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Deguchi S, Iwakami A, Tujigiwa M, Otake H, Mano Y, Yamamoto N, Nakazawa Y, Misra M, Nagai N. Recovery from indomethacin-induced gastrointestinal bleeding by treatment with teprenone. J Pharm Health Care Sci 2023; 9:44. [PMID: 38012767 PMCID: PMC10683117 DOI: 10.1186/s40780-023-00312-y] [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: 06/27/2023] [Accepted: 10/12/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Gastrointestinal injuries caused by nonsteroidal anti-inflammatory drugs (NSAIDs) is a serious side effect in patients with rheumatoid arthritis (RA). However, effective therapeutic strategies have yet to be established. In this study, we investigated the therapeutic effects of teprenone (TEP), a gastric mucosal protective drug, on NSAID-induced gastrointestinal injuries in rats with RA (AA rats). METHODS Gastrointestinal injury was induced by oral administration of indomethacin (IMC), a typical NSAID. TEP was orally administered after IMC-induced gastrointestinal bleeding, and the stomach, jejunum, and ileum were excised. RESULTS On day 14 of IMC administration, lesion areas in the stomach, jejunum, and ileum were significantly larger in AA rats than in normal rats. When TEP was orally administered to AA rats, the lesion areas in the stomach, jejunum, and ileum significantly decreased compared with those in control rats (IMC-induced AA rats). Therefore, we measured NOS2 mRNA and NO levels, which were significantly decreased in rats with IMC-induced AA after treatment with TEP. CONCLUSIONS These results suggest that the oral administration of TEP may be useful for the treatment of NSAID-induced gastrointestinal injuries in patients with RA.
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Affiliation(s)
- Saori Deguchi
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka,Osaka, 577-8502, Japan
| | - Ayusa Iwakami
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka,Osaka, 577-8502, Japan
| | - Mizuki Tujigiwa
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka,Osaka, 577-8502, Japan
| | - Hiroko Otake
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka,Osaka, 577-8502, Japan
| | - Yu Mano
- Department of Pharmacy, Bell Land General Hospital, 500-3, Higashiyama, Naka-ku, Sakai, Osaka, 599-8247, Japan
| | - Naoki Yamamoto
- Support Office for Bioresource Research, Research Promotion Headquarters, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Yosuke Nakazawa
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan
| | - Manju Misra
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research; Opposite AirForce Station, Palaj Basan Road, Village Palaj, Gandhinagar, 382355, Gujarat, India
- Graduate school of Pharmacy, Gujarat Technological University Gandhinagar Campus Nr. Government Polytechnic K-6 Circle, E-4 Electronic Estate G.I.D.C, Sector-26, Gandhinagar, 382028, Gujarat, India
| | - Noriaki Nagai
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka,Osaka, 577-8502, Japan.
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Abstract
The field of nanomedicine continues to grow with new technologies and formulations in development for several disease states. Much research focuses on the use of injectable nanomedicines for treatment of neoplasms; however, there are several formulations in development that use nanotechnology that can be administered enterally for noncancer indications. These nanomedicine treatments have been developed for systemic drug delivery or local drug delivery along the gastrointestinal tract. This Review gives a brief overview of the alimentary canal and highlights new research in nanomedicine in noncancer disease states delivered via enteral routes of administration. Relevant recent research is summarized on the basis of the targeted site of action or absorption, including the buccal, sublingual, stomach, small intestine, and large intestine areas of the alimentary canal. The benefits of nanodrug delivery are discussed as well as barriers and challenges for future development in the field.
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Affiliation(s)
- Brianna Cote
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, 2730 S. Moody Avenue, RLSB, Portland, Oregon 97201, United States
| | - Deepa Rao
- School of Pharmacy, Pacific University, 222 SE 8th Avenue, Suite 451, Hillsboro, Oregon 97123, United States
| | - Adam W G Alani
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, 2730 S. Moody Avenue, RLSB, Portland, Oregon 97201, United States.,Biomedical Engineering Department, Oregon Health & Science University, 2730 S. Moody Avenue, RLSB, Portland, Oregon 97201, United States.,Knight Cancer Institute, Oregon Health & Science University, 2730 S. Moody Avenue, RLSB, Portland, Oregon 97201, United States
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Nagai N, Ogata F, Otake H, Kawasaki N. Oral Administration System Based on Meloxicam Nanocrystals: Decreased Dose Due to High Bioavailability Attenuates Risk of Gastrointestinal Side Effects. Pharmaceutics 2020; 12:pharmaceutics12040313. [PMID: 32244754 PMCID: PMC7238067 DOI: 10.3390/pharmaceutics12040313] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/19/2022] Open
Abstract
Meloxicam (MLX) is widely applied as a therapy for rheumatoid arthritis (RA); however, it takes far too long to reach its peak plasma concentration for a quick onset effect, and gastrointestinal toxicity has been observed in RA patients taking it. To solve these problems, we designed MLX solid nanoparticles (MLX-NPs) by the bead mill method and used them to prepare new oral formulations. The particle size of the MLX-NPs was approximately 20-180 nm, and they remained in the nano-size range for 1 month. The tmax of MLX-NPs was shorter than that of traditional MLX dispersions (MLX-TDs), and the intestinal penetration of MLX-NPs was significantly higher in comparison with MLX-TDs (P < 0.05). Caveolae-dependent endocytosis (CavME), clathrin-dependent endocytosis (CME), and micropinocytosis (MP) were found to be related to the high intestinal penetration of MLX-NPs. The area under the plasma MLX concentration-time curve (AUC) for MLX-NPs was 5-fold higher than that for MLX-TDs (P < 0.05), and the AUC in rats administered 0.05 mg/kg MLX-NPs were similar to rats administered the therapeutic dose of 0.2 mg/kg MLX-TDs. In addition, the anti-inflammatory effect of the MLX-NPs was also significantly higher than that of MLX-TDs at the corresponding dose (P < 0.05), and the therapeutic effect of 0.2 mg/kg MLX-TDs and 0.05 mg/kg MLX-NPs in adjuvant-induced arthritis (AA) rats showed no difference. Furthermore, the gastrointestinal lesions in AA rats treated repetitively with 0.05 mg/kg MLX-NPs were fewer than in rats receiving 0.2 mg/kg MLX-TDs (P < 0.05). In conclusion, we demonstrate that MLX solid nanoparticles allow a quick onset of therapeutic effect and that three endocytosis pathways, CavME, CME, and MP, are related to the high absorption of solid nanoparticles. In addition, we found that MLX solid nanoparticles make it possible to reduce the amount of orally administered drugs, and treatment with low doses of MLX-NPs allows RA therapy without intestinal ulcerogenic responses to MLX. These findings are useful for designing therapies for RA patients.
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