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Venkatesh R, Narayan AC, Kandasamy J. Synthesis of deoxybenzoins from β-alkoxy styrenes and arylboronic acids via palladium-catalyzed regioselective Heck-arylation reactions. Org Biomol Chem 2024; 22:5193-5197. [PMID: 38864361 DOI: 10.1039/d4ob00616j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Palladium-catalyzed synthesis of deoxybenzoin derivatives from styryl ethers and arylboronic acids is reported. The reaction proceeds under mild conditions in the presence of TEMPO and provides the desired products in good to excellent yields. Simple operation, broad substrate scope, and functional group tolerance are the salient features of the developed methodology.
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Affiliation(s)
- Rapelly Venkatesh
- Department of Chemistry, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh-221005, India.
| | - Aswathi C Narayan
- Department of Chemistry, Pondicherry University, Pondicherry-605014, India.
| | - Jeyakumar Kandasamy
- Department of Chemistry, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh-221005, India.
- Department of Chemistry, Pondicherry University, Pondicherry-605014, India.
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2
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Teng Z, Yang J, Chen X, Liu Y. Intranasal Morphology Transformation Nanomedicines for Long-Term Intervention of Allergic Rhinitis. ACS NANO 2023; 17:25322-25334. [PMID: 38088363 DOI: 10.1021/acsnano.3c08752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Intranasal administration has been widely explored as a potential treatment for allergic rhinitis, and improving intranasal penetration and retention of drugs is a challenging requirement to further improve efficacy. Delivery strategies of nanocarriers that enhance mucosal adhesion or mucus penetration have been proposed to improve nasal drug delivery; however, delivery efficiency remains limited by excessive pulmonary deposition and nonspecific cell phagocytosis. In this work, a "nasal in situ assembly" strategy was presented to construct intranasal morphology transformation nanomedicines with enhanced effective drug concentration for long-term intervention of allergic rhinitis. The polymer-polypeptide nanomedicine (PHCK) with a CCR3 antagonistic peptide (C) and a pH-responsive polyethylene glycol (H) was developed, encapsulating ketotifen (KT). PHCK nanoparticles displayed nasal mucosa permeability and transformed to nanofibers in the acidic environment of the nasal cavity, realizing responsive burst release of KT simultaneously. The fibrotic reassembly reduced the cellular internalization of nanomedicine and increased the CCR3 blockade on the eosinophil (EOS) membranes. Both in vitro and in vivo data indicated that PHCK achieved improved drug accumulation and retention in the nasal cavity and decreased pulmonary deposition, then effectively inhibited mast cell degranulation and EOS chemotaxis. This study demonstrates that the "nasal in situ assembly" strategy can improve drug delivery efficiency upon nasal responsive morphologic transformation, providing exploratory perspectives for nasal delivery platforms establishment and boosting therapeutic effect of allergic rhinitis.
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Affiliation(s)
- Zhuang Teng
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, PR China
| | - Jianke Yang
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, PR China
| | - Xiguang Chen
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, PR China
- Qingdao National Laboratory for Marine Science and Technology, Qingdao 266000, PR China
| | - Ya Liu
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, PR China
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3
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Ma C, Li H, Lu S, Li X, Wang S, Wang W. Tryptase and Exogenous Trypsin: Mechanisms and Ophthalmic Applications. J Inflamm Res 2023; 16:927-939. [PMID: 36891173 PMCID: PMC9987324 DOI: 10.2147/jir.s402900] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
Ocular injuries caused by inflammation, surgery or accidents are subject to a physiological healing process that ultimately restores the structure and function of the damaged tissue. Tryptase and trypsin are essential component of this process and they play a role in promoting and reducing the inflammatory response of tissues, respectively. Following injury, tryptase is endogenously produced by mast cells and can exacerbate the inflammatory response both by stimulating neutrophil secretion, and through its agonist action on proteinase-activated receptor 2 (PAR2). In contrast, exogenously introduced trypsin promotes wound healing by attenuating inflammatory responses, reducing oedema and protecting against infection. Thus, trypsin may help resolve ocular inflammatory symptoms and promote faster recovery from acute tissue injury associated with ophthalmic diseases. This article describes the roles of tryptase and exogenous trypsin in affected tissues after onset of ocular injury, and the clinical applications of trypsin injection.
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Affiliation(s)
- Chao Ma
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Haoyu Li
- Department of Ophthalmology, the Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,Hunan Clinical Research Centre of Ophthalmic Disease, Changsha, Hunan, People's Republic of China
| | - Shuwen Lu
- Department of Ophthalmology, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - Xian Li
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, the University of Manchester, Manchester, UK
| | - Shuai Wang
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Wenzhan Wang
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
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4
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Willems M, Seβenhausen P, Gies I, Vloeberghs V, Tournaye H, Goossens E, Van Saen D. To graft or not to graft? Intratesticular xenografting of (pre)pubertal testicular tissue from Klinefelter patients as potential ex vivo model to study testicular fibrosis. Reprod Biomed Online 2022; 44:896-906. [DOI: 10.1016/j.rbmo.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/07/2022] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
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5
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Goyal T, Kohli S, Tayal R. Antihistamines in children: A dermatological perspective. INDIAN JOURNAL OF PAEDIATRIC DERMATOLOGY 2022. [DOI: 10.4103/ijpd.ijpd_124_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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Anti-Allergic Effects of Myrciaria dubia (Camu-Camu) Fruit Extract by Inhibiting Histamine H1 and H4 Receptors and Histidine Decarboxylase in RBL-2H3 Cells. Antioxidants (Basel) 2021; 11:antiox11010104. [PMID: 35052608 PMCID: PMC8773304 DOI: 10.3390/antiox11010104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 11/21/2022] Open
Abstract
Although Myrciaria dubia (camu-camu) has been shown to exert anti-oxidant and anti-inflammatory effects in both in vitro and in vivo studies, its use in allergic responses has not been elucidated. In the present study, the anti-allergic effect of 70% ethanol camu-camu fruit extract was tested on calcium ionophore (A23187)-induced allergies in RBL-2H3 cells. The RBL-2H3 cells were induced with 100 nM A23187 for 6 h, followed by a 1 h camu-camu fruit extract treatment. A23187 sanitization exacerbated mast cell degranulation; however, camu-camu fruit extract decreased the release of histamine and β-hexosaminidase, which are considered as key biomarkers in cell degranulation. Camu-camu fruit extract inhibited cell exocytosis by regulating the calcium/nuclear factor of activated T cell (NFAT) signaling. By downregulating the activation of mitogen-activated protein kinase (MAPK) signaling, camu-camu fruit extract hindered the activation of both histamine H1 and H4 receptors and inhibited histidine decarboxylase (HDC) expression by mediating its transcription factors KLF4/SP1 and GATA2/MITF. In A23187-induced ROS overproduction, camu-camu fruit extract activated nuclear factor erythroid-2-related factor 2 (Nrf2) to protect mast cells against A23187-induced oxidative stress. These findings indicate that camu-camu fruit extract can be developed to act as a mast cell stabilizer and an anti-histamine. This work also “opens the door” to new investigations using natural products to achieve breakthroughs in allergic disorder treatment.
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Nizawa T, Bhutto IA, Tiwari A, Grebe RR, Alt J, Rais R, Edwards MM, Lutty GA. Topical Ketotifen Fumarate Inhibits Choroidal Mast Cell Degranulation and Loss of Retinal Pigment Epithelial Cells in Rat Model for Geographic Atrophy. Transl Vis Sci Technol 2021; 10:37. [PMID: 34967831 PMCID: PMC8727493 DOI: 10.1167/tvst.10.14.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose This study evaluates whether topical ketotifen fumarate (KTF) can prevent geographic atrophy (GA)-like phenotypes in a rat model. Methods Pharmacokinetics (PKs) of KTF after topical administration twice daily for 5 days was analyzed in rat retina, retinal pigment epithelium (RPE)/choroid/sclera, and in plasma by an liquid chromatography tandem mass spectrometry (LC-MS/MS) method. Rats were then given hydrogel implants +/- 48/80 in the superior subconjunctival space and topically treated with 1% and 0.25% of KTF or phosphate buffer saline (PBS) twice daily. Rats were euthanized at 1, 2, 4, and 8 weeks postinjection. Choroidal mast cells (MCs) were stained with nonspecific esterase and the RPE monolayer was labeled with RPE65 and ZO-1 in whole mount choroids. Retinal and choroidal areas were determined in cryosections stained with picrosirius red. Dark-adapted electroretinogram (ERG) was also performed to evaluate retinal function. Results PK results showed the highest level of KTF (average 5.6 nM/mg) in the RPE/choroid/sclera in rats given topical 1% KTF. Topical 1% KTF significantly reduced choroidal MC degranulation at 1 week and 2 weeks (both P < 0.001) and RPE loss at 4 weeks (P < 0.001) as well as retinal and choroidal thinning (both P < 0.001) and reduction in ERG amplitude at 8 weeks (P < 0.05) compared to PBS. Similar results were obtained with 0.25% KTF. Conclusions Both 1% and 0.25% KTF eye drops effectively reduced MC degranulation, RPE loss, and retinal and choroidal thinning while preventing the decline of ERG amplitude in a GA-like rat model. These data suggest that topical KTF might be a new therapeutic drug for treating GA. Translational Relevance The results of this study demonstrate that topical KTF successfully reduced GA-like phenotypes in a rat model and may provide a novel therapy for GA.
