dietary sugar intake should be discouraged in at risk populations. Coffee, polyphenols, vanadium, dietary fibre, fruits and vegetables show encouraging results in terms of chemoprevention. Red meat intake may be associated with increased risk of HCC. The evidence for fatty acids is inconclusive, but they might exert anti-cancer effects. Inconclusive results are available on vitamins, selenium probiotics and prebiotics. There is increasing evidence that diet may play an important role in the development of HCC, and may also have a chemopreventive role in at risk populations.

β-Ionone arrests cell cycle of gastric carcinoma cancer cells by a MAPK pathway

β-Ionone is an end ring analog of β-carotenoid which has been shown to possess potent anti-proliferative activity both in vitro and in vivo. To investigate the possible inhibitory effects of β-ionone, we studied cell growth characteristics, DNA synthesis, cell cycle progression, as well as mitogen-activated protein kinases (MAPKs) pathways in the human gastric adenocarcinoma cancer cell line (SGC-7901). Our results show that cell growth and DNA synthesis were inhibited, and the cell cycle was arrested at the G0/G1 phase in a dose-dependent manner in cells treated with β-ionone (25, 50, 100 and 200 μmol/L) for 24 h. We found that the β-ionone significantly decreased the extracellular signal-regulated kinase protein expression and significantly increased the levels of p38 and Jun-amino-terminal kinase protein expression (P < 0.01). β-Ionone also inhibited cell cycle-related proteins of Cdk4, Cyclin B1, D1 and increased p27 protein expression in SGC-7901 cells. These results suggested that the cell cycle arrest observed may be regulated through a MAPK pathway by transcriptional down-regulation of cell cycle proteins. These results demonstrate potent ability of β-ionone to arrest cell cycle of SGC-7901 cells and decrease proliferation.

Evaluation of antioxidant and antiproliferative properties of three Actinidia (Actinidia kolomikta, Actinidia arguta, Actinidia chinensis) extracts in vitro

The total phenolic content, total flavonoid content, vitamin C content, and antioxidant activities of ethanol extracts from different kiwifruit varieties (Actinidia kolomikta, Actinidia arguta, Actinidia chinensis) were determined in this study. Multiple scavenging activity assays including the hydroxyl radical, O(2) (-)·radical, DPPH, and the ABTS(+) radical scavenging activity assays were used to identify the antioxidant activities of Actinidia extracts. The cell viability of HepG2 and HT-29 cells was also examined in this study. The results demonstrated that the Actinidia kolomikta extract had a higher antioxidant activity than the other two Actinidia extracts. There is a positive correlation between antioxidant activity and the polyphenols and vitamin C content in all three extracts (R(2) ≥ 0.712, p < 0.05). The Actinidia arguta extract had the highest inhibitory effect on HepG2 and HT-29 cell growth. These results provide new insight into the health functions of fruit and demonstrate that Actinidia extracts can potentially have health benefits.

Effects of epidural capsaicin on nociceptive threshold and neurological functions in rabbits

Capsaicin, as a principle active component of Chili peppers, is popularly consumed by many people around the world. Whether capsaicin-induced neuropathy alters the function of sensory neurons is still unknown.

OBJECTIVE

  The objectives of this study were to determine the effects of epidural capsaicin on nociceptive threshold and neurological functions in a rabbit model.

DESIGN

  An intrathecal injection system was set up using a rabbit model. Rabbits were treated with capsaicin at doses of 0.04, 0.10, and 0.20 mg/kg once. The changes in neurological functions and morphology of the spinal cord and spinal nerve roots were determined within 24 hours. Changes in the nociceptive threshold in the hind limbs of the rabbits were observed for 30 days.

METHODS

  Capsaicin's effect on the changing neurological functions was evaluated by the neurological functional scores. The structural changes of spinal cord and spinal nerve roots were observed by hematoxylin and eosin staining and transmission electron microscopy. The nociceptive threshold changes in the rabbits were measured by the responding time for pain induced by a thermostimulation.

RESULTS

  The results showed that capsaicin reversed changes in the neurological function of rabbit hindlimbs. In the 0.10 and 0.20 mg/kg groups, structural abnormalities were found in the rabbit's spinal nerves. Capsaicin also significantly increased the pain threshold in rabbits when compared with the control group (P < 0.05 or P < 0.01). The maximum values of pain threshold were found in the 0.10 mg/kg capsaicin group after 3 days of capsaicin treatment.

CONCLUSION

  With the exception of a potential toxicity, capsaicin may be a potential candidate agent for providing pain relief of both neuropathic and nociceptive conditions.