Application Of Non-steroidal Anti-inflammatory Drugs Research Articles

Repurposing celecoxib as adjuvant therapy in patients with Parkinsonian disease: a new therapeutic dawn: randomized controlled pilot study.

The clinical presentations of Parkinson's disease (PD), a chronic neurodegenerative condition, include bradykinesia, hypokinesia, stiffness, resting tremor, and postural instability. Recently, neuroinflammation is involved in pathogenesis of PD. Application of nonsteroidal anti-inflammatory drugs captured attention to treat these neuroinflammation. To investigate the possible effectiveness of celecoxib in patients with PD treated with conventional treatment. Sixty outpatients who fulfilled the inclusion requirements for PD were enrolled in this randomized, prospective, and controlled study. The patients were allocated into two groups at random (n = 30); the control group received standard PD treatment, consisting of levodopa/carbidopa, and the celecoxib group received standard PD treatment plus celecoxib. A neurologist evaluated each patient at the beginning of the treatment and after 6months. Assessment of Unified Parkinson's disease rating scale (UPDRS) for each patient. Before and after treatment, α -synuclein (α-Syn), tumor necrosis factor alpha (TNF-α), Toll like receptors-4 (TLR-4), nuclear factor erythroid 2-related factor 2 (Nrf-2) and brain-derived neurotropic factor (BDNF) were assessed. Paired and unpaired t tests were used to assess statistical significance within and between groups respectively. The celecoxib group exhibited a significant and statistical reduction in the level of measured parameters by unpaired t test as followed: TLR-4 (p = 0.004), TNF-α (p = 0.042), and α-Syn (p = 0.004) apart from a significant increase in BDNF (p = 0.0005) and Nrf-2 (p = 0.004), in comparison with the control group. Also, UPDRS was significantly decreased in celecoxib group (p < 0.05). Celecoxib could be a promising adjuvant therapy in managing patients with PD. NCT05962957.

Evaluation of Emulgel and Nanostructured Lipid Carrier-Based Gel Formulations for Transdermal Administration of Ibuprofen: Characterization, Mechanical Properties, and Ex-Vivo Skin Permeation

In transdermal applications of nonsteroidal anti-inflammatory drugs, the rheological and mechanical properties of the dosage form affect the performance of the drug. The aim of this study to develop emulgel and nanostructured lipid carrier NLC-based gel formulations containing ibuprofen, evaluate their mechanical properties, bioadhesive value and ex-vivo rabbit skin permeability. All formulations showed non-Newtonian pseudoplastic behavior and their viscosity values are suitable for topical application. The particle size of the nanostructured lipid carrier system was found to be 468 ± 21 nm, and the encapsulation efficiency was 95.58 ± 0.41%. According to the index of viscosity, consistency, firmness, and cohesiveness values obtained as a result of the back extrusion study, E2 formulation was found to be more suitable for transdermal application. The firmness and work of shear values of the E2 formulation, which has the highest viscosity value, were also found to be the highest and it was chosen as the most suitable formulation in terms of the spreadability test. The work of bioadhesion values of NLC-based gel and IBU-loaded NLC-based gel were found as 0.226 ± 0.028 and 0.181 ± 0.006 mJ/cm2 respectively. The percentages of IBU that penetrated through rabbit skin from the Ibuactive-Cream and the E2 were 87.4 ± 2.11% and 93.4 ± 2.72% after 24 h, respectively. When the penetration of ibuprofen through the skin was evaluated, it was found that the E2 formulation increased penetration due to its lipid and nanoparticle structure. As a result of these findings, it can be said that the NLC-based gel formulation will increase the therapeutic efficacy and will be a good alternative transdermal formulation.Graphical

Analysis of risk factors for ulcer recurrence and upper gastrointestinal bleeding in children with peptic ulcer treated with Helicobacter pylori eradication therapy.