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Affiliation(s)
- Tomohiro Nizawa
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Imran A Bhutto
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anupama Tiwari
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rhonda R Grebe
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jesse Alt
- Brain Science Institute, Johns Hopkins Drug Discovery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rana Rais
- Brain Science Institute, Johns Hopkins Drug Discovery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Malia M Edwards
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gerard A Lutty
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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8
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Aberg AKG, Arulnesan N, Bolger GT, Ciofalo VB, Pucaj K, Walle K, Walle T. Ketotifen is a Prodrug. Norketotifen is the active metabolite. Drug Dev Res 2021; 83:362-367. [PMID: 34410005 DOI: 10.1002/ddr.21865] [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: 04/29/2021] [Revised: 07/15/2021] [Accepted: 07/24/2021] [Indexed: 11/10/2022]
Abstract
Evaluation of the in vitro human liver microsome and hepatocyte metabolism of ketotifen demonstrated that norketotifen (NK) is the major demethylated hepatic metabolite of ketotifen. It is here reported that NK is completely devoid of the severe and dose-limiting sedative effects of ketotifen. Thus, while ketotifen is clinically dose-limited to 1 mg, bid, there are no dose-limiting sedative effects elicited by NK, even after the highest single-dose (16 mg) or after repeat-doses (8 mg × 7 days) in humans or after the highest doses given to dogs in repeat-dose toxicological studies (40 mg/kg × 14 days). In addition, NK-but not ketotifen-was found to express potent and dose-dependent inhibition of the release of the pro-inflammatory cytokine TNFα from activated human buffy coat preparations. Thus, when used as an anti-inflammatory drug, ketotifen is the sedating prodrug which is converted to NK a nonsedating metabolite with anti-inflammatory activity.
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Affiliation(s)
| | - Nada Arulnesan
- Department of Toxicology, Nucro-Technics, Scarborough, Ontario, Canada
| | | | | | - Kresimir Pucaj
- Bridge Pharma Toronto, Inc., Scarborough, Ontario, Canada
| | - Kristina Walle
- Department of Pharmacology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Thomas Walle
- Department of Pharmacology, Medical University of South Carolina, Charleston, South Carolina, USA
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9
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Mast cell stabilizer ketotifen fumarate reverses inflammatory but not neuropathic-induced mechanical pain in mice. Pain Rep 2021; 6:e902. [PMID: 34104835 PMCID: PMC8177879 DOI: 10.1097/pr9.0000000000000902] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/16/2020] [Accepted: 12/18/2020] [Indexed: 12/17/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. Our preclinical findings indicate that ketotifen fumarate's analgesic effects are MC-dependent, and the case series report presented supports its use for the treatment of chronic pain. Introduction: Mast cell (MC) activation could establish a positive feedback loop that perpetuates inflammation and maintains pain. Stabilizing MCs with ketotifen fumarate (KF) may disrupt this loop and relieve pain. Objective: We aimed to test the effect of treatment with KF in pain assays in mice and in a case series of patients with chronic widespread pain. Methods: The analgesic effect of KF was tested in CD-1 mice injected with formalin, complete Freund's adjuvant, or subjected to spared nerve injury. In addition, wild-type (C57BL/6) and MC-deficient (C57BL/6-KitW-sh/W-sh) mice were injected with formalin or complete Freund's adjuvant and treated with KF. Patients with chronic widespread pain (n = 5; age: 13–16 years) who failed to respond to standard of care participated in a 16-week treatment trial with KF (6 mg/d). Ketotifen fumarate's therapeutic effect was evaluated using the patient global impression of change. Results: In the mouse experiments, KF produced dose- and MC-dependent analgesic effects against mechanical allodynia in the acute and chronic inflammatory pain but not neuropathic pain assays. In the patient case series, 4 patients reported that activity limitations, symptoms, emotions, and overall quality of life related to their pain condition were “better” or “a great deal better” since beginning treatment with KF. This was accompanied by improvements in pain comorbid symptoms. Conclusion: Treatment with KF is capable of reducing established inflammatory-induced mechanical nociception in an MC-dependent manner in mice, and it may be beneficial for the treatment of chronic pain conditions.
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10
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Triantafillou V, Maina IW, Patel NN, Tong CCL, Papagiannopoulos P, Kohanski MA, Kennedy DW, Palmer JN, Adappa ND, Cohen NA, Bosso JV. In vitro safety of ketotifen as a topical nasal rinse. Int Forum Allergy Rhinol 2021; 10:265-270. [PMID: 32086998 DOI: 10.1002/alr.22461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/24/2019] [Accepted: 10/02/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND Ketotifen is a second-generation noncompetitive H1-antihistamine and mast-cell stabilizer. It is commonly used to treat or prevent allergic conjunctivitis, asthma, chronic urticaria, anaphylaxis, mast-cell, and other allergic-type disorders. However, it has never been studied in aspirin-exacerbated respiratory disease (AERD), an aggressive phenotype of chronic rhinosinusitis with nasal polyps, where the mast cell plays a prominent role its pathogenesis. METHODS Human sinonasal epithelial cells were grown at an air-liquid interface (ALI). Ketotifen powder was dissolved in saline to make 4 test solutions at 1.04, 2.08, 10.4, and 20.8 µg/mL. Control (saline) or ketotifen solution was added apically to ALI cultures from tissue of 5 unique patients, and ciliary beat frequency (CBF) changes were recorded. Lactate dehydrogenase was measured at 24 and 48 hours to estimate long-term cellular toxicity. RESULTS Apical application of ketotifen at all concentrations was neither ciliotoxic nor ciliostimulatory, with no change in CBF over a period of 15 minutes after application. Cellular toxicity for all concentrations at 24 and 48 hours after application was <3% and <7%, respectively, that of lysed cultures. CONCLUSION Topical application of ketotifen to an in vitro model of sinonasal epithelium is safe, as evaluated by CBF and lactate dehydrogenase. Ketotifen is neither ciliotoxic nor ciliostimulatory, and no long-term cellular toxicity was observed. Ketotifen may have promise as a topical nasal rinse in the treatment of AERD.
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Affiliation(s)
- Vasiliki Triantafillou
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Ivy W Maina
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Neil N Patel
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Charles C L Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Peter Papagiannopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Michael A Kohanski
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - David W Kennedy
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - James N Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Noam A Cohen
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA.,Corporal Michael J. Crescenz Veterans Administration Medical Center, Philadelphia, PA.,Monell Chemical Senses Center, Philadelphia, PA
| | - John V Bosso
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
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Moreno D, Sobarzo CM, Lustig L, Rodríguez Peña MG, Guazzone VA. Effect of ketotifen fumarate on experimental autoimmune orchitis and torsion of the spermatic cord. Asian J Androl 2020; 22:112-117. [PMID: 31115365 PMCID: PMC6958983 DOI: 10.4103/aja.aja_30_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The aim of this work was to study effects of ketotifen fumarate (KF) on prevention of tissue damage in testes of rats with experimental autoimmune orchitis (EAO) and on the contralateral testis in a model of prolonged testicular cord torsion (TCT). Rats with EAO or TCT were injected intraperitoneally once daily with KF or saline solution (vehicle group). Incidence and severity of testicular damage were evaluated by histopathology using an EAO score or a Johnsen score. Mast cells (MC) were identified by histochemistry and quantified. In EAO model, KF significantly reduced severity of histopathological testicular damage compared to rats in the vehicle group. KF also reduced the number of testicular MC compared to vehicle group. Similarly, in TCT model, multifocal damage of the contralateral testis was observed 30 days after testicular torsion characterized by sloughing of the germinal epithelium, seminiferous tubule atrophy, and interstitial edema. Focal signs of inflammation and fibrosis of seminiferous tubular walls were also observed. In contrast, sections of contralateral testis of rats injected with KF and killed 30 days after surgery showed normal histological features. A significant decrease in the number of MC was observed in rats treated with KF compared to untreated animals. In conclusion, we demonstrated that treatment with KF reduced testicular inflammatory process and MC infiltrates in both EAO and TCT models. The results suggest a promising treatment for infertile male patients with testicular pathologies associated with inflammation and germ cell loss.
