Anti-pruritic effect of L-carnitine against chloroquine-induced pruritus mediated via nitric oxide pathway

BACKGROUND

Pruritus, or itching, is a distressing symptom associated with various dermatological and systemic diseases. L-carnitine (βeta hydroxy-γ-tri methyl amino-butyric acid), is a naturally occurring substance, it controls numerous physiological processes. The present research aims to identify L-carnitine for its anti-pruritic effect via nitric oxide-dependent mechanism.

METHODS

Chloroquine-induced pruritus serves as an experimental model to investigate possible therapeutic interventions. In this study, we evaluated the efficacy of L-carnitine in combating oxidative stress, nitric oxide, and inflammatory cytokines in a chloroquine-induced pruritus model.

RESULTS

L-carnitine treatment significantly reduced scratching behavior compared to the disease group (***P < 0.001 vs. chloroquine group), indicating its antipruritic potential. The markers of oxidative stress, GST, GSH, Catalase, and LPO were dysregulated in the disease model, but administration of L-carnitine restored GST, GSH, and Catalase levels and decreased LPO levels (***P < 0.001 vs. chloroquine group), thereby alleviating oxidative stress. L-carnitine also reduced nitric oxide synthase (NOS) activity, suggesting that it modulates nitric oxide signaling pathways involved in pruritus. In addition, L-carnitine lowered levels of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), inflammatory marker nuclear factor kappa B (p-NFκB) and also reduces an inflammatory enzyme, cyclooxygenase-2 (COX-2), determined by ELISA (Enzyme-Linked Immunosorbent Assay) (***P < 0.001 vs. chloroquine group). It downregulates nNOS mRNA expression confirmed by real-time polymerase chain reaction (RT-PCR).

CONCLUSION

These findings highlight the therapeutic effects of L-carnitine in alleviating chloroquine-induced pruritus.

Emodin alleviates chronic constriction injury-induced neuropathic pain and inflammation via modulating PPAR-gamma pathway

Neuropathic pain has been characterized as chronic pain resulting from pathological damage to the sensorimotor system. Because of its complex nature, it remains refractory to most of the therapeutic interventions, and surgical intervention and physiotherapy alongside steroidal treatments remain the only treatment protocols with limited success, hence solidifying the need to find efficacious therapeutic alternatives. Emodin was used as a post-treatment for its potential to be neuroprotective in the treatment of chronic constriction injury-induced NP. The first day following surgery, Emodin treatment began, and it lasted until the 21st day. On days 3, 7, 14 and 21, all behavioral investigations were conducted. The sciatic nerve and spinal cord were extracted for further molecular examination. Emodin elevated response latency, was able to delay the onset of mechanical hyperalgesia in rats on days 7, 14, and 21 and reduced the CCI-induced paw deformation. Emodin treatment significantly reduced lipid peroxidation and NO levels while restoring the GST, GSH and catalase. It significantly improved the disorientation of the sciatic nerve and spinal cord confirmed by H & E staining and reduced inflammatory markers as observed by the quantification of COX-2, TNF-α, p-NFκb and up-regulated PPAR-γ levels by ELISA and PCR. According to the findings, Emodin has antinociceptive and anti-hyperalgesic properties, which reduced pain perception and inflammation. We also suggested the involvement of PPAR-γ pathway in the therapeutic potential of emodin in chronic nerve injury.

Patient characteristics and clinical outcomes of type 2 myocardial infarction in patients with acute ischemic stroke in the united states

Background

Type 2 myocardial infarction (MI) due to supply-demand mismatch may occur as a sequala of acute ischemic stroke (AIS). However, scarce data exits on the patient profiles and the prognostic impact of type 2 MI on outcomes of AIS.

Purpose

To determine the risk profiles and examine the association of type 2 MI with outcomes and resource utilization in primary AIS hospitalizations.

Methods

We utilized the Nationwide Readmission Database from October 1st, 2017 to December 31st, 2018 to identify primary AIS hospitalizations with and without type 2 MI in the United States. The International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes I63.x were utilized to identify patients with AIS. Complex samples multivariable logistic and linear regression models were used to determine the predictors of type 2 MI and the association with outcomes (in-hospital mortality, poor functional outcomes [defined as a composite of mortality or discharge to hospice or to a long-term facility], index length of stay, hospital costs, discharge to nursing facility, and 30-day all-cause readmissions).

Results

Of 587,550 AIS hospitalizations included in this study, 4,182 (0.71%) had type 2 MI. Compared to AIS hospitalization without type 2 MI, those with type 2 MI were older (73 years vs. 70 years; P&lt;0.001), more likely to be females (52% vs. 49.7%; P&lt;0.001), and had a higher prevalence of heart failure (32% vs. 15.5%; P&lt;0.001), atrial fibrillation (38.5% vs. 24.2%; P&lt;0.001), prior myocardial infarction (8.8% vs. 7.7%; P&lt;0.001), valvular heart disease (17% vs. 9.8%; P&lt;0.001), peripheral vascular disease (12.2% vs. 9.2%; P&lt;0.001), chronic kidney disease (24.4% vs. 16.7%; P&lt;0.001), neurological disorders (49.3% vs. 34.6%; P&lt;0.001), drug abuse (4.9% vs. 4.1%; P=0.04), chronic liver disease (2.6% vs. 1.7%; P&lt;0.001), chronic lung disease (18.1% vs. 15.8%; P&lt;0.001), anemia (4.3% vs. 2.8%; P&lt;0.001), and weight loss (9.7% vs. 4.4%; P&lt;0.001). Compared with their counterparts without type 2 MI, AIS with type 2 MI had significantly higher in-hospital mortality, poor functional outcomes, hospital costs, rate of discharge to nursing facility, length of stay, and rate of 30-day all-cause readmissions (Table 1). Heart failure, weight loss, neurological disorders, drug abuse, valvular heart disease, atrial fibrillation, chronic kidney disease, and age (per year) were identified as independent predictors of type 2 MI among AIS hospitalizations (Figure 1).

Conclusion

Patients with AIS complicated by type 2 MI have a high prevalence of underlying cardiovascular disease. In addition, type 2 MI in patients hospitalized with AIS is associated with poor prognosis and higher resource utilization.

Funding Acknowledgement

Type of funding sources: None.

Computational and pharmacological investigation of novel 1,5-diaryl-1,4-pentadien-3-one derivatives for analgesic, anti-inflammatory and anticancer potential

Objective(s):

The novel 1,5-diaryl-1,4-pentadien-3-one derivatives were studied for analgesic, anti-inflammatory and anticancer potential to establish their role in pain, inflammatory disorders and cancer.

Materials and Methods:

Two 1,5- diaryl-1,4-pentadien-3-one derivatives: (1E,4E)- 5-(4-fluoro phenyl)-1-(4-methoxyphenyl)- 2-methylpenta-1,4-dien-3-one (A2K2A17) and (1E,4E)-5-(4-nitrophenyl)-1-(4-nitrophenyl)-2-ethylhexa-1,4-dien-3-one (A11K3A11) were synthesized and characterized via 1H NMR and 13C NMR techniques. Molecular docking, anti-inflammatory, analgesic and anticancer activities were performed using Auto Doc Vina, carrageenan mediated paw edema and formalin induced chronic inflammation, acetic acid induced writhings and hotplate assay and brine-shrimp lethality assay.

Results:

A2K2A17 and A11K3A11 showed high computational affinities (binding energy > -9.0 Kcal/mol) against COX-1, kappa receptor and braf kinase domain. A2K2A17 and A11K3A11 exhibited moderate docking affinities (binding energy > -8.0 Kcal/mol) against COX-2, human capsaicin receptor, tumor necrosis factor, lipoxygenase, colony stimulating factor, delta receptor, cyclin dependent protein kinase-2, mitogen activated kinase, mu receptor and kit kinase domain. A2K2A17 and A11K3A11 possess low docking affinities (binding energy > -7.0 Kcal/mol) against purinoceptor, platelets-derived growth Factor-1 and vascular-endothelial growth factor. In analgesic activity, A2K2A17 (1-30 mg/kg) and A11K3A11 (1-10 mg/kg) decreased acetic acid induced writhes and prolonged the latency time (P<0.01, P<0.001 vs saline group) respectively. A2K2A17 (10-30 mg/kg) and A11K3A11 (1-10 mg/kg) reduced carrageenan as well as formalin mediated edema (P<0.01, P<0.001). A2K2A17 found effective for cytotoxicity assay with LC₅₀ value 1.5 µg/ml.

Conclusion:

The in silico, in vitro and in vivo studies on A2K2A17 and A11K3A11 reports their computational binding affinities against targets as well as the analgesic, anti-inflammatory and the anticancer effects.

Anti-hyperlipidemic effects of Caralluma edulis (Asclepiadaceae) and Verbena officinalis (Verbenaceae) whole plants against high-fat diet-induced hyperlipidemia in mice

Purpose: To investigate the anti-hyperlipidemic effect of Caralluma edulis and  Verbena officinalis.Methods: Phytochemical analysis of crude extracts of Caralluma edulis (Ce.Cr) and Verbena officinalis (Vo.Cr) were carried out. Hyperlipidemia was induced in mice with high-fat diet (HFD, 1.25 % w/w cholesterol, 0.5 % w/w cholic acid and 10 % v/w coconut oil). All the groups, except the saline-treated group, were fed on HFD for 4 weeks (lead-in period) to induce hyperlipidemia. Thereafter, the groups were treated with varying doses of the plant extract for 2 weeks (treatment period) as well as atorvastatin (10 mg/kg) reference standard. Body weight was measured fortnightly for all groups. Total cholesterol (TC), triglyceride (TGs) and low density lipoprotein (LDL) were assayed using Merck diagnostic kits. For histopathological analysis, liver slices were fixed in 10 % formalin and embedded in paraffin wax and was examined with the aid of hematoxylin and eosin staining (H & E).Results: Caralluma edulis (Ce.Cr) contains saponins, alkaloids, tannins, phenol, glycosides, terpenoids and flavonoids while Verbena officinalis (Vo.Cr) tested  positive for the presence of alkaloids, carbohydrates, flavonoids, saponins and tannins. HFD increased total cholesterol (TC), triglyceride (TGs), low density  lipoprotein (LDL) and very low density lipoprotein (VLDL) compared to regulator diet (p < 0.001). Treatment of the animals with Ce.Cr and Vo.Cr dose-dependently (500 - 1000 mg/kg) reduced serum TC, TGs, LDL and VLDL (p < 0.05, p < 0.01, p < 0.001, vs. HFD group) and raised high density lipoprotein (HDL) (p < 0.01, vs. HFD group), similar to that observed with atorvastatin (10 mg/kg). The  anti-hyperlipidemic effects of Ce.Cr and Vo.Cr were also confirmed via liver  histopathology results, showing improved structure with no hepatocellular necrosis and fat accumulation.Conclusion: These results indicate that Caralluma edulis and Verbena officinalis  exhibit antihyperlipidemic effect; thus, the plants have therapeutic potentials for the management of lipid disorders.Keywords: Caralluma edulis, Verbena officinalis, Anti-hyperlipidemia,   Hepatocellular necrosis