The incidence of peptic ulcer disease (PUD) has been increasing yearly, especially in the adolescent population. The eradication of Helicobacter pylori (H. pylori) may reduce recurrence and bleeding to some extent, but it does not completely change the clinical status of PUD. Therefore, this study aims to analyze the risk factors for ulcer recurrence and upper gastrointestinal bleeding after H. pylori eradication therapy in order to provide a reference for reducing the risk of PUD and improving the quality of life of patients. We retrospectively analyzed 536 adolescent patients who developed peptic ulcer and received H. pylori eradication therapy from June 2016 to July 2021. The relationship between the clinical characteristics of the patients and gastrointestinal bleeding and recurrence was analyzed using the t-test and chi-squared test. Binary logistic regression was used to analyze the independent risk factors for the occurrence of bleeding and recurrence. A total of 536 patients were included in this retrospective study. Gender, history of ulcers, number, size, location and staging of ulcers, and application of nonsteroidal anti-inflammatory drugs (NSAIDs), and other characteristics were significantly different between the bleeding and nonbleeding groups (P<0.05); family history of upper gastrointestinal ulcer, history of ulcers, number and size of ulcers and application of NSAIDs, and other characteristics were significantly different between the recurrent and nonrecurrent groups (P<0.05). Binary logistic regression analysis showed that history of ulcers, number and location of ulcers, coagulation abnormalities, and other characteristics were independent risk factors for the occurrence of bleeding; the occurrence of previous bleeding, number and size of ulcers, and other characteristics were independent risk factors for recurrence. In the clinical treatment of adolescent patients, it is important to pay high attention to clinical characteristics, such as the patient's previous ulcer history, the size, number and location of ulcers, and coagulation function, so as to adopt individualized treatment methods to effectively reduce the harmfulness of the disease in response to the risk factors of ulcer bleeding and recurrence after H. pylori eradication therapy. This can decrease the occurrence of complications and improve the prognosis of patients.

Perspectives of the Application of Non-Steroidal Anti-Inflammatory Drugs in Cancer Therapy: Attempts to Overcome Their Unfavorable Side Effects.

Non-steroidal anti-inflammatory drugs (NSAIDs) express anti-tumoral activity mainly by blocking cyclooxygenase-2 involved in the synthesis of prostaglandins. Therefore, in the last few decades, many have attempted to explore the possibilities of applying this group of drugs as effective agents for the inhibition of neoplastic processes. This review summarizes the evidence presented in the literature regarding the anti-tumoral actions of NSAIDs used as monotherapies as well as in combination with conventional chemotherapeutics and natural products. In several clinical trials, it was proven that combinations of NSAIDs and chemotherapeutic drugs (CTDs) were able to obtain suitable results. The combination with phospholipids may resolve the adverse effects of NSAIDs and deliver derivatives with increased antitumor activity, whereas hybrids with terpenoids exhibit superior activity against their parent drugs or physical mixtures. Therefore, the application of NSAIDs in cancer therapy seems to be still an open chapter and requires deep and careful evaluation. The literature's data indicate the possibilities of re-purposing anti-inflammatory drugs currently approved for cancer treatments.

Application of non-steroidal anti-inflammatory drugs in prevention of pancreatitis after endoscopic retrograde cholangiopancreatography

Application of non-steroidal anti-inflammatory drugs in prevention of pancreatitis after endoscopic retrograde cholangiopancreatography

NSAID-Associated Small Intestinal Injury: An Overview From Animal Model Development to Pathogenesis, Treatment, and Prevention.

With the wide application of non-steroidal anti-inflammatory drugs (NSAIDs), their gastrointestinal side effects are an urgent health burden. There are currently sound preventive measures for upper gastrointestinal injury, however, there is a lack of effective defense against lower gastrointestinal damage. According to a large number of previous animal experiments, a variety of NSAIDs have been demonstrated to induce small intestinal mucosal injury in vivo. This article reviews the descriptive data on the administration dose, administration method, mucosal injury site, and morphological characteristics of inflammatory sites of various NSAIDs. The cells, cytokines, receptors and ligands, pathways, enzyme inhibition, bacteria, enterohepatic circulation, oxidative stress, and other potential pathogenic factors involved in NSAID-associated enteropathy are also reviewed. We point out the limitations of drug modeling at this stage and are also pleased to discover the application prospects of chemically modified NSAIDs, dietary therapy, and many natural products against intestinal mucosal injury.

Місцеве застосування нестероїдних протизапальних засобів: переваги та недоліки

У статті наведені дані літератури щодо ефективності та безпеки декскетопрофену трометамолу у вигляді гелю при місцевому застосуванні та порівняльна характеристика даного фармакологічного засобу з іншими трансдермальними формами нестероїдних протизапальних препаратів. В процесі досліджень було встановлено, що декскетопрофен при місцевому застосуванні у вигляді гелю має високу здатність до накопичення у шкірі, м’язовій і нервовій (нейрони, мієлін та гіпоталамус) тканинах, що обумовлює хороший протизапальний, протинабряковий та аналгезуючий ефект даного лікарського засобу. Декскетопрофен продемонстрував низький рівень накопичення у хрящовій тканині, що не стимулює дегенеративні зміни тканини хряща, оскільки не пригнічує синтез протеогліканів хондроцитами. Разом з тим декскетопрофен показав невисоку здатність до накопичення у клітинах крові та у внутрішніх органах, демонструючи низьку ймовірність системних побічних ефектів.

Application of nonsteroidal anti-inflammatory drugs in aortic aneurysm

INTRODUCTION: Aortic aneurysms have among their main factor for rupture, growth, produced by the weakening of the aneurysmal wall influenced by different risk factors. MATERIAL AND METHOD: A 5-year investigation was carried out with a group of 63 patients with aortic aneurysms who, for different reasons, were not operated on during the study period. They were divided into two groups, one called a study with 48 patients and another with 15 who use in the study group, ibuprofen-based medical treatment (non-steroidal anti-inflammatory drugs [NSAIDs) in doses of 800 mg per day and sixmonthly ultrasound controls throughout the period of the investigation, measuring the aneurysmal diameters to demonstrate the growth, detection or reduction of the same. RESULTS: The usefulness and efficacy of the use of NSAIDs in the field of medical treatment of aortic aneurysms was demonstrated, since during the investigation of the two study groups, we achieved higher survival rates for the group treated with NSAIDs. CONCLUSIONS: Through growth control as the main rupture factor and therefore a complication that in most cases is fatal, we achieved a reduction in the aneurysmal diameter in a number of patients with higher survival rates than in the control group. Graphs up to 5 years are presented that support the results achieved.

Expert consensus of Chinese Association for the Study of Pain on the non-opioid analgesics for chronic musculoskeletal pain.

Chronic musculoskeletal pain (CMP) is a common occurrence in clinical practice and there are a variety of options for the treatment of it. However, the pharmacological therapy is still considered to be a primary treatment. The recent years have witnessed the emergence of opioid crisis, yet there are no relevant guidelines on how to treat CMP with non-opioid analgesics properly. The Chinese Medical Association for the Study of Pain convened a panel meeting to develop clinical practice consensus for the treatment of CMP with non-opioid analgesics. The purpose of this consensus is to present the application of nonsteroidal anti-inflammatory drugs, serotonin norepinephrine reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, muscle relaxants, ion channel drugs and topical drugs in CMP.

Effectiveness of topical interventions to prevent or treat intravenous therapy-related phlebitis: A systematic review.

To evaluate the effectiveness of topical interventions in the prevention or treatment of intravenous therapy-related phlebitis. Phlebitis is a severe inflammatory reaction that can be caused by intravenous therapy with hyperosmolar drugs. Although a variety of interventions are performed in several different countries, the most efficient method is yet to be established. A systematic review of randomised controlled trials (RCTs) was conducted. Following the PRISMA checklist, we conducted a literature search using seven different databases using an individual strategy adapted for each. Studies in which any topical intervention was applied to prevent or treat intravenous therapy-related phlebitis which were published between 1998 and 2019 were analysed. Data were collected of 13 RCTs, which in total collected data from 2,015 patients during hospital treatments with different types of intravenous therapies, such as fluid replacement, antibiotics, chemotherapy and antiarrhythmic drugs. The effectiveness of different topical interventions such as the application of nonsteroidal anti-inflammatory drugs, Sesame indicum oil, heparin sodium formulations, Chamomilla recutita tea and ointment, and Rosmarinus officinalis ointment were identified. Although the studies suggest a potential to use phytotherapy agents as topical interventions, pharmaceutical preparations, main substrate, and pharmaceutical or phytotherapeutic origins are very different between studies. There are insufficient data to build a solid conclusion that lead us to recommend a specific topical intervention in the prevention or treatment of intravenous therapy-related phlebitis.

Od kory wierzby do koksybów: rys historyczny i nowatorskie zastosowania niesteroidowych leków przeciwzapalnych. Część I

Od kory wierzby do koksybów: rys historyczny i nowatorskie zastosowania niesteroidowych leków przeciwzapalnych. Część I

Od kory wierzby do koksybów: rys historyczny i nowatorskie zastosowania niesteroidowych leków przeciwzapalnych. Część II

Od kory wierzby do koksybów: rys historyczny i nowatorskie zastosowania niesteroidowych leków przeciwzapalnych. Część II

The prostaglandin E2 receptor EP3 controls CC-chemokine ligand 2–mediated neuropathic pain induced by mechanical nerve damage

Prostaglandin (PG) E2 is an important lipid mediator that is involved in several pathophysiological processes contributing to fever, inflammation, and pain. Previous studies have shown that early and continuous application of nonsteroidal anti-inflammatory drugs significantly reduces pain behavior in the spared nerve injury (SNI) model for trauma-induced neuropathic pain. However, the role of PGE2 and its receptors in the development and maintenance of neuropathic pain is incompletely understood but may help inform strategies for pain management. Here, we sought to define the nociceptive roles of the individual PGE2 receptors (EP1-4) in the SNI model using EP knockout mice. We found that PGE2 levels at the site of injury were increased and that the expression of the terminal synthase for PGE2, cytosolic PGE synthase was up-regulated in resident positive macrophages located within the damaged nerve. Only genetic deletion of the EP3 receptor affected nociceptive behavior and reduced the development of late-stage mechanical allodynia as well as recruitment of immune cells to the injured nerve. Importantly, EP3 activation induced the release of CC-chemokine ligand 2 (CCL2), and antagonists against the CCL2 receptor reduced mechanical allodynia in WT but not in EP3 knockout mice. We conclude that selective inhibition of EP3 might present a potential approach for reducing chronic neuropathic pain.

Results clinical assessment of the application of nonsteroidal anti-inflammatory drugs for pain symptoms occurring after endodontic dental treatment

Pain is one of the most common and most difficult on subjective perception of dental symptoms. These domestic and foreign literature stating a fact that more than 80% of patients after endodontic treatment there is a feeling «fullness» in the tooth, pain when biting on the tooth, radiating to neighboring teeth or along the branches of the trigeminal nerve. From the pathogenesis point of view, the above manifestations are acute toxic-traumatic neuropathy of the trigeminal nerve. This often leads to an unreasonable removal of a qualitatively and competently cured tooth. A comparison was made of the analgesic activity of ketanov in the relief of pain that occurs after root canal filling, with the analgesic activity of nimesulide in 57 patients aged 20 to 55 years. In acute pain, an analgesic effect with the administration of ketanov appeared within 15 to 20 minutes, with the administration of nimesil, the effect occurred within 30-40 minutes. After a course of treatment, patients in both groups significantly decreased irritability, sleep normalized. Patients believed in the success of treatment, because a decrease or a significant decrease in the pain syndrome reflexively leads to an improvement in the psycho-emotional sphere of patients, which in turn favors long-term remission.

Chemical oral burn cum erosive gingival lesion arising from self-medication for toothache

Chemical burn of the oral mucosa occurring as a result of a noxious agent placed in direct contact with the mucosa either by the patient or a dentist is frequently associated with gingival erosion. The objective of this study was to report a case of chemical oral burn with erosive gingival lesion due to self medication with nonsteroid anti inflammatory drug topically in patient with acute apical abscess. We report a case of 63-year-old male public servant with health insurance that presented to the periodontology clinic with chemical oral burns and erosive gingival lesion due to topical application of nonsteroidal anti-inflammatory drug for relief of toothache from apical abscess of lower left central incisor (tooth 31). The patient was advised to discontinue topical application of Anacin. Full-mouth scaling was done, oral hygiene instructions given, warm saline mouthrinse therapy prescribed, and patient referredb to the conservative clinic where root canal treatment. Increased public awareness is required regarding chemical injuries that can result from topical self-medication. Dentists must recognize the local effects of topically applied aspirin as well as other medications on the oral mucosa and incorporate them into the treatment plan to prevent complications.

Autophagy: novel applications of nonsteroidal anti-inflammatory drugs for primary cancer.

In eukaryotic cells, autophagy is a process associated with programmed cell death. During this process, cytoplasmic proteins and organelles are engulfed by double‐membrane autophagosomes, which then fuse with lysosomes to form autolysosomes. These autolysosomes then degrade their contents to recycle the cellular components. Autophagy has been implicated in a wide variety of physiological and pathological processes that are closely related to tumorigenesis. In recent years, an increasing number of studies have indicated that nonsteroidal anti‐inflammatory drugs, such as celecoxib, meloxicam, sulindac, aspirin, sildenafil, rofecoxib, and sodium salicylate, have diverse effects in cancer that are mediated by the autophagy pathway. These nonsteroidal anti‐inflammatory drugs can modulate tumor autophagy through the PI3K/Akt/mTOR, MAPK/ERK1/2, P53/DRAM, AMPK/mTOR, Bip/GRP78, CHOP/ GADD153, and HGF/MET signaling pathways and inhibit lysosome function, leading to p53‐dependent G1 cell‐cycle arrest. In this review, we summarize the research progress in autophagy induced by nonsteroidal anti‐inflammatory drugs and the molecular mechanisms of autophagy in cancer cells to provide a reference for the potential benefits of nonsteroidal anti‐inflammatory drugs in cancer chemotherapy.

Effects of licofelone, a novel 5-LOX inhibitor, in comparison to celecoxib on gastric mucosa of dogs

Despite the extensive application of nonsteroidal anti-inflammatory drugs (NSAIDs), the use of these drugs is limited due to their adverse effects especially on gastric mucosa. Dual inhibitors that inhibit both cyclooxygenase (COX) and lipoxygenase (LOX) metabolites are considered to have less gastric toxicity in comparison to non-selective and COX-2 selective inhibitors. In this study, fifteen mixed breed dogs were randomly divided into three groups: group 1 (n=5) received placebo, group 2 (n=5) licofelone, an inhibitor of COX- 1, COX-2, and 5-LOX (2.5 mg/kg; twice daily) and group 3 (n=5) celecoxib, a COX-2 selective inhibitor (3 mg/kg; twice daily) per os for 14 days. All dogs underwent blinded gastroscopies on days 0, 7, 14 and one week after cessation of treatment and gastric lesions were scored. Examinations to detect fecal occult blood were performed daily. Results showed that licofelone is significantly better tolerated than celecoxib in terms of gastric side effects (P=0.008). Therefore, it seems that licofelone can be an appropriate alternative in dogs when NSAID therapy is necessary. Occult blood was not detected in any dog during the study.

Experimental study of the nonsteroidal anti-inflammatory drugs application under using low-intensity infrared laser radiation

Topicality. The combined application of nonsteroidal anti-inflammatory drugs (NSAIDs) and low-intensity infrared laser radiation (LIIRLR) for treatment of osteoarthrosis has remained an actual task. Aim to study the NSAIDs usage under LIIRLR application in experiments in rats.Materials and Methods. The time for LIIRLR application (15 min after drug administration) was chosen according to our previous studies on diclofenac sodium (DNa) pharmacokinetics in rats blood plasma. To study the NSAIDs application at the influence of LIIRLR, white beedless male rats (n=15) of 250-300 g were used in the experiments. The animals were divided into 3 groups. Rats of group the 1were received purified water (per os) and exposed to LIIRLR. Rats of group the 2 were received DNa at a dose of ED50 (per os, 8 mg/kg). Rats of group the 3 were influenced of LIIRLR and in 15 min received DNa (per os, 8 mg/kg). For DNa extraction from rat plasma samples, the method of solid-phase extraction was used. Concentration of DNa was determined by method of high-performance liquid chromatography (HPLC).Results. It was established that at the combined use LIIRLR and DNa the drug concentration in the rats blood serum was 1.7 fold higher in comparison to DNa application alone.Conclusions. It is proved, that the method of combine application of LIIRLRand NSAIDs (in 15 min) was more effective than the use of NSAIDs alone.

Ethanolic leaf extract of &lt;i&gt;Langenaria breviflora&lt;/i&gt; (bitter gourd) inhibits gastric onslaught in indomethacininduced ulcerated rats

Objective : Gastrointestinal toxicity remains a barrier to applications of non-steroidal anti-inflammatory drugs in medical practice. Plant extract with excellent therapeutic potential may proffer solution to this menace. This study investigated the gastroprotective effect of Lagenaria breviflora leaves extract against indomethacinmediated gastric ulcer in rats. Methodology and result : Ulceration in the rat was induced by a single oral dose of indomethacin (60 mg/kg body weight). Ulcerated rats were orally administered with Lagenaria breviflora extract at 200 mg/kg body weight once daily for 21 days prior to and after ulcer induction. Gastric secretions and antioxidant parameters were then evaluated. The study indicates that indomethacin caused a significant increase in ulcer index, gastric acidity, malondialadehyde level and pepsin activity. Administration of Lagenaria breviflora in rats reversed these metabolic alterations. The extract also attenuated the reduced activity of catalase, pH and mucin content in the ulcerated rats. Conclusions and application of findings : These findings are indicative of gastroprotective and antioxidative attributes of the extract, which is revealed in the percentage protection offered against ulceration. The supportive evidences in this study suggest that the effect of leaves extract of Lagenaria breviflora proved to be capable of modulating indomethacin-mediated gastric ulceration and could be harnessed as preventive therapy in the treatment of gastric ulcer related disorder. Key words : Gastroprotective; H 2 receptor; Medicinal; NSAIDS; Proton pump inhibitor; Ulceration.

Formulation of Novel Layered Sodium Carboxymethylcellulose Film Wound Dressings with Ibuprofen for Alleviating Wound Pain.

Effective assessment and management of wound pain can facilitate both improvements in healing rates and overall quality of life. From a pharmacological perspective, topical application of nonsteroidal anti-inflammatory drugs in the form of film wound dressings may be a good choice. Thus, the aim of this work was to develop novel layered film wound dressings containing ibuprofen based on partially substituted fibrous sodium carboxymethylcellulose (nonwoven textile Hcel NaT). To this end, an innovative solvent casting method using a sequential coating technique has been applied. The concentration of ibuprofen which was incorporated as an acetone solution or as a suspension in a sodium carboxymethylcellulose dispersion was 0.5 mg/cm2 and 1.0 mg/cm2 of film. Results showed that developed films had adequate mechanical and swelling properties and an advantageous acidic surface pH for wound application. An in vitro drug release study implied that layered films retained the drug for a longer period of time and thus could minimize the frequency of changing the dressing. Films with suspended ibuprofen demonstrated higher drug content uniformity and superior in vitro drug release characteristics in comparison with ibuprofen incorporation as an acetone solution. Prepared films could be potential wound dressings for the effective treatment of wound pain in low exuding wounds.