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Affiliation(s)
- Diego Moreno
- National Scientific and Technical Research Council - University of Buenos Aires, Institute of Biomedical Research (INBIOMED, UBA-CONICET), Buenos Aires C 1121ABG, Argentina.,Central Militar Hospital "Cirujano Mayor Dr. Cosme Argerich", Buenos Aires C 1426BOR, Argentina
| | - Cristian M Sobarzo
- National Scientific and Technical Research Council - University of Buenos Aires, Institute of Biomedical Research (INBIOMED, UBA-CONICET), Buenos Aires C 1121ABG, Argentina.,University of Buenos Aires, School of Medicine, Department of Cellular Biology and Histology/Academic Unit II, Buenos Aires C 1121ABG, Argentina
| | - Livia Lustig
- National Scientific and Technical Research Council - University of Buenos Aires, Institute of Biomedical Research (INBIOMED, UBA-CONICET), Buenos Aires C 1121ABG, Argentina.,University of Buenos Aires, School of Medicine, Department of Cellular Biology and Histology/Academic Unit II, Buenos Aires C 1121ABG, Argentina
| | | | - Vanesa Anabella Guazzone
- National Scientific and Technical Research Council - University of Buenos Aires, Institute of Biomedical Research (INBIOMED, UBA-CONICET), Buenos Aires C 1121ABG, Argentina.,University of Buenos Aires, School of Medicine, Department of Cellular Biology and Histology/Academic Unit II, Buenos Aires C 1121ABG, Argentina
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12
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Limberg AK, Tibbo ME, Salib CG, McLaury AR, Turner TW, Berry CE, Jay AG, Carter JM, Bolon B, Berry DJ, Morrey ME, Sanchez-Sotelo J, van Wijnen AJ, Abdel MP. Reduction of arthrofibrosis utilizing a collagen membrane drug-eluting scaffold with celecoxib and subcutaneous injections with ketotifen. J Orthop Res 2020; 38:2474-2483. [PMID: 32134136 PMCID: PMC7483403 DOI: 10.1002/jor.24647] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 02/29/2020] [Indexed: 02/04/2023]
Abstract
The dense formation of abnormal scar tissue after total knee arthroplasty results in arthrofibrosis, an unfortunate sequela of inflammation. The purpose of this study was to use a validated rabbit model to assess the effects on surgically-induced knee joint contractures of two combined pharmacological interventions: celecoxib (CXB) loaded on an implanted collagen membrane, and subcutaneously (SQ) injected ketotifen. Thirty rabbits were randomly divided into five groups. The first group received no intervention after the index surgery. The remaining four groups underwent intra-articular implantation of collagen membranes loaded with or without CXB at the time of the index surgery; two of which were also treated with SQ ketotifen. Biomechanical joint contracture data were collected at 8, 10, 16, and 24 weeks. At the time of necropsy (24 weeks), posterior capsule tissue was collected for messenger RNA and histopathologic analyses. At 24 weeks, there was a statistically significant increase in passive extension among rabbits in all groups treated with CXB and/or ketotifen compared to those in the contracture control group. There was a statistically significant decrease in COL3A1, COL6A1, and ACTA2 gene expression in the treatment groups compared to the contracture control group (P < .001). Histopathologic data also demonstrated a trend towards decreased fibrous tissue density in the CXB membrane group compared to the vehicle membrane group. The present data suggest that intra-articular placement of a treated collagen membrane blunts the severity of contracture development in a rabbit model of arthrofibrosis, and that ketotifen and CXB may independently contribute to the prevention of arthrofibrosis. Statement of clinical significance: Current literature has demonstrated that arthrofibrosis may affect up to 5% of primary total knee arthroplasty patients. For that reason, novel pharmacologic prophylaxis and treatment modalities are critical to mitigating reoperations and revisions while improving the quality of life for patients with this debilitating condition.
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Affiliation(s)
| | - Meagan E. Tibbo
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | | | - Alex R. McLaury
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | | | | | - Anthony G. Jay
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | - Jodi M. Carter
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | | | - Daniel J. Berry
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | - Mark E. Morrey
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | | | - Andre J. van Wijnen
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN,Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, MN
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13
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Ogura S, Baldeosingh R, Bhutto IA, Kambhampati SP, Scott McLeod D, Edwards MM, Rais R, Schubert W, Lutty GA. A role for mast cells in geographic atrophy. FASEB J 2020; 34:10117-10131. [PMID: 32525594 DOI: 10.1096/fj.202000807r] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 02/06/2023]
Abstract
Mast cells (MCs) are the initial responders of innate immunity and their degranulation contribute to various etiologies. While the abundance of MCs in the choroid implies their fundamental importance in the eye, little is known about the significance of MCs and their degranulation in choroid. The cause of geographic atrophy (GA), a progressive dry form of age-related macular degeneration is elusive and there is currently no therapy for this blinding disorder. Here we demonstrate in both human GA and a rat model for GA, that MC degranulation and MC-derived tryptase are central to disease progression. Retinal pigment epithelium degeneration followed by retinal and choroidal thinning, characteristic phenotypes of GA, were driven by continuous choroidal MC stimulation and activation in a slow release fashion in the rat. Genetic manipulation of MCs, pharmacological intervention targeting MC degranulation with ketotifen fumarate or inhibition of MC-derived tryptase with APC 366 prevented all of GA-like phenotypes following MC degranulation in the rat model. Our results demonstrate the fundamental role of choroidal MC involvement in GA disease etiology, and will provide new opportunities for understanding GA pathology and identifying novel therapies targeting MCs.
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Affiliation(s)
- Shuntaro Ogura
- Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Imran A Bhutto
- Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Siva P Kambhampati
- Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Donald Scott McLeod
- Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Malia M Edwards
- Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Rana Rais
- Johns Hopkins Drug Discovery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Gerard A Lutty
- Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, USA
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Feng F, Fawcett JP, Zhang H, Tucker IG. Cell-based, animal and H 1 receptor binding studies relative to the sedative effects of ketotifen and norketotifen atropisomers. ACTA ACUST UNITED AC 2020; 72:507-518. [PMID: 32030755 DOI: 10.1111/jphp.13220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/29/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Ketotifen (K) and its active metabolite norketotifen (N) exist as optically active atropisomers. They both have antihistaminic and anti-inflammatory properties but the S-atropisomer of N (SN) causes less sedation than K and RN in rodents. This study investigated whether this could be related to a lower concentration of SN in brain or a lower affinity of SN for rat brain H1 receptors. METHODS Ketotifen and norketotifen atropisomers were quantified using a validated chiral HPLC assay. RBE4 and Caco-2 cell monolayers were used in uptake and permeability studies, respectively. Free and total brain-to-plasma (B/P) ratios were determined after injecting racemic K and N into rat tail veins. Affinity for rat brain H1 receptors (KI ) was determined using the [3 H]mepyramine binding assay. KEY FINDINGS Uptake and permeation studies indicate no stereoselective transport for K or N. B/P ratios reveal the brain concentration of N is lower than K with no stereoselective transport into brain. Finally, the [3 H]mepyramine binding assay shows SN has the lowest affinity for rat brain H1 receptors. CONCLUSION The lower sedative effect of SN in rodents is probably due to a combination of a lower uptake of N than K into the brain and less affinity of SN for CNS H1 receptors.
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Affiliation(s)
- Feifei Feng
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - J Paul Fawcett
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Hu Zhang
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Ian G Tucker
- School of Pharmacy, University of Otago, Dunedin, New Zealand
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15
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Pinke KH, Zorzella-Pezavento SFG, de Campos Fraga-Silva TF, Mimura LAN, de Oliveira LRC, Ishikawa LLW, Fernandes AAH, Lara VS, Sartori A. Calming Down Mast Cells with Ketotifen: A Potential Strategy for Multiple Sclerosis Therapy? Neurotherapeutics 2020; 17:218-234. [PMID: 31463682 PMCID: PMC7007452 DOI: 10.1007/s13311-019-00775-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS) characterized by extensive inflammation, demyelination, axonal loss and gliosis. Evidence indicates that mast cells contribute to immunopathogenesis of both MS and experimental autoimmune encephalomyelitis (EAE), which is the most employed animal model to study this disease. Considering the inflammatory potential of mast cells, their presence at the CNS and their stabilization by certain drugs, we investigated the effect of ketotifen fumarate (Ket) on EAE development. EAE was induced in C57BL/6 mice by immunization with MOG35-55 and the animals were injected daily with Ket from the seventh to the 17th day after disease induction. This early intervention with Ket significantly reduced disease prevalence and severity. The protective effect was concomitant with less NLRP3 inflammasome activation, rebalanced oxidative stress and also reduced T cell infiltration at the CNS. Even though Ket administration did not alter mast cell percentage at the CNS, it decreased the local CPA3 and CMA1 mRNA expression that are enzymes typically produced by these cells. Evaluation of the CNS-barrier permeability indicated that Ket clearly restored the permeability levels of this barrier. Ket also triggered an evident lymphadenomegaly due to accumulation of T cells that produced higher levels of encephalitogenic cytokines in response to in vitro stimulation with MOG. Altogether these findings reinforce the concept that mast cells are particularly relevant in MS immunopathogenesis and that Ket, a known stabilizer of their activity, has the potential to be used in MS control.
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Affiliation(s)
- Karen Henriette Pinke
- Department of Microbiology and Immunology, Institute of Biosciences, São Paulo State University (UNESP), Rua Dr. Plinio Pinto e Silva, S/N, Distrito de Rubião Júnior, Botucatu, São Paulo, 18618-691, Brazil.
| | - Sofia Fernanda Gonçalves Zorzella-Pezavento
- Department of Microbiology and Immunology, Institute of Biosciences, São Paulo State University (UNESP), Rua Dr. Plinio Pinto e Silva, S/N, Distrito de Rubião Júnior, Botucatu, São Paulo, 18618-691, Brazil
| | - Thais Fernanda de Campos Fraga-Silva
- Department of Microbiology and Immunology, Institute of Biosciences, São Paulo State University (UNESP), Rua Dr. Plinio Pinto e Silva, S/N, Distrito de Rubião Júnior, Botucatu, São Paulo, 18618-691, Brazil
| | - Luiza Ayumi Nishiyama Mimura
- Department of Microbiology and Immunology, Institute of Biosciences, São Paulo State University (UNESP), Rua Dr. Plinio Pinto e Silva, S/N, Distrito de Rubião Júnior, Botucatu, São Paulo, 18618-691, Brazil
| | - Larissa Ragozo Cardoso de Oliveira
- Department of Microbiology and Immunology, Institute of Biosciences, São Paulo State University (UNESP), Rua Dr. Plinio Pinto e Silva, S/N, Distrito de Rubião Júnior, Botucatu, São Paulo, 18618-691, Brazil
| | - Larissa Lumi Watanabe Ishikawa
- Department of Microbiology and Immunology, Institute of Biosciences, São Paulo State University (UNESP), Rua Dr. Plinio Pinto e Silva, S/N, Distrito de Rubião Júnior, Botucatu, São Paulo, 18618-691, Brazil
| | - Ana Angélica Henrique Fernandes
- Department of Chemistry and Biochemistry, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Vanessa Soares Lara
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo, Brazil
| | - Alexandrina Sartori
- Department of Microbiology and Immunology, Institute of Biosciences, São Paulo State University (UNESP), Rua Dr. Plinio Pinto e Silva, S/N, Distrito de Rubião Júnior, Botucatu, São Paulo, 18618-691, Brazil
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16
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Muñoz-Cano RM, Casas-Saucedo R, Valero Santiago A, Bobolea I, Ribó P, Mullol J. Platelet-Activating Factor (PAF) in Allergic Rhinitis: Clinical and Therapeutic Implications. J Clin Med 2019; 8:jcm8091338. [PMID: 31470575 PMCID: PMC6780525 DOI: 10.3390/jcm8091338] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 11/16/2022] Open
Abstract
Platelet-activating factor (PAF) is a lipid mediator involved in several allergic reactions. It is released from multiple cells of the immune system, such as eosinophils, neutrophils, and mast cells, and also exerts its effect on most of them upon specific binding to its receptor, becoming a pleiotropic mediator. PAF is considered a potential relevant mediator in allergic rhinitis, with a key role in nasal congestion and rhinorrhoea due to its effect on vascular permeability. Interestingly, despite its potential relevance as a therapeutic target, no specific PAF inhibitors have been studied in humans. However, rupatadine, a second-generation antihistamine with dual antihistamine and anti-PAF effects has shown promising results by both blocking nasal symptoms and inhibiting mast cell activation induced by PAF, in comparison to antihistamine receptor drugs. In conclusion, the inhibition of PAF may be an interesting approach in the treatment of allergic rhinitis as part of a global strategy directed at blocking as many relevant inflammatory mediators as possible.
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Affiliation(s)
- Rosa M Muñoz-Cano
- Allergy Section, Pheumology & Allergy Department, Hospital Clinic, Barcelona, 08036 Catalonia, Spain.
- Clinical & Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, 08036 Catalonia, Spain.
- ARADyAL, Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Rocio Casas-Saucedo
- Allergy Section, Pheumology & Allergy Department, Hospital Clinic, Barcelona, 08036 Catalonia, Spain
- Clinical & Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, 08036 Catalonia, Spain
- ARADyAL, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonio Valero Santiago
- Allergy Section, Pheumology & Allergy Department, Hospital Clinic, Barcelona, 08036 Catalonia, Spain
- Clinical & Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, 08036 Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Irina Bobolea
- Allergy Section, Pheumology & Allergy Department, Hospital Clinic, Barcelona, 08036 Catalonia, Spain
- Clinical & Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, 08036 Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Paula Ribó
- Allergy Section, Pheumology & Allergy Department, Hospital Clinic, Barcelona, 08036 Catalonia, Spain
- Clinical & Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, 08036 Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Joaquim Mullol
- Clinical & Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, 08036 Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clinic, Barcelona, 08036 Catalonia, Spain
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Noda M, Sultana N, Hayashi I, Fukamachi M, Sugiyama M. Exopolysaccharide Produced by Lactobacillus paracasei IJH-SONE68 Prevents and Improves the Picryl Chloride-Induced Contact Dermatitis. Molecules 2019; 24:molecules24162970. [PMID: 31426284 PMCID: PMC6720527 DOI: 10.3390/molecules24162970] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 02/07/2023] Open
Abstract
Allergic disease is one of the most important and common health problems worldwide. We have previously demonstrated that a fig leaf-derived lactic acid bacterium Lactobacillus (Lb.) paracasei IJH-SONE68 produces a novel exopolysaccharide (EPS). Furthermore, we have shown that the EPS inhibits the catalytic activity of hyaluronidase (EC 3.2.1.36) promoting inflammatory reactions. To evaluate the anti-allergy and anti-inflammatory effects of the EPS, in the present study, we employed the picryl-chloride-induced delayed-type (type IV) allergy model mice, which is used to evaluate the contact dermatitis. Oral administration of the EPS was observed to reduce the ear swelling in the model mice. We also observed that the overexpression of ear interleukin-4 (T helper (Th) 2 cytokine) mRNA and the increase in serum immunoglobulin E (IgE) are repressed. However, the expression of interferon-γ (Th1 cytokine) was not accelerated in all of the allergen-challenged model mice. The improvement may be responsible for the Th2 downregulation rather than the Th1 upregulation. In addition, the symptom of immediate-type (type I) allergy model mice was improved by oral administration of the IJH-SONE68 cell (data not shown). We can conclude that the IJH-SONE68-derived EPS is useful to improve the type I and IV allergies including atopic dermatitis.
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Affiliation(s)
- Masafumi Noda
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan
| | - Nasrin Sultana
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan
| | - Ikue Hayashi
- Central Research Laboratory, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan
| | | | - Masanori Sugiyama
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan.
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18
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Abstract
Supplemental Digital Content is Available in the Text. Purpose: A contact lens (CL)-based drug delivery system for therapeutic delivery of the antihistamine ketotifen was tested in 2 parallel, conjunctival allergen challenge-based trials. Methods: Both trials employed the same multicenter, randomized, placebo-controlled protocol. Test lenses were etafilcon A with 0.019 mg ketotifen; control lenses were etafilcon A with no added drug. Subjects were randomized into 3 treatment groups. Group 1 received test lens in one eye and control lens in the contralateral eye; the eye chosen to receive test lens was randomly selected in a 1:1 ratio. Group 2 received test lenses bilaterally, and group 3 received control lenses bilaterally. Allergen challenges were conducted on 2 separate visits: following lens insertion, the subjects were challenged at 15 minutes (to test onset) and 12 hours (to test duration). The primary endpoint was ocular itching measured using a 0 to 4 scale with half-unit steps. Secondary endpoints included ciliary, conjunctival, and episcleral hyperemia. Results: The mean itching scores were lower for eyes wearing the test lens as compared to those that received control lenses, indicating that the test lens effectively reduced allergic responses. Mean differences in itching were statistically and clinically significant (mean score difference ≥ 1) at both onset and duration for both trials. Conclusions: This large-scale assessment (n = 244) is the first demonstration of efficacy for CL delivery of a therapeutic for ocular allergy. Results are comparable to direct topical drug delivery and suggest that the lens/ketotifen combination can provide a means of simultaneous vision correction and treatment for CL wearers with ocular allergies.
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19
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Choi YH, Seo C, Jeong W, Lee JE, Lee JY, Ahn EK, Kang JS, Lee JH, Choi CW, Oh JS, Lee D, Hong SS. Glycopentanolones A-D, four new geranylated quinolone alkaloids from Glycosmis pentaphylla. Bioorg Chem 2019; 87:714-719. [DOI: 10.1016/j.bioorg.2019.03.069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/04/2019] [Accepted: 03/26/2019] [Indexed: 01/12/2023]
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20
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Parrella E, Porrini V, Benarese M, Pizzi M. The Role of Mast Cells in Stroke. Cells 2019; 8:cells8050437. [PMID: 31083342 PMCID: PMC6562540 DOI: 10.3390/cells8050437] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/18/2022] Open
Abstract
Mast cells (MCs) are densely granulated perivascular resident cells of hematopoietic origin. Through the release of preformed mediators stored in their granules and newly synthesized molecules, they are able to initiate, modulate, and prolong the immune response upon activation. Their presence in the central nervous system (CNS) has been documented for more than a century. Over the years, MCs have been associated with various neuroinflammatory conditions of CNS, including stroke. They can exacerbate CNS damage in models of ischemic and hemorrhagic stroke by amplifying the inflammatory responses and promoting brain–blood barrier disruption, brain edema, extravasation, and hemorrhage. Here, we review the role of these peculiar cells in the pathophysiology of stroke, in both immature and adult brain. Further, we discuss the role of MCs as potential targets for the treatment of stroke and the compounds potentially active as MCs modulators.
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Affiliation(s)
- Edoardo Parrella
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Vanessa Porrini
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Marina Benarese
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Marina Pizzi
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
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21
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Zhang X, Huang Q, Wang X, Deng Z, Li J, Yan X, Jauhiainen M, Metso J, Libby P, Liu J, Shi GP. Dietary cholesterol is essential to mast cell activation and associated obesity and diabetes in mice. Biochim Biophys Acta Mol Basis Dis 2019; 1865:1690-1700. [PMID: 30978390 DOI: 10.1016/j.bbadis.2019.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 12/20/2018] [Accepted: 01/06/2019] [Indexed: 12/13/2022]
Abstract
Mast cell (MC) deficiency in KitW-sh/W-sh mice and inhibition with disodium chromoglycate (DSCG) or ketotifen reduced obesity and diabetes in mice on a high-cholesterol (1.25%) Western diet. Yet, Kit-independent MC-deficient mice and mice treated with DSCG disproved MC function in obesity and diabetes when mice are fed a high-fat diet (HFD) that contains no cholesterol. This study reproduced the obesity and diabetes inhibitory activities of DSCG and ketotifen from mice on a Western diet. Yet, such inhibitory effects were diminished in mice on the HFD. DSCG and ketotifen MC inhibitory activities were recovered from mice on the HFD supplemented with the same amount of cholesterol (1.25%) as that in the Western diet. DSCG and ketotifen effectively blunted the high-cholesterol diet-induced elevations of blood histamine and adipose tissue MC degranulation. Pearson's correlation test demonstrated significant and positive correlations between plasma histamine and total cholesterol or low-density lipoprotein-cholesterol (LDL). In cultured bone marrow-derived MCs, plasma from mice following a Western diet or a cholesterol-supplemented HFD, but not those from HFD-fed mice, induced MC degranulation and the release of β-hexosaminidase, histamine, and serotonin. IgE, LDL, very low-density lipoprotein, and high-density lipoprotein also induced MC activation, which can be inhibited by DSCG and ketotifen depending on the doses and types of MC inhibitors and cholesterol, and also the MC granule molecules of interest. DSCG or ketotifen lost their activities in inhibiting LDL-induced activation of MCs from LDL receptor-deficient mice. These results indicate that dietary cholesterol critically influences the function of mouse MCs.
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Affiliation(s)
- Xian Zhang
- School of Food & Biological Engineering, Hefei University of Technology, Hefei 230009, China; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Qin Huang
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xin Wang
- School of Food & Biological Engineering, Hefei University of Technology, Hefei 230009, China
| | - Zhiyong Deng
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Geriatrics, National Key Clinical Specialty, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Jie Li
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Geriatrics, National Key Clinical Specialty, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xiang Yan
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Matti Jauhiainen
- Minerva Foundation Institute for Medical Research, National Institute for Health and Welfare, Genomics and biomarkers unit, Biomedicum 2U, Helsinki, Finland
| | - Jari Metso
- Minerva Foundation Institute for Medical Research, National Institute for Health and Welfare, Genomics and biomarkers unit, Biomedicum 2U, Helsinki, Finland
| | - Peter Libby
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jian Liu
- School of Food & Biological Engineering, Hefei University of Technology, Hefei 230009, China.
| | - Guo-Ping Shi
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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22
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Leonardi A, Capobianco D, Benedetti N, Capobianco A, Cavarzeran F, Scalora T, Modugno R, Feuerman OM. Efficacy and Tolerability of Ketotifen in the Treatment Of Seasonal Allergic Conjunctivitis: Comparison between Ketotifen 0.025% and 0.05% Eye Drops. Ocul Immunol Inflamm 2018; 27:1352-1356. [PMID: 30303746 DOI: 10.1080/09273948.2018.1530363] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: To study the tolerability and efficacy of two formulations of topical ketotifen ophthalmic solutions for the treatment of seasonal allergic conjunctivitis (SAC).Methods: 81 active SAC patients were treated with either ketotifen 0.025% or 0.05% eye drops for 3 weeks. Allergic signs and symptoms were evaluated at baseline (V0), after 7 (V1) and 21 days (V2). Drugs tolerability and ratings of global efficacy were recorded.Results: Both concentrations of ketotifen were highly effective. The total signs and symptoms scores (TSSS) were significantly better reduced by ketotifen 0.025% compared to 0.05% at both V1 and V2 (p < 0.001). Ketotifen 0.025% was better tolerated than 0.05% at the first instillation and at days 2, 4, and 6 (p < 0.0001), and had a better responder rate (p < 0.001) according to the patient's and investigator's assessments.Conclusions: Ketotifen 0.025% was more effective and better tolerated than 0.05% in SAC.
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Affiliation(s)
- Andrea Leonardi
- Department of Neuroscience, Ophthalmology Unit, University of Padova, Padova, Italy
| | | | - Nicola Benedetti
- Ophthalmology Service, Casa di Cura Don Lorenzo Avezzano, L'Aquila, Italy
| | | | - Fabiano Cavarzeran
- Department of Neuroscience, Ophthalmology Unit, University of Padova, Padova, Italy
| | - Tania Scalora
- Department of Neuroscience, Ophthalmology Unit, University of Padova, Padova, Italy
| | - Rocco Modugno
- Department of Neuroscience, Ophthalmology Unit, University of Padova, Padova, Italy
| | - Oren Mark Feuerman
- Department of Neuroscience, Ophthalmology Unit, University of Padova, Padova, Italy
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23
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Investigation on the Effect of Ketotifen Upon Morphine Tolerance and Dependence in Mice. Jundishapur J Nat Pharm Prod 2018. [DOI: 10.5812/jjnpp.16303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Survey on synergism effect of ketotifen in combination with pyrimethamine in treatment of acute murine toxoplasmosis. Trop Med Health 2017; 45:39. [PMID: 29200930 PMCID: PMC5697358 DOI: 10.1186/s41182-017-0079-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/12/2017] [Indexed: 01/30/2023] Open
Abstract
Background Standard treatment of toxoplasmosis is accompanied by severe side effects and low tolerability; accordingly, alternative medicines are critically needed. Ketotifen (KET) as a cell membrane stabilizer could be an appropriate inhibitor of Toxoplasma gondii (T. gondii) parasite entrance into the host cells. Therefore, the focus of current study is characterization of the anti-Toxoplasma activity of KET in the acute phase of toxoplasmosis in murine model as pre-treatment and post-treatment (before and after infection with RH strain). KET was used intraperitoneally both individually (2 and 3 mg/kg/day) and in combination with pyrimethamine (PYR) (50 mg/kg/day). One week after the post infection, DNA was extracted from brain biopsies samples. Parasite load was calculated using Quantitative-PCR (Q-PCR) in a triplicate reaction for each DNA with the target for at RE (a 529 bp repeat element) gene. Results A significant difference between KET and control groups was observed (P < 0.001) in the pre-treatment and post-treatment groups. Both KET and the combination of KET and PYR showed a reduction in the parasite load in brain through the acute phase of the infection. 2 mg/kg/day dose of KET resulted in higher anti-Toxoplasma activity (15,698 parasites/ml) compared to 3 mg/kg/day dose of KET (72,898 parasites/ml) in brain in the pre-treatment group. In addition, KET combined with PYR significantly decreased the parasite load in the post-treatment group. Conclusions Our results indicated that KET has both prophylactic and therapeutic effects on acute phases of the disease.
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25
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Nakazawa Y, Oka M, Takehana M. Model for Studying Anti- Allergic Drugs for Allergic Conjunctivitis in Animals. Open Med (Wars) 2017; 12:231-238. [PMID: 28848937 PMCID: PMC5545756 DOI: 10.1515/med-2017-0034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 06/09/2017] [Indexed: 11/15/2022] Open
Abstract
Allergic conjunctivitis (AC), which is characterized by ocular itching, hyperemia, and edema, deteriorates quality of life. In this study, effects of anti-allergic drugs were evaluated by assessing eye-scratching behavior, the number of eosinophils in conjunctiva epithelial tissues, and concentrations of chemical mediators in the tears of the guinea pig model of ovalbumin (OA)-induced AC.
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Affiliation(s)
- Yosuke Nakazawa
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo105-8512, 105-8512, Japan
| | - Mikako Oka
- Laboratory of Clinical Pharmacology, Yokohama University of Pharmacy, Yokohama, Kanagawa, 245-0066, Japan
| | - Makoto Takehana
- Laboratory of Clinical Pharmacology, Yokohama University of Pharmacy, Yokohama, Kanagawa, 245-0066, Japan.,Faculty of Pharmacy, Keio University, Minato-ku, Tokyo105-8512, Japan
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26
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Faustino-Rocha AI, Ferreira R, Gama A, Oliveira PA, Ginja M. Antihistamines as promising drugs in cancer therapy. Life Sci 2017; 172:27-41. [DOI: 10.1016/j.lfs.2016.12.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/11/2016] [Accepted: 12/13/2016] [Indexed: 12/28/2022]
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27
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Panthavee W, Noda M, Danshiitsoodol N, Kumagai T, Sugiyama M. Characterization of Exopolysaccharides Produced by Thermophilic Lactic Acid Bacteria Isolated from Tropical Fruits of Thailand. Biol Pharm Bull 2017; 40:621-629. [DOI: 10.1248/bpb.b16-00856] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Wanchai Panthavee
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University
- Institute of Food Research and Product Development, Kasetsart University
| | - Masafumi Noda
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Narandalai Danshiitsoodol
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Takanori Kumagai
- Department of Molecular Microbiology and Biotechnology, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Masanori Sugiyama
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University
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28
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Abstract
Pruritus is a common problem that can result from many conditions. Some, such as fungal or parasitic infection, may be fairly obvious. However, others, such as iron deficiency and psychogenic disorder, are more difficult to diagnose. Evaluation must include a thorough inspection of the skin, history taking for drug intake and chemical exposure, and appropriate laboratory testing. The location on the body and characteristics of the itching may point to a cause. In some cases, attention to exacerbating factors (eg, dry skin, coarse fabrics against the skin, dry environmental conditions) and application of topical preparations may be sufficient. Antihistamines are the foundation of oral treatment, and with the advent of second-generation agents, they can be taken with fewer concerns about their sedative effects. Specific conditions of which pruritus is one feature may require specific treatment. For example, in patients undergoing dialysis, activated charcoal, UV light treatment, or heparin therapy may be useful.
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Affiliation(s)
- W G Phillips
- Department of Family Medicine, Medical College of Georgia, Augusta 30912
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El-Shitany NA, El-Desoky K. Cromoglycate, not ketotifen, ameliorated the injured effect of warm ischemia/reperfusion in rat liver: role of mast cell degranulation, oxidative stress, proinflammatory cytokine, and inducible nitric oxide synthase. Drug Des Devel Ther 2015; 9:5237-46. [PMID: 26396497 PMCID: PMC4577270 DOI: 10.2147/dddt.s88337] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Hepatic ischemia/reperfusion (ISCH/REP) is a major clinical problem that is considered to be the most common cause of postoperative liver failure. Recently, mast cells have been proposed to play an important role in the pathophysiology of ISCH/REP in many organs. In contrast, the role played by mast cells during ISCH/REP-induced liver damage has remained an issue of debate. This study aimed to investigate the protective role of mast cells in order to search for an effective therapeutic agent that could protect against fatal ISCH/REP-induced liver damage. A model of warm ISCH/REP was induced in the liver of rats. Four groups of rats were used in this study: Group I: SHAM (normal saline, intravenously [iv]); Group II: ISCH/REP; Group III: sodium cromoglycate + ISCH/REP (CROM + ISCH/REP), and Group IV: ketotifen (KET) + ISCH/REP (KET + ISCH/REP). Liver damage was assessed both histopathologically and biochemically. Mast cell degranulation was assessed histochemically. Lipid peroxidation (malondialdehyde [MDA]) as well as the levels of glutathione (GSH), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α), the formation of nitric oxide (NO), and the expression of inducible NO synthase (iNOS) were determined. The results of this study revealed increased mast cell degranulation in the liver during the acute phase of ISCH/REP. Moreover, CROM, but not KET, decreased the activity of alanine aminotransferase, aspartate aminotransferase, and lactic dehydrogenase and maintained normal liver tissue histology. Both CROM and KET protected against mast cell degranulation in the liver. In addition, both CROM and KET decreased IL-6 and TNF-α. However, CROM, but not KET, decreased MDA formation and increased GSH. Furthermore, KET, but not CROM, increased both NO formation and iNOS expression. In conclusion, this study clearly demonstrated mast cell degranulation in warm ISCH/REP in the liver of rats. More importantly, CROM, but not KET, ameliorated the effect of ISCH/REP-induced injury in rat liver. CROM may protect the liver through mast cell stabilization, inhibition of TNF-α, IL-6, MDA, and iNOS and increased GSH. KET may maintain ISCH/REP-induced liver injury through the NO/iNOS pathway.
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Affiliation(s)
- Nagla A El-Shitany
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Karema El-Desoky
- Department of Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Mast Cell Stabilizer (Ketotifen) in Fibromyalgia: Phase 1 Randomized Controlled Clinical Trial. Clin J Pain 2015; 31:836-842. [PMID: 25370135 DOI: 10.1097/ajp.0000000000000169] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Compared with pain-free controls, patients with fibromyalgia (FM) have more mast cells in the skin. Whether mast cells are involved in the pathogenesis of FM is unclear. We sought to determine the effects of a mast cell stabilizer (ketotifen) on FM symptoms. MATERIALS AND METHODS Fifty-one FM patients were randomized to daily oral ketotifen 2 mg bid (n=24) for 8 weeks or placebo (N=27). Mean age of patients was 51.2 years (SD=8.4); 88% were female and 88% were white; 22% were taking concomitant opiates; and mean pressure pain sensitivity (range, 0 to 20) was 10.0 (0.4). At study entry, the weekly average pain intensity was 6.4 (1.1) and the mean score on the Revised Fibromyalgia Impact Questionnaire-Revised was 66.8 (14.0). RESULTS We found no statistically significant treatment group differences from baseline in either group for the 2 primary measures: weekly average pain intensity (ketotifen -1.3 [1.9] vs. placebo -1.5 [1.9], P=0.7); and Fibromyalgia Impact Questionnaire-Revised score (-12.1 [19.5] vs. -12.2 [18.1], P=0.9). No secondary outcome measures (Brief Pain Inventory pain intensity and pressure pain sensitivity) reached statistical significance; results did not differ in the intent-to-treat and completer analyses. Other than transient sedation (6 [28.6%] vs. 1 [4.0%]), ketotifen was well tolerated. DISCUSSION The study results question whether skin mast cells play a major role in the pathogenesis of FM. However, given the role of mast cells in peripheral and central nociception, and the minimal side effects of ketotifen, a randomized clinical trial using increasing doses of ketotifen may be warranted.
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Rychter J, Ortega O, Berdun S, Arenas C, Lopez I, Espin F, Vergara P, Clavé P. Mast cell degranulation inhibits motor patterns of human ileum and sigmoid colon in vitro: relevance for postoperative ileus. Neurogastroenterol Motil 2015; 27:1098-109. [PMID: 25974622 DOI: 10.1111/nmo.12589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/16/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Local release of mast cell proteases during gastrointestinal surgery is associated with the inhibition of motility and postoperative ileus (POI). We determined whether activation of intramuscular mast cell affects the motor patterns of the human ileum and colon and whether proteases are involved. METHODS Motor response of ileal and colonic circular muscle strips was measured in organ bath. Mast cell degranulation was induced by compound 48/80 (c48/80; 25-675 μg/mL). Motor response was quantified as tone, rhythmic phasic contractions (RPCs) and contractions to electric field stimulation (EFS; 40 Hz), and bethanechol-evoked contractions. Ketotifen (10(-6) mol/L) and a protease inhibitor cocktail (P8340) were used to evaluate the role of mast cell mediators. KEY RESULTS (a) c48/80 impaired the spontaneous and the electrically evoked motor response in small bowel and colonic strips (sigmoid colon EC50 : 460.0 μg/mL for RPCs and 8.9 μg/mL for electrically evoked contraction amplitudes) and bethanechol-evoked contractions. (b) Preincubation with ketotifen (10(-6) mol/L, 1 h) prevented the impairment of RPCs and EFS-evoked contractions in the sigmoid colon and ileum but not in the right colon. (c) Preincubation with P8340 also prevented the impairment of contractions in the sigmoid colon but not in the ileum or the right colon. CONCLUSIONS & INFERENCES Mast cell degranulation by c48/80 inhibits the spontaneous and the nerve-mediated motor response in the human ileum and colon. The effect is partially mediated by mast cell proteases and could be relevant in the pathophysiology of POI.
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Affiliation(s)
- J Rychter
- CIBERehd, Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain.,Department of Cell Biology, Physiology and Immunology, Veterinary School, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - O Ortega
- Department of Surgery, Hospital de Mataró, Universitat Autónoma de Barcelona, Mataró, Catalonia, Spain
| | - S Berdun
- Department of Cell Biology, Physiology and Immunology, Veterinary School, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - C Arenas
- CIBERehd, Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain
| | - I Lopez
- Department of Surgery, Hospital de Mataró, Universitat Autónoma de Barcelona, Mataró, Catalonia, Spain
| | - F Espin
- Department of Surgery, Hospital de Mataró, Universitat Autónoma de Barcelona, Mataró, Catalonia, Spain
| | - P Vergara
- CIBERehd, Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain.,Department of Cell Biology, Physiology and Immunology, Veterinary School, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - P Clavé
- CIBERehd, Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain.,Department of Surgery, Hospital de Mataró, Universitat Autónoma de Barcelona, Mataró, Catalonia, Spain
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Zhang T, Finn DF, Barlow JW, Walsh JJ. Mast cell stabilisers. Eur J Pharmacol 2015; 778:158-68. [PMID: 26130122 DOI: 10.1016/j.ejphar.2015.05.071] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 05/05/2015] [Accepted: 05/17/2015] [Indexed: 01/18/2023]
Abstract
Mast cells play a critical role in type 1 hypersensitivity reactions. Indeed, mast cell mediators are implicated in many different conditions including allergic rhinitis, conjunctivitis, asthma, psoriasis, mastocytosis and the progression of many different cancers. Thus, there is intense interest in the development of agents which prevent mast cell mediator release or which inhibit the actions of such mediators once released into the environment of the cell. Much progress into the design of new agents has been made since the initial discovery of the mast cell stabilising properties of khellin from Ammi visnaga and the clinical approval of cromolyn sodium. This review critically examines the progress that has been made in the intervening years from the design of new agents that target a specific signalling event in the mast cell degranulation pathway to those agents which have been developed where the precise mechanism of action remains elusive. Particular emphasis is also placed on clinically used drugs for other indications that stabilise mast cells and how this additional action may be harnessed for their clinical use in disease processes where mast cells are implicated.
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Affiliation(s)
- Tao Zhang
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland
| | - Deirdre Frances Finn
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland
| | - James William Barlow
- Department of Pharmaceutical & Medicinal Chemistry, Royal College of Surgeons in Ireland, Stephens Green, Dublin 2, Ireland
| | - John Jarlath Walsh
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland.
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Riccardi VM. Ketotifen suppression of NF1 neurofibroma growth over 30 years. Am J Med Genet A 2015; 167:1570-7. [PMID: 25974154 DOI: 10.1002/ajmg.a.37045] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 01/29/2015] [Indexed: 01/23/2023]
Abstract
A patient with NF1 was treated with oral ketotifen for 30 years since infancy. Review of the patient's course and treatment details establishes a basis for reconsideration of several fundamental precepts about NF1 pathogenesis. The data suggest a distinctive benefit to treating an NF1 patient with an inhibitor of mast cell degranulation before cutaneous neurofibromas are clinically apparent: the neurofibromas appear to be arrested at a very early stage of development. The patient's skin was especially remarkable for both the paucity of cutaneous neurofibromas and the distinctive monotonous uniformity of those present, which were small and flat or barely sessile. While the data do not, of themselves, prove that ketotifen treatment commencing in childhood preempts neurofibroma maturation, in the context of earlier publications, they certainly warrant further investigation.
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Monument MJ, Hart DA, Salo PT, Befus AD, Hildebrand KA. Neuroinflammatory Mechanisms of Connective Tissue Fibrosis: Targeting Neurogenic and Mast Cell Contributions. Adv Wound Care (New Rochelle) 2015; 4:137-151. [PMID: 25785237 DOI: 10.1089/wound.2013.0509] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 11/26/2013] [Indexed: 12/26/2022] Open
Abstract
Significance: The pathogenesis of fibrogenic wound and connective tissue healing is complex and incompletely understood. Common observations across a vast array of human and animal models of fibroproliferative conditions suggest neuroinflammatory mechanisms are important upstream fibrogenic events. Recent Advances: As detailed in this review, mast cell hyperplasia is a common observation in fibrotic tissue. Recent investigations in human and preclinical models of hypertrophic wound healing and post-traumatic joint fibrosis provides evidence that fibrogenesis is governed by a maladaptive neuropeptide-mast cell-myofibroblast signaling pathway. Critical Issues: The blockade and manipulation of these factors is providing promising evidence that if timed correctly, the fibrogenic process can be appropriately regulated. Clinically, abnormal fibrogenic healing responses are not ubiquitous to all patients and the identification of those at-risk remains an area of priority. Future Directions: Ultimately, an integrated appreciation of the common pathobiology shared by many fibrogenic connective tissue conditions may provide a scientific framework to facilitate the development of novel antifibrotic prevention and treatment strategies.
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Affiliation(s)
- Michael J. Monument
- Division of Orthopaedic Surgery, McCaig Institute for Bone & Joint Health, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David A. Hart
- Division of Orthopaedic Surgery, McCaig Institute for Bone & Joint Health, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul T. Salo
- Division of Orthopaedic Surgery, McCaig Institute for Bone & Joint Health, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - A. Dean Befus
- Pulmonary Research Group, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kevin A. Hildebrand
- Division of Orthopaedic Surgery, McCaig Institute for Bone & Joint Health, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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Hong SS, Jeong W, Kim JK, Kwon JG, Lee JY, Ahn EK, Oh J, Seo DW, Oh JS. Neolignan inhibitors of antigen-induced degranulation in RBL-2H3 cells from the needles of Pinus thunbergii. Fitoterapia 2014; 99:347-51. [PMID: 25451795 DOI: 10.1016/j.fitote.2014.10.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/21/2014] [Accepted: 10/26/2014] [Indexed: 02/07/2023]
Abstract
The ethanolic extract of the needles of Pinus thunbergii was found to suppress antigen mediated degranulation of rat basophilic leukemia (RBL-2H3) cells. A new neolignan glycoside, named pinusthunbergiside A (1), as well as six known neolignan glycosides (2-7) were isolated from the ethanolic extract using bioassay-guided fractionation. Their structures were elucidated by a combination of 1D and 2D NMR, HRESI-MS, and circular dichroism (CD) data. Compounds 2-7 were found for the first time in this plant. The inhibitory effects of isolated constituents on the release of β-hexosaminidase from RBL-2H3 cells were examined, and compounds 2, 3, 5, and 6 were found to show the inhibitory activity with IC₅₀ values ranging between 52.3 and 75.3 μM.
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Affiliation(s)
- Seong Su Hong
- Gyeonggi Institute of Science & Technology Promotion Natural Products Research Institute, Suwon 443-766, Republic of Korea
| | - Wonsik Jeong
- Gyeonggi Institute of Science & Technology Promotion Natural Products Research Institute, Suwon 443-766, Republic of Korea; College of Pharmacy, Dankook University, Cheonan 330-714, Republic of Korea
| | - Jin Kyu Kim
- Gyeonggi Institute of Science & Technology Promotion Natural Products Research Institute, Suwon 443-766, Republic of Korea
| | - Jin Gwan Kwon
- Gyeonggi Institute of Science & Technology Promotion Natural Products Research Institute, Suwon 443-766, Republic of Korea
| | - Jae Yeon Lee
- Gyeonggi Institute of Science & Technology Promotion Natural Products Research Institute, Suwon 443-766, Republic of Korea
| | - Eun-Kyung Ahn
- Gyeonggi Institute of Science & Technology Promotion Natural Products Research Institute, Suwon 443-766, Republic of Korea
| | - Junho Oh
- Department of Biology, Duke University, Durham, NC 27708, USA
| | - Dong-Wan Seo
- College of Pharmacy, Dankook University, Cheonan 330-714, Republic of Korea
| | - Joa Sub Oh
- Gyeonggi Institute of Science & Technology Promotion Natural Products Research Institute, Suwon 443-766, Republic of Korea; College of Pharmacy, Dankook University, Cheonan 330-714, Republic of Korea.
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Bolleddula J, DeMent K, Driscoll JP, Worboys P, Brassil PJ, Bourdet DL. Biotransformation and bioactivation reactions of alicyclic amines in drug molecules. Drug Metab Rev 2014; 46:379-419. [DOI: 10.3109/03602532.2014.924962] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Lee EY, Chun MK, Chang JS, Choi HK. Development of matrix based transdermal delivery system for ketotifen. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2014. [DOI: 10.1007/s40005-014-0126-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Comparison of preservative-free ketotifen fumarate and preserved olopatadine hydrochloride eye drops in the treatment of moderate to severe seasonal allergic conjunctivitis. J Fr Ophtalmol 2014; 37:1-8. [DOI: 10.1016/j.jfo.2013.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 02/18/2013] [Accepted: 02/19/2013] [Indexed: 11/30/2022]
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Hildebrand KA. Posttraumatic elbow joint contractures: defining pathologic capsular mechanisms and potential future treatment paradigms. J Hand Surg Am 2013; 38:2227-33. [PMID: 24075128 DOI: 10.1016/j.jhsa.2013.07.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 07/29/2013] [Accepted: 07/30/2013] [Indexed: 02/02/2023]
Abstract
The Andrew J. Weiland Medal is presented by the American Society for Surgery of the Hand to a midcareer researcher who is dedicated to advancing patient care in the field of hand surgery. This essay, awarded the Weiland Medal in 2012, focuses on posttraumatic elbow joint contractures. Joint contractures are well known to hand surgeons because they limit function of our patients. There is a thorough understanding of the pathoanatomy underlying joint contractures. However, the mechanisms leading to the pathoanatomy are either unknown or partially understood, depending on the etiology of the particular clinical condition. This review describes our research over the past 14 years on posttraumatic elbow joint contractures. It defines pathologic cellular, matrix, and growth factor changes in the joint capsule, elaborates on the development of an animal model of posttraumatic joint contractures, presents an evaluation of a potential prevention strategy based on our research, and outlines future plans to bring this work to the clinical realm for the benefit of patients.
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Affiliation(s)
- Kevin A Hildebrand
- Department of Surgery, University of Calgary and Alberta Health Services-Calgary Zone, Calgary, Alberta, Canada..
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Mantelli F, Calder VL, Bonini S. The Anti-Inflammatory Effects of Therapies for Ocular Allergy. J Ocul Pharmacol Ther 2013; 29:786-93. [DOI: 10.1089/jop.2013.0161] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Stefano Bonini
- Department of Ophthalmology, Campus Bio-Medico University of Rome, Rome, Italy
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Sokol KC, Amar NK, Starkey J, Grant JA. Ketotifen in the management of chronic urticaria: resurrection of an old drug. Ann Allergy Asthma Immunol 2013; 111:433-6. [PMID: 24267353 DOI: 10.1016/j.anai.2013.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 10/01/2013] [Accepted: 10/06/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Kristin C Sokol
- Division of Allergy and Immunology, University of Texas Medical Branch, Galveston, Texas.
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Zhang A, Chi X, Luo G, Hei Z, Xia H, Luo C, Wang Y, Mao X, Xia Z. Mast cell stabilization alleviates acute lung injury after orthotopic autologous liver transplantation in rats by downregulating inflammation. PLoS One 2013; 8:e75262. [PMID: 24116032 PMCID: PMC3792971 DOI: 10.1371/journal.pone.0075262] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 08/12/2013] [Indexed: 12/16/2022] Open
Abstract
Background Acute lung injury (ALI) is one of the most severe complications after orthotopic liver transplantation. Amplified inflammatory response after transplantation contributes to the process of ALI, but the mechanism underlying inflammation activation is not completely understood. We have demonstrated that mast cell stabilization attenuated inflammation and ALI in a rodent intestine ischemia/reperfusion model. We hypothesized that upregulation of inflammation triggered by mast cell activation may be involve in ALI after liver transplantation. Methods Adult male Sprague–Dawley rats received orthotopic autologous liver transplantation (OALT) and were executed 4, 8, 16, and 24 h after OALT. The rats were pretreated with the mast cell stabilizers cromolyn sodium or ketotifen 15 min before OALT and executed 8 h after OALT. Lung tissues and arterial blood were collected to evaluate lung injury. β-hexosaminidase and mast cell tryptase levels were assessed to determine the activation of mast cells. Tumor necrosis factor α (TNF-α), interleukin (IL)-1β and IL-6 in serum and lung tissue were analyzed by enzyme-linked immunosorbent assay. Nuclear factor-kappa B (NF-κB) p65 translocation was assessed by Western blot. Results The rats that underwent OALT exhibited severe pulmonary damage with a high wet-to-dry ratio, low partial pressure of oxygen, and low precursor surfactant protein C levels, which corresponded to the significant elevation of pro-inflammatory cytokines, β-hexosaminidase, and tryptase levels in serum and lung tissues. The severity of ALI progressed and maximized 8 h after OALT. Mast cell stabilization significantly inhibited the activation of mast cells, downregulated pro-inflammatory cytokine levels and translocation of NF-κB, and attenuated OALT-induced ALI. Conclusions Mast cell activation amplified inflammation and played an important role in the process of post-OALT related ALI.
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Affiliation(s)
- Ailan Zhang
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China
| | - Xinjin Chi
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China
| | - Gangjian Luo
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China
| | - Ziqing Hei
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China
- * E-mail:
| | - Hua Xia
- Department of Anesthesiology, the Affiliated Hospital of Luzhou Medical College, Luzhou City, People's Republic of China
| | - Chenfang Luo
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China
| | - Yanling Wang
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China
| | - Xiaowen Mao
- Department of Anesthesiology, Research Centre of Heart, Brain, Hormone and Healthy Aging, University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Zhengyuan Xia
- Department of Anesthesiology, Research Centre of Heart, Brain, Hormone and Healthy Aging, University of Hong Kong, Hong Kong SAR, People's Republic of China
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de Haan JJ, Hadfoune M, Lubbers T, Hodin C, Lenaerts K, Ito A, Verbaeys I, Skynner MJ, Cailotto C, van der Vliet J, de Jonge WJ, Greve JWM, Buurman WA. Lipid-rich enteral nutrition regulates mucosal mast cell activation via the vagal anti-inflammatory reflex. Am J Physiol Gastrointest Liver Physiol 2013; 305:G383-91. [PMID: 23812038 DOI: 10.1152/ajpgi.00333.2012] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Nutritional stimulation of the cholecystokinin-1 receptor (CCK-1R) and nicotinic acetylcholine receptor (nAChR)-mediated vagal reflex was shown to reduce inflammation and preserve intestinal integrity. Mast cells are important early effectors of the innate immune response; therefore modulation of mucosal mast cells is a potential therapeutic target to control the acute inflammatory response in the intestine. The present study investigates intestinal mast cell responsiveness upon nutritional activation of the vagal anti-inflammatory reflex during acute inflammation. Mucosal mast cell degranulation was induced in C57/Bl6 mice by administration of Salmonella enterica LPS. Lipid-rich enteral feeding prior to LPS significantly decreased circulatory levels of mouse mast cell protease at 30 min post-LPS compared with isocaloric low-lipid nutrition or fasting. CCK-1R blockage reversed the inhibitory effects of lipid-rich feeding, whereas stimulation of the peripheral CCK-1R mimicked nutritional mast cell inhibition. The effects of lipid-rich nutrition were negated by nAChR blockers chlorisondamine and α-bungarotoxin and vagal intestinal denervation. Accordingly, release of β-hexosaminidase by MC/9 mast cells following LPS or IgE-ovalbumin complexes was dose dependently inhibited by acetylcholine and nicotine. Application of GSK1345038A, a specific agonist of the nAChR α7, in bone marrow-derived mast cells from nAChR β2-/- and wild types indicated that cholinergic inhibition of mast cells is mediated by the nAChR α7 and is independent of the nAChR β2. Together, the present study reveals mucosal mast cells as a previously unknown target of the nutritional anti-inflammatory vagal reflex.
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Affiliation(s)
- Jacco J de Haan
- Dept. of Surgery at Maastricht Univ. Medical Centre+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
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Comparison of the efficacy of KOB03, ketotifen, and montelukast in an experimental mouse model of allergic rhinitis. Int Immunopharmacol 2013; 16:254-60. [PMID: 23643816 DOI: 10.1016/j.intimp.2013.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 02/28/2013] [Accepted: 04/04/2013] [Indexed: 11/23/2022]
Abstract
KOB03 is a polyherbal medicine derived from an oriental prescription traditionally used to treat allergic diseases. In the present study, we compared the efficacy of KOB03 with modern drugs such as ketotifen and montelukast in an experimental mouse model of allergic rhinitis (AR). Ketotifen is a H1 receptor antagonist and montelukast is a leukotriene receptor antagonist. Mice were treated with KOB03, ketotifen or montelukast in an established AR mouse model using ovalbumin (OVA)-sensitized/challenged BALB/c mice. The treatment of KOB03 had inhibitory effects on symptom scores, serum levels of OVA-specific IgE, histamine, leukotriene C4, IL-4, TNF-α, and IL-1β in AR mice, and the histolopathological changes of nasal mucosa with mucin release and inflammation. AR mice treated with KOB03 had significantly lower serum levels of OVA-specific IgE, LTC4, IL-4, and IL-1β than mice treated with ketotifen, whereas they only had significantly lower serum levels of OVA-specific IgE and IL-4 than those treated with montelukast. In addition, the histolopathological changes of nasal mucosa with eosinophil infiltration were significantly lower in the KOB03-treated mice than those in the ketotifen and montelukast-treated group. These results suggest that KOB03 has therapeutic potential for treating AR like other modern medicines.
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Graham AC, Hilmer KM, Zickovich JM, Obar JJ. Inflammatory response of mast cells during influenza A virus infection is mediated by active infection and RIG-I signaling. THE JOURNAL OF IMMUNOLOGY 2013; 190:4676-84. [PMID: 23526820 DOI: 10.4049/jimmunol.1202096] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Influenza A virus (IAV) is a major respiratory pathogen of both humans and animals. The lung is protected from pathogens by alveolar epithelial cells, tissue-resident alveolar macrophages, dendritic cells, and mast cells. The role of alveolar epithelial cells, endothelial cells, and alveolar macrophages during IAV infection has been studied previously. In this study, we address the role of mast cells during IAV infection. Respiratory infection with A/WSN/33 causes significant disease and immunopathology in C57BL/6 mice but not in B6.Cg-Kit(W-sh) mice, which lack mast cells. During in vitro coculture, A/WSN/33 caused mast cells to release histamine, secrete cytokines and chemokines, and produce leukotrienes. Moreover, when mast cells were infected with IAV, the virus did not replicate within mast cells. Importantly, human H1N1, H3N2, and influenza B virus isolates also could activate mast cells in vitro. Mast cell production of cytokines and chemokines occurs in a RIG-I/MAVS-dependent mechanism; in contrast, histamine production occurred through a RIG-I/MAVS-independent mechanism. Our data highlight that, following IAV infection, the response of mast cells is controlled by multiple receptors. In conclusion, we identified a unique inflammatory cascade activated during IAV infection that could potentially be targeted to limit morbidity following IAV infection.
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Affiliation(s)
- Amy C Graham
- Department of Immunology and Infectious Diseases, Montana State University, Bozeman, MT 59718, USA
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A class of tricyclic compounds blocking malaria parasite oocyst development and transmission. Antimicrob Agents Chemother 2012; 57:425-35. [PMID: 23129054 DOI: 10.1128/aac.00920-12] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Malaria is a deadly infectious disease in many tropical and subtropical countries. Previous efforts to eradicate malaria have failed, largely due to the emergence of drug-resistant parasites, insecticide-resistant mosquitoes and, in particular, the lack of drugs or vaccines to block parasite transmission. ATP-binding cassette (ABC) transporters are known to play a role in drug transport, metabolism, and resistance in many organisms, including malaria parasites. To investigate whether a Plasmodium falciparum ABC transporter (Pf14_0244 or PfABCG2) modulates parasite susceptibility to chemical compounds or plays a role in drug resistance, we disrupted the gene encoding PfABCG2, screened the recombinant and the wild-type 3D7 parasites against a library containing 2,816 drugs approved for human or animal use, and identified an antihistamine (ketotifen) that became less active against the PfABCG2-disrupted parasite in culture. In addition to some activity against asexual stages and gametocytes, ketotifen was highly potent in blocking oocyst development of P. falciparum and the rodent parasite Plasmodium yoelii in mosquitoes. Tests of structurally related tricyclic compounds identified additional compounds with similar activities in inhibiting transmission. Additionally, ketotifen appeared to have some activity against relapse of Plasmodium cynomolgi infection in rhesus monkeys. Further clinical evaluation of ketotifen and related compounds, including synthetic new derivatives, in blocking malaria transmission may provide new weapons for the current effort of malaria eradication.
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Horak F, Stuebner P, Zieglmayer R, McWhirter CL, Gekkieva M. Efficacy and safety of ketotifen eye drops as adjunctive therapy to mometasone nasal spray in subjects with seasonal allergic rhinoconjunctivitis. Clin Drug Investig 2012; 23:597-604. [PMID: 17535073 DOI: 10.2165/00044011-200323090-00006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To compare the efficacy and safety of ketotifen 0.025% ophthalmic solution (one drop/eye) with placebo as adjunctive therapy to mometasone nasal spray (50 microg/spray, two puffs/nostril) in subjects with seasonal allergic rhinoconjunctivitis (SARC). STUDY DESIGN Single-centre, randomised, double-masked, two-treatment, two-period crossover study. SETTING 8-hour allergen challenge in the Vienna Challenge Chamber. STUDY PARTICIPANTS Subjects were >/=18 years old, had a >/=2-year history of SARC, and were sufficiently responsive to allergen challenge. INTERVENTIONS During each challenge, subjects received a single dose of mometasone + ketotifen or mometasone + placebo. MAIN OUTCOME MEASURES AND RESULTS 47 subjects were randomised, and 44 completed both treatment sequences. Efficacy was based on mean area under the curve (AUC) values for symptom relief scores over time, with the primary variable being the AUC 4-6 hours postdose (AUC(4-6)) for relief of ocular itching. Between-treatment differences were assessed using analysis of variance. While improvement in ocular itching (AUC(4-6)) was observed with both treatments, improvement was significantly (p = 0.014) better with mometasone + ketotifen versus mometasone + placebo, as was improvement based on AUC(0-6) (p = 0.009) and AUC(0-2) (p = 0.006). Similar trends (in favour of mometasone + ketotifen) were observed for improvements in ocular redness, running nose, sneezing and ocular/nasal composite scores (p </= 0.05). None of the safety findings (slit-lamp biomicroscopy, vital signs, adverse events) were clinically significant. One subject discontinued treatment due to mild pharyngitis. CONCLUSION Ketotifen eye drops adjunctive to mometasone nasal spray provided greater relief of both ocular and nasal signs and symptoms than mometasone alone in subjects with SARC.
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Affiliation(s)
- F Horak
- ENT Clinic, University of Vienna, Vienna, Austria
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Bioequivalence assessment of Fumatifen® tablet to Zaditen® tablet (ketotifen fumarate 1 mg) by liquid chromatography tandem mass spectrometry. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2012. [DOI: 10.1007/s40005-012-0031-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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