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PubMedDate not supplied

[Atherosclerosis and inflammation].

Atherosclerosis is a disease of the large arteries. There are several risk factors, mainly genetic and environmental, associated with atherosclerosis. Recently acquired knowledge has clearly shown that a prominent role is played by several inflammatory mechanisms in the pathogenesis of this disease. Several pro-inflammatory molecules such as LDL, macrophage colony stimulating factor, and adhesion molecules, deserve special mention because of their major role in the inflammatory response that takes place in atherosclerosis.

Arteriosclerosis↗
PubMed1998

The role of inflammation after acute stroke: utility of pursuing anti-adhesion molecule therapy.

A growing body of evidence, primarily from animal models of cerebral ischemia and preliminary human studies, indicates that inflammatory mechanisms contribute to secondary neuronal injury after acute cerebral ischemia. Ischemia followed by reperfusion rapidly leads to the expression of inflammatory cytokines, particularly tumor necrosis factor-alpha and interleukin-1beta, which stimulate a complex cascade of events involving local endothelial cells, neurons, astrocytes, and perivascular cells. A secondary response includes the release of other cytokines, an increase in components of the coagulation system, an upregulation of cell adhesion molecule expression, and changes in the expression of components of the immune response. The net effect of these events is transformation of the local endothelium to a prothrombotic/proinflammatory state and induction of leukocyte migration to the site of injury. A number of studies have shown that leukocyte migration occurs within hours of reperfusion. Leukocytes accumulate in the injured region, where they cause tissue injury by several mechanisms, including occlusion of microvasculature, generation of oxygen free radicals, release of cytotoxic enzymes, alteration of vasomotor reactivity, and increase in cytokine and chemoattractant release. Monoclonal antibodies against leukocyte adhesion molecules have been shown to reduce infarct volume in animal models of ischemia-reperfusion. However, this treatment failed to show benefit in the Enlimomab Acute Stroke Trial. A number of factors may complicate the use of antibody directed adhesion molecule blockade in acute stroke and will be discussed in this article. Overall, an increased understanding of inflammatory and immunologic mechanisms still offers great potential for reducing acute stroke injury.

Acute Disease↗
PubMed1997

Experimental analysis of progressive necrosis after spinal cord trauma in the rat: etiological role of the inflammatory response.

Progressive tissue necrosis is a unique reaction to spinal cord trauma in which the site of injury is gradually transformed into a large, cavity-filled lesion. The earliest histopathological changes after injury include a widely disseminated extravasation of erythrocytes and neutrophils. To test whether such an inflammatory reaction might initiate progressive necrosis, we examined the effects of the following anti-inflammatory treatments: allopurinol (Ap) to inhibit injury-induced xanthine oxidase, indomethacin (I) or naproxen to inhibit constitutive and inducible cyclooxygenase, aminoguanidine (Ag) to inhibit inducible nitric oxide synthase, pregnenolone (P) as a precursor steroid, and a bacterial lipopolysaccharide (L) to stimulate secretory activities of glial cells and macrophages. The spinal cord of adult rats was crushed at T8 with jeweler's forceps and, after 3 or 21 days of treatment, the cords were studied quantitatively by light microscopical image analysis. Ag, Ag+I, or Ap significantly reduced the size of the primary lesion at 3 days postoperatively, while P+L+I did so only after 21 days of treatment. A secondary lesion developed in the dorsal column and gradually extended for many millimeters rostral and caudal from the primary lesion. The size of the dorsal column lesion was diminished by 3-day treatment with Ap and by 21-day treatment with Ap or P+L+I, but Ag or Ag+I had no effect. We conclude that (a) progressive necrosis is initiated and maintained by inflammatory mechanisms and (b) for this reason, treatment with specific anti-inflammatory agents selectively attenuates various components of the necrotizing process.

Allopurinol↗
PubMed1999

Minocycline modulation of alpha-MSH production by keratinocytes in vitro.

The anti-inflammatory mechanisms of minocycline, an antibiotic used in the treatment of the inflammatory component of acne, are only partially understood. In addition to inflammation due to cytokines (IL-1, IL-6, TNF-alpha, etc.), recent studies have shown that neuropeptide-mediated neurogenic inflammation may play an important role in cutaneous inflammation. The purpose of this study was to investigate minocycline-induced modulation of cutaneous production of alpha-melanocyte-stimulating hormone (alpha-MSH), a neuropeptide with known anti-inflammatory activity. Two different skin models were used: explants of inflammatory skin and reconstituted skin, both incubated with minocycline at different concentrations and for different time periods. Epidermal production of alpha-MSH, as evaluated by immunofluorescence and immunoperoxidase techniques, showed increased expression in both models. This neuropeptide, which has an anti-inflammatory activity (notably through production of IL-10, antagonism of IL-1 and inhibition of the chemotaxis of polymorphonuclear leukocytes), thus plays a role in the anti-inflammatory action of minocycline.

Anti-Bacterial Agents↗
PubMed1991

Are mast cells all bad?

Over the past ten years there have been considerable advances in our understanding of the pathogenesis of asthma. This understanding has been accompanied by the introduction and increased usage of a whole range of new therapies for the treatment of asthma. Unfortunately he increased understanding and available therapy has done very little to prevent asthma from being considered the only 'preventable' disease whose morbidity and mortality are still on the increase in most parts of the world. Why does this paradox occur? I will try to put forward a plausible scientific explanation for this paradox. I fell that this is to be found in a long recognised but little publicised pharmacological effect of beta 2 agonists, a widely prescribed drug class in the treatment of bronchial asthma, that is the ability of these drugs to inhibit mast cell degranulation. Through this mechanism beta 2 agonists may be inhibiting a natural anti-inflammatory mechanism mediated by mast cell products and thus be contributing to the worldwide increase in asthma morbidity and mortality.

Adrenergic beta-Agonists↗
PubMed2006

Inflammation of different tissues in spontaneously hypertensive rats.

The hypertension is one of chronic vascular diseases, which often implicates multiple tissues causing stroke, cardiac hypertrophy, and renal failure. A growing body of evidence suggests that inflammatory mechanisms are important participants in the pathophysiology of hypertension. In this study, the inflammatory status of these tissues (kidney, liver, heart, and brain) in spontaneously hypertensive rats (SHR) was analyzed and its molecular mechanism was explored. The tissues were dissected from SHR and age-matched control Wistar-Kyoto (WKY) rats to investigate the abundance of inflammation-related mediators (IL-1beta, TNFalpha, ICAM-1, iNOS, C/EBPdelta and PPARgamma). mRNA levels were determined by reverse transcription-polymerase chain reaction and protein expression was evaluated by Western blot. To evaluate the oxidative stress of tissues, carbonyl protein content and total antioxidant capacity of tissues were detected by spectrophotometry and ferric reduction ability power (FRAP) method. The results suggest that: (1) Expressions of inflammation-related mediators (IL-1beta, TNFalpha, ICAM-1, iNOS, C/EBPdelta and PPARgamma) in SHR were higher compared with those in WKY rats except no evident increase of IL-1beta mRNA in liver and brain in SHR. (2) Tissues in SHR contained obviously increased carbonyl protein (nmol/mg protein) compared to that in WKY rats (8.93+/-1.08 vs 2.27+/-0.43 for kidney, 2.23+/-0.23 vs 0.17+/-0.02 for heart, 13.42+/-1.10 vs 5.72+/-1.01 for brain, respectively, P<0.05). However, no evident difference in the amount of carbonyl protein in liver was detected between SHR and WKY rats. (3) Total antioxidant capacities of kidney, liver, heart and brain were markedly lower in SHR than that in WKY rats (P<0.05). Thus, the present data reveal a higher inflammatory status in the important tissues in SHR and indicate that inflammation might play a potential role in pathogenesis of hypertension and secondary organ complications.

Animals↗
PubMed2005

Inflammation and accelerated atherosclerosis: basic mechanisms.

This article summarizes knowledge of the pathogenic mechanisms in autoimmune rheumatic diseases as risk factors for accelerated atherosclerosis. The studies described support a role for immunologic-inflammatory mechanisms in the pathogenesis of atherosclerosis. This immunologic-inflammatory state is evident in many autoimmune diseases, but also in the general population lacking an overt autoimmune disease. The ability to immunomodulate atherosclerosis (currently only experimental) should lead to future research into the mechanisms and treatment of atherosclerosis, the leading cause of death in the Western world.

Arteriosclerosis↗
PubMed1998

Glucocorticoids in Alzheimer's disease. The story so far.

The inflammatory hypothesis of Alzheimer's disease states that specific inflammatory mechanisms, including the cytokine-driven acute-phase response, complement activation and microglial activation, contribute to neurodegeneration. If the hypothesis is correct, anti-inflammatory treatment aimed at suppression of these mechanisms could slow the rate of disease progression. Towards this goal, a multicentre trial of prednisone in Alzheimer's disease is under way and pilot studies of other anti-inflammatory regimens are being conducted.

Aged↗
PubMed2005

Aging is characterized by a profound reduction in anti-inflammatory lipoxin A4 levels.

Ongoing low-grade chronic inflammation represents a pathogenetic background for age-related diseases. In this report, we tested the hypothesis that endogenous anti-inflammatory mechanisms may become less efficient with age, resulting in increased susceptibility to inflammatory disorders. Using previously validated ELISA assays, we evaluated urinary levels of the anti-inflammatory, pro-resolution, arachidonic acid (AA) metabolite, lipoxin (LX)A(4) and of the pro-inflammatory cysteinyl leukotrienes (cysLTs) in volunteers aged from 26 to over 100 years. (i) LXA(4) excretion was decreased in elderly people, resulting in a profound unbalance of the LXA(4)/cysLTs ratio, which may be considered an index of the endogenous anti-inflammatory potential. A significant inverse correlation was denoted between age and the LXA(4)/cysLTs ratio (rho = -0.41, P = 0.0026). We conclude that aging is associated with a switch in arachidonic acid metabolism that prevents formation of key 'stop signals' of the inflammatory reaction. This may contribute to promote the development of disease in elderly.

Adult↗
PubMed2004

Connection of lipid peroxide oxidation with the sphingomyelin pathway in the development of Alzheimer's disease.

Alzheimer's disease (AD) is characterized by progressive decline in cognition, memory and intellect. It has been hypothesized that amyloid-beta peptide (A-beta) may have a prominent role in neurodegeneration. Oxidative mechanisms have been implicated in this pathway. There is substantial evidence that inflammatory mechanisms, induced by tumour necrosis factor alpha (TNF-alpha), are also involved in AD. TNF-alpha activates receptors linked to multiple effector systems, including a sphingomyelin pathway and peroxide oxidation. We have determined the changes of neutral sphingomyelinase activity, sphingomyelin and ceramide contents, and the level of lipid peroxide products (conjugated dienes), in the cerebral cortex, hippocampus and cerebellum of rats within 3 h and 7 days of intracerebral injection of A-beta and TNF-alpha. A single injection of A-beta and TNF-alpha has been shown to increase the level of peroxide products in the hippocampus and cerebral cortex within 3 h and 7 days. Sphingomyelinase activity and ceramide levels have been found to increase 7 days after A-beta administration. We found that activation of the sphingomyelin pathway lies downstream from the oxidative stress.

Alzheimer Disease↗
PubMed2002

Presence of cysteinyl leukotrienes in asthmatic patients with chronic sinusitis.

INTRODUCTION: The association between asthma and sinusitis has long been recognized. Numerous studies point to a complex, yet undeniable relationship between asthma and chronic sinusitis and rhinitis. There have also been extensive attempts to characterize the inflammatory mechanisms of both disorders. Increasingly, the cysteinyl leukotrienes, a potent group of inflammatory mediators, have gained attention as important contributors to the manifestation of both disorders. Leukotriene production has been shown to be upregulated in the bronchial tissue of asthmatics. Our study sought to determine if leukotriene production was increased in the sinus mucosa of asthmatics with chronic sinusitis. STUDY DESIGN: Prospective study. METHODS: Nasal polyp tissue was evaluated from 27 consecutive patients undergoing elective polypectomy. The presence of asthma was determined by patient history, their medical record, and use of asthma medication. Sinus tissue was extracted during the course of endoscopic surgery. Cysteinyl leukotrienes (CysLT) were quantified by a sensitive competitive enzyme immunoassay, and the levels of CysLT were compared in the group with and without asthma. RESULTS: Cysteinyl leukotrienes were detected in 23 of 27 patients. The average level of LTC4 in non-asthmatic patients was 25.6 picograms (pg)/g. The average amount of LTC4 in asthmatic patients with sinusitis was 19.2 pg/g. There was no significant difference between the two groups (P =.64). CONCLUSIONS: The presence of asthma does not correlate with increased levels of leukotrienes in the sinus mucosa of patients with chronic sinusitis.

Asthma↗
PubMed2006

The blood-brain barrier and epilepsy.

During the past several years, there has been increasing interest in the role of the blood-brain barrier (BBB) in epilepsy. Advances in neuroradiology have enhanced our ability to image and study the human cerebrovasculature, and further developments in the research of metabolic deficiencies linked to seizure disorders (e.g., GLUT1 deficiency), neuroinflammation, and multiple drug resistance to antiepileptic drugs (AEDs) have amplified the significance of the BBB's relationship to epilepsy. Prior to 1986, BBB research in epilepsy focused on three main areas: ultrastructural studies, brain glucose availability and transport, and clinical uses of AEDs. However, contrast-based imaging techniques and medical procedures such as BBB disruption provided a framework that demonstrated that the BBB could be reversibly disrupted by pathologic or iatrogenic manipulations, with important implications in terms of CNS drug delivery to "multiple drug resistant" brain. This concept of BBB breakdown for therapeutic purposes has also unveiled a previously unrecognized role for BBB failure as a possible etiologic mechanism in epileptogenesis. Finally, a growing body of evidence has shown that inflammatory mechanisms may participate in the pathological changes observed in epileptic brain, with increasing awareness that blood-borne cells or signals may participate in epileptogenesis by virtue of a leaky BBB. In this article we will review the relationships between BBB function and epilepsy. In particular, we will illustrate consensus and divergence between clinical reality and animal studies.

Animals↗
PubMed2000

Paediatric issues relating to the pharmacotherapy of allergic rhinitis.

The prevalence of allergic rhinitis in children has risen significantly over the last two decades. Important comorbidities like asthma have grown in parallel due to a complex mix of environmental and genetic factors. These conditions have similar allergic inflammatory mechanisms, which raises the possibility of treating both conditions by targeting shared inflammatory mediators pharmacologically. The first line treatment for paediatric allergic rhinitis is a topical nasal corticosteroid or a non-sedating antihistamine. Available intranasal corticosteroids show superior symptom control to second-generation antihistamines. However, most topical steroids and non-sedating antihistamines have equivalent clinical efficacy within their respective classes, so the choice of agent depends on safety and tolerability. Ideally, topical nasal steroids should exhibit high local receptor binding affinity and low systemic bioavailability, allied with a lack of long-term growth suppression in children and adolescents. Regular use of topical steroids is advisable, but intermittent and prophylactic use is also effective. Second-generation antihistamines are effective and some have no adverse cardiac or sedative effects. Non-sedating antihistamine treatment can ameliorate rhinitis-induced decrements in learning. alpha-Adrenergic nasal decongestants provide short-term benefit, but topical agents can cause rebound symptoms. Prophylactic treatment with chromones is safe and effective, but multiple daily dosing is needed. Ipratroprium bromide nasal spray is useful as an intermittent therapy for mild disease or as add-on treatment, but its effect is limited to the control of rhinorrhoea. Children with allergic rhinitis should receive pharmacotherapy if allergen avoidance measures are ineffective, ideally with a topical intranasal steroid or a second-generation antihistamine.

Administration, Inhalation↗
PubMed2002

Overview of causes of COPD. New understanding of pathogenesis and mechanisms can guide future therapy.

Recent studies have greatly expanded the understanding of pathogenetic mechanisms underlying COPD. Cigarette smoking is the most important cause. Activation of inflammatory mechanisms in the lung leads to tissue damage by a variety of mechanisms. Active proteases and oxidants are believed to play crucial roles. In response to this injury, repair mechanisms are activated. Unfortunately, these repair mechanisms also may be adversely affected by cigarette smoking. Insufficient repair of alveolar structures in response to injury likely leads to emphysema. Repair with scarring likely leads to airflow limitation in chronic bronchitis. Moreover, mediators that drive these processes have systemic effects that contribute to the syndromes characteristic of COPD. Understanding these mechanisms has created novel therapeutic approaches to the management of this disorder.

Endopeptidases↗
PubMed2006

Cytokine network and its manipulation in rheumatoid arthritis.

Studies of the inflammatory process in the inflamed synovium from rheumatoid arthritis patients have shown an intricate network of molecules involved in its initiation, perpetuation and regulation trial balances the pro- and anti-inflammatory process. This system is self-regulating though the action of anti-inflammatory and pro-inflammatory cytokines cytokine receptor antagonists and naturally occurring antibodies cytokines. Inflammatory synovitis in rheumatoid arthritis (and possibly in other inflammatory arthritidies) appears to be the result of an imbalance in the cytokine network with either an excess production of pro-inflammatory cytokines or from inadequacy of the natural anti-inflammatory mechanisms. Using this knowledge the newer therapeutic approaches to RA and other inflammatory arthritides are being aimed at correcting this imbalance. Monoclonal antibodies to INF-alpha (humanised form of this is called infliximab), soluble TNF-alpha receptors (etanercept) are already in clinical use and adalimumab (humanised TNF-alpha antibody). IL-1Ra is undergoing clinical trials. Other promising therapeutic agents that could regulate the cytokine network are in various stages of laboratory and clinical evaluation. These studies promise to yield therapeutic targets that could dramatically change the way inflammatory diseases would he treated in the future. The now established efficacy of infliximab and etanercept in inflammatory arthritides could be considered just a glimpse of the exciting scenario of the future.

Arthritis, Rheumatoid↗
PubMed2000

Analgesic effect of thalidomide on inflammatory pain.

Tumor necrosis factor alpha (TNF-alpha) may have a pivotal role in the genesis of mechanical inflammatory hyperalgesia in rats and in the nociceptive writhing response in mice. Thalidomide has been shown to selectively inhibit TNF-alpha production. We therefore investigated the effect of thalidomide on these responses as well as on the hot plate response in mice. Hyperalgesic responses to intraplantar (i.pl.) injections of carrageenin or bradykinin, which act by stimulating TNF-alpha release, but not responses to TNF-alpha or prostaglandin E(2), were inhibited in a dose-dependent manner by pretreatment of the animals with thalidomide. The nociceptive writhing responses induced by intraperitoneal (i.p.) injections of zymosan or acetic acid were also inhibited in a dose-dependent manner by pretreatment of mice with thalidomide. Moreover, the thalidomide pretreatment also reduced the TNF-alpha mRNA levels in the peritoneal cells induced by injection of zymosan in mice. The analgesic effect of thalidomide is not due to a central effect, since the drug had no effect in the hot plate test. The demonstration that thalidomide is able to inhibit inflammatory hyperalgesia in rats and the writhing nociceptive response in mice suggests that these analgesic effects seem to be a consequence of the inhibition of TNF-alpha production, and indicates the need for investigations on the possibility of the use of thalidomide for the treatment of pain refractory to classical non-narcotic analgesics.

Acetates↗
PubMed2002

Fenoterol inhibits superoxide anion generation by human polymorphonuclear leukocytes via beta-adrenoceptor-dependent and -independent mechanisms.

BACKGROUND: Beta2-adrenoceptor agonists, used widely as bronchodilator in treating bronchial asthma, may have anti-inflammatory activity. OBJECTIVE: We examined whether various widely prescribed beta2-adrenoceptