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Maganin AG, Souza GR, Fonseca MD, Lopes AH, Mano Guimarães RM, Dagostin A, Cecilio NT, Mendes AS, Gonçalves WA, Silva CE, Fernandes Gomes FI, Mauriz Marques LM, Silva RL, Arruda LM, Santana DA, Lemos H, Huang L, Davoli-Ferreira M, Santana-Coelho DS, Sant'Anna MB, Kusuda R, Talbot J, Pacholczyk G, Buqui GA, Lopes N, Alves-Filho JC, Leão RM, O'Connor JC, Cunha FQ, Mellor A, Cunha T. Meningeal dendritic cells drive neuropathic pain through elevation of the kynurenine metabolic pathway in mice. J Clin Invest 2022; 132:153805. [PMID: 36227694 DOI: 10.1172/jci153805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/11/2022] [Indexed: 11/17/2022] Open
Abstract
Neuropathic pain is one of the most important clinical consequences of injury to the somatosensory system. Nevertheless, the critical pathophysiological mechanisms involved in neuropathic pain development are poorly understood. In this study, we found that neuropathic pain is abrogated when the kynurenine metabolic pathway initiated by the enzyme indoleamine 2,3-dioxygenase (IDO1) is ablated pharmacologically or genetically. Mechanistically, it was found that IDO1-expressing dendritic cells (DCs) accumulated in the dorsal root leptomeninges and led to an increase in kynurenine levels in the spinal cord. In the spinal cord, kynurenine was metabolized by kynurenine-3-monooxygenase-expressing astrocytes into a pro-nociceptive metabolite 3-hydroxykynurenine. Ultimately, 3-hydroxyanthranilate 3,4-dioxygenase-derived quinolinic acid formed in the final step of the canonical KYNPATH was also involved in neuropathic pain development through the activation of the glutamatergic N-methyl-D-aspartate (NMDA) receptor. In conclusion, these data revealed a novel role for DCs driving neuropathic pain development through elevation of the kynurenine metabolic pathway. This novel paradigm offers potential new targets for drug development against this type of chronic pain.
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Affiliation(s)
- Alexandre Gm Maganin
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Guilherme R Souza
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Miriam D Fonseca
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Alexandre H Lopes
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Rafaela M Mano Guimarães
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - André Dagostin
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Nerry T Cecilio
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Atlante S Mendes
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - William A Gonçalves
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Conceição Ea Silva
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | - Lucas M Mauriz Marques
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Rangel L Silva
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Letícia M Arruda
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Denis A Santana
- Department of Pharmacology, University of São Paulo at Ribeirão Preto Medical School, Ribeirao Preto, Brazil
| | - Henrique Lemos
- Cancer Immunology, Inflammation and Tolerance Program, Cancer Center, Georgia Regents University, Augusta, United States of America
| | - Lei Huang
- Cancer Immunology, Inflammation and Tolerance Program, Cancer Center, Georgia Regents University, Augusta, United States of America
| | - Marcela Davoli-Ferreira
- Department of Pharmacology, University of São Paulo at Ribeirão Preto Medical School, Ribeirao Preto, Brazil
| | - Danielle S Santana-Coelho
- Department of Pharmacology, University of Texas Health Science Center at San Antonio and Audie L. Murphy VA Hospital, San Antonio, United States of America
| | - Morena B Sant'Anna
- Department of Pharmacology, University of São Paulo at Ribeirão Preto Medical School, Ribeirao Preto, Brazil
| | - Ricardo Kusuda
- Department of Pharmacology, University of São Paulo at Ribeirão Preto Medical School, Ribeirao Preto, Brazil
| | - Jhimmy Talbot
- Department of Pharmacology, University of São Paulo at Ribeirão Preto Medical School, Ribeirao Preto, Brazil
| | - Gabriela Pacholczyk
- Cancer Immunology, Inflammation and Tolerance Program, Cancer Center, Georgia Regents University, Augusta, United States of America
| | - Gabriela A Buqui
- NPPNS, Department of Physic and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Norberto Lopes
- NPPNS, Department of Physic and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Jose C Alves-Filho
- Department of Pharmacology, University of São Paulo at Ribeirão Preto Medical School, Ribeirao Preto, Brazil
| | - Ricardo M Leão
- Graduate Program in Basic and Applied Immunology Ribeirao Preto Medical Sch, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Jason C O'Connor
- Department of Pharmacolog, University of Texas Health Science Center at San Antonio and Audie L. Murphy VA Hospital, San Antonio, United States of America
| | - Fernando Q Cunha
- Department of Pharmacology, University of São Paulo at Ribeirão Preto Medical School, Ribeirao Preto, Brazil
| | - Andrew Mellor
- Cancer Immunology, Inflammation and Tolerance Program, Cancer Center, Georgia Regents University, Augusta, United States of America
| | - Thiago Cunha
- Department of Pharmacology, University of São Paulo at Ribeirão Preto Medical School, Ribeirao Preto, Brazil
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Lopes AH, Silva RL, Fonseca MD, Gomes FI, Maganin AG, Ribeiro LS, Marques LMM, Cunha FQ, Alves-Filho JC, Zamboni DS, Lopes NP, Franklin BS, Gombault A, Ramalho FS, Quesniaux VFJ, Couillin I, Ryffel B, Cunha TM. Molecular basis of carrageenan-induced cytokines production in macrophages. Cell Commun Signal 2020; 18:141. [PMID: 32894139 PMCID: PMC7487827 DOI: 10.1186/s12964-020-00621-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 07/02/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Low molecular weight carrageenan (Cg) is a seaweed-derived sulfated polysaccharide widely used as inflammatory stimulus in preclinical studies. However, the molecular mechanisms of Cg-induced inflammation are not fully elucidated. The present study aimed to investigate the molecular basis involved in Cg-induced macrophages activation and cytokines production. METHODS Primary culture of mouse peritoneal macrophages were stimulated with Kappa Cg. The supernatant and cell lysate were used for ELISA, western blotting, immunofluorescence. Cg-induced mouse colitis was also developed. RESULTS Here we show that Cg activates peritoneal macrophages to produce pro-inflammatory cytokines such as TNF and IL-1β. While Cg-induced TNF production/secretion depends on TLR4/MyD88 signaling, the production of pro-IL-1β relies on TLR4/TRIF/SYK/reactive oxygen species (ROS) signaling pathway. The maturation of pro-IL1β into IL-1β is dependent on canonical NLRP3 inflammasome activation via Pannexin-1/P2X7/K+ efflux signaling. In vivo, Cg-induced colitis was reduced in mice in the absence of NLRP3 inflammasome components. CONCLUSIONS In conclusion, we unravel a critical role of the NLRP3 inflammasome in Cg-induced pro-inflammatory cytokines production and colitis, which is an important discovery on the pro-inflammatory properties of this sulfated polysaccharide for pre-clinical studies. Video abstract Carrageenan (Cg) is one the most used flogistic stimulus in preclinical studies. Nevertheless, the molecular basis of Cg-induced inflammation is not totally elucidated. Herein, Lopes et al. unraveled the molecular basis for Cg-induced macrophages production of biological active IL-1β. The Cg-stimulated macrophages produces pro-IL-1β depends on TLR4/TRIF/Syk/ROS, whereas its processing into mature IL-1β is dependent on the canonical NLRP3 inflammasome.
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Affiliation(s)
- Alexandre H. Lopes
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Center for Research in Inflammatory Diseases (CRID)Av. Bandeirantes 3900, 14049-900, Ribeirão Preto, SP Brazil
| | - Rangel L. Silva
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Center for Research in Inflammatory Diseases (CRID)Av. Bandeirantes 3900, 14049-900, Ribeirão Preto, SP Brazil
| | - Miriam D. Fonseca
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Center for Research in Inflammatory Diseases (CRID)Av. Bandeirantes 3900, 14049-900, Ribeirão Preto, SP Brazil
| | - Francisco I. Gomes
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Center for Research in Inflammatory Diseases (CRID)Av. Bandeirantes 3900, 14049-900, Ribeirão Preto, SP Brazil
| | - Alexandre G. Maganin
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Center for Research in Inflammatory Diseases (CRID)Av. Bandeirantes 3900, 14049-900, Ribeirão Preto, SP Brazil
| | - Lucas S. Ribeiro
- Institute of Innate Immunity, University Hospitals, University of Bonn, 53127 Bonn, Germany
| | | | - Fernando Q. Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Center for Research in Inflammatory Diseases (CRID)Av. Bandeirantes 3900, 14049-900, Ribeirão Preto, SP Brazil
| | - Jose C. Alves-Filho
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Center for Research in Inflammatory Diseases (CRID)Av. Bandeirantes 3900, 14049-900, Ribeirão Preto, SP Brazil
| | - Dario S. Zamboni
- Department of Cellular and Molecular Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Norberto P. Lopes
- Department of Physics and Chemistry, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Bernardo S. Franklin
- Institute of Innate Immunity, University Hospitals, University of Bonn, 53127 Bonn, Germany
| | - Aurélie Gombault
- University of Orleans and CNRS, UMR7355 Experimental and Molecular Immunology, Orleans, France
| | - Fernando Silva Ramalho
- Department of Pathology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Valerie F. J. Quesniaux
- University of Orleans and CNRS, UMR7355 Experimental and Molecular Immunology, Orleans, France
| | - Isabelle Couillin
- University of Orleans and CNRS, UMR7355 Experimental and Molecular Immunology, Orleans, France
| | - Bernhard Ryffel
- University of Orleans and CNRS, UMR7355 Experimental and Molecular Immunology, Orleans, France
| | - Thiago M. Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Center for Research in Inflammatory Diseases (CRID)Av. Bandeirantes 3900, 14049-900, Ribeirão Preto, SP Brazil
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Piñeros AR, de Lima MHF, Rodrigues T, Gembre AF, Bertolini TB, Fonseca MD, Berretta AA, Ramalho LNZ, Cunha FQ, Hori JI, Bonato VLD. Green propolis increases myeloid suppressor cells and CD4 +Foxp3 + cells and reduces Th2 inflammation in the lungs after allergen exposure. J Ethnopharmacol 2020; 252:112496. [PMID: 31870795 DOI: 10.1016/j.jep.2019.112496] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Propolis is a natural product produced by honeybees used as a medicine at least to 300 BC. In the last decades, several studies showed biological and pharmacological properties of propolis, witch scientifically explains the empirical use for centuries. The anti-inflammatory activity of propolis with the purpose to reduce Th2 inflammation has been evaluated in allergic asthma. However, it remains to be determined how propolis negatively regulates the immune response after allergen re-exposure. AIM OF THE STUDY We hypothesized that the anti-inflammatory activity of propolis is dependent on the induction of myeloid derived suppressor cells (MDSC) and regulatory T cells. MATERIALS AND METHODS To assess this hypothesis, we used an ovalbumin-induced asthma model to evaluate the effect of EPP-AF® dry extract from Brazilian green propolis. RESULTS Propolis treatment decreased pulmonary inflammation and mucus production as well as eosinophils and IL-5 in the broncoalveolar lavage. Propolis enhanced also in vitro differentiation and in vivo frequency of lung MDSC and CD4+Foxp3+ regulatory T cells. CONCLUSIONS Together these results confirm the immunomodulatory potential of propolis during sensitization and challenge with allergen. In addition, the collecting findings show, for the first time, that propolis increases the frequency of MDSC and CD4+Foxp3+ regulatory T cells in the lungs, and suggest that it could be use as target for development of new immunotherapy or adjuvant immunotherapy for asthma.
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Affiliation(s)
- Annie R Piñeros
- Basic and Applied Immunology Program, Department of Biochemistry and Immunology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
| | - Mikhael H F de Lima
- Basic and Applied Immunology Program, Department of Biochemistry and Immunology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
| | - Tamara Rodrigues
- Basic and Applied Immunology Program, Department of Biochemistry and Immunology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
| | - Ana Flávia Gembre
- Basic and Applied Immunology Program, Department of Biochemistry and Immunology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
| | - Thais B Bertolini
- Basic and Applied Immunology Program, Department of Biochemistry and Immunology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
| | - Miriam D Fonseca
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
| | - Andresa A Berretta
- Apis Flora Industrial e Comercial Ltda, Ribeirao Preto, Sao Paulo, Brazil.
| | - Leandra N Z Ramalho
- Department of Pathology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
| | - Fernando Q Cunha
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
| | - Juliana I Hori
- Apis Flora Industrial e Comercial Ltda, Ribeirao Preto, Sao Paulo, Brazil.
| | - Vânia L D Bonato
- Basic and Applied Immunology Program, Department of Biochemistry and Immunology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
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Silva NR, Gomes FV, Fonseca MD, Mechoulam R, Breuer A, Cunha TM, Guimarães FS. Antinociceptive effects of HUF-101, a fluorinated cannabidiol derivative. Prog Neuropsychopharmacol Biol Psychiatry 2017; 79:369-377. [PMID: 28720466 DOI: 10.1016/j.pnpbp.2017.07.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 06/12/2017] [Accepted: 07/13/2017] [Indexed: 12/19/2022]
Abstract
Cannabidiol (CBD) is a phytocannabinoid with multiple pharmacological effects and several potential therapeutic properties. Its low oral bioavailability, however, can limit its clinical use. Preliminary results indicate that fluorination of the CBD molecule increases its pharmacological potency. Here, we investigated whether HUF-101 (3, 10, and 30mg/kg), a fluorinated CBD analogue, would induce antinociceptive effects. HUF-101 effects were compared to those induced by CBD (10, 30, and 90mg/kg) and the cannabinoid CB1/2 receptor agonist WIN55,212-2 (1, 3, and 5mg/kg). These drugs were tested in male Swiss mice submitted to the following models predictive to antinociceptive drugs: hot plate, acetic acid-induced writhing, and carrageenan-induced inflammatory hyperalgesia. To evaluate the involvement of CB1 and CB2 receptors in HUF-101 and CBD effects, mice received the CB1 receptor antagonist AM251 (1 or 3mg/kg) or the CB2 receptor antagonist AM630 (1 or 3mg/kg) 30min before HUF-101, CBD, or WIN55,212-2. In the hot plate test, HUF-101 (30mg/kg) and WIN55,212-2 (5mg/kg) induced antinociceptive effects, which were attenuated by the pretreatment with AM251 and AM630. In the abdominal writhing test, CBD (30 and 90mg/kg), HUF-101 (30mg/kg), and WIN55,212-2 (3 and 5mg/kg) induced antinociceptive effects indicated by a reduction in the number of writhing. Whereas the pretreatment with AM630 did not mitigate the effects induced by any drug in this test, the pretreatment with AM251 attenuated the effect caused by WIN55,212-2. In the carrageenan-induced hyperalgesia test, CBD (30 and 90mg/kg), HUF-101 (3, 10 and 30mg/kg) and WIN55,212-2 (1mg/kg) decreased the intensity of mechanical hyperalgesia measured by the electronic von Frey method. The effects of all compounds were attenuated by the pretreatment with AM251 and AM630. Additionally, we evaluated whether HUF-101 would induce the classic cannabinoid CB1 receptor-mediated tetrad (hypolocomotion, catalepsy, hypothermia, and antinociception). Unlike WIN55,212-2, CBD and HUF-101 did not induce the cannabinoid tetrad. These findings show that HUF-101 produced antinociceptive effects at lower doses than CBD, indicating that the addition of fluoride improved its pharmacological profile. Furthermore, some of the antinociceptive effects of CBD and HUF-101 effects seem to involve the activation of CB1 and CB2 receptors.
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Affiliation(s)
- Nicole R Silva
- Department of Pharmacology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil.
| | - Felipe V Gomes
- Department of Pharmacology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
| | - Miriam D Fonseca
- Department of Pharmacology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
| | - Raphael Mechoulam
- Department of Medicinal Chemistry and Natural Products, Medical Faculty, Hebrew University of Jerusalem, Israel
| | - Aviva Breuer
- Department of Medicinal Chemistry and Natural Products, Medical Faculty, Hebrew University of Jerusalem, Israel
| | - Thiago M Cunha
- Department of Pharmacology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
| | - Francisco S Guimarães
- Department of Pharmacology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
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Fonseca MD, Cunha FQ, Kashfi K, Cunha TM. NOSH-aspirin (NBS-1120), a dual nitric oxide and hydrogen sulfide-releasing hybrid, reduces inflammatory pain. Pharmacol Res Perspect 2015; 3:e00133. [PMID: 26236481 PMCID: PMC4492749 DOI: 10.1002/prp2.133] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 02/04/2015] [Accepted: 02/11/2015] [Indexed: 12/14/2022] Open
Abstract
The development of nitric oxide (NO)- and hydrogen sulfide (H2S)-releasing nonsteroidal anti-inflammatory drugs (NSAIDs) has generated more potent anti-inflammatory drugs with increased safety profiles. A new hybrid molecule incorporating both NO and H2S donors into aspirin (NOSH-aspirin) was recently developed. In the present study, the antinociceptive activity of this novel molecule was compared with aspirin in different models of inflammatory pain. It was found that NOSH-aspirin inhibits acetic acid-induced writhing response and carrageenan (Cg)-induced inflammatory hyperalgesia in a dose-dependent (5–150 μmol/kg, v.o.) manner, which was superior to the effect of the same doses of aspirin. NOSH-aspirin’s antinociceptive effect was also greater and longer compared to aspirin upon complete Freund’s adjuvant (CFA)-induced inflammatory hyperalgesia. Mechanistically, NOSH-aspirin, but not aspirin, was able to reduce the production/release of interleukin-1 beta (IL-1β) during Cg-induced paw inflammation. Furthermore, NOSH-aspirin, but not aspirin, reduced prostaglandin E2-induced hyperalgesia, which was prevented by treatment with a ATP-sensitive potassium channel (KATP) blocker (glibenclamide; glib.). Noteworthy, the antinociceptive effect of NOSH-aspirin was not associated with motor impairment. The present results indicate that NOSH-aspirin seems to present greater potency than aspirin to reduce inflammatory pain in several models. The enhanced effects of NOSH-aspirin seems to be due to its ability to reduce the production of pronociceptive cytokines such as IL-1 β and directly block hyperalgesia caused by a directly acting hyperalgesic mediator in a mechanism dependent on modulation of KATP channels. In conclusion, we would like to suggest that NOSH-aspirin represents a prototype of a new class of analgesic drugs with more potent effects than the traditional NSAID, aspirin.
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Affiliation(s)
- Miriam D Fonseca
- Department of Pharmacology, Ribeirao Preto Medical School, University of São Paulo Av. Bandeirantes 3900, 14049-900, Ribeirao Preto, SP, Brazil
| | - Fernando Q Cunha
- Department of Pharmacology, Ribeirao Preto Medical School, University of São Paulo Av. Bandeirantes 3900, 14049-900, Ribeirao Preto, SP, Brazil
| | - Khosrow Kashfi
- Department of Physiology, Pharmacology and Neuroscience, Sophie Davis School of Biomedical Education, City University of New York Medical School New York, NY, 10031 ; Avicenna Pharmaceuticals Inc. New York, NY, 10019
| | - Thiago M Cunha
- Department of Pharmacology, Ribeirao Preto Medical School, University of São Paulo Av. Bandeirantes 3900, 14049-900, Ribeirao Preto, SP, Brazil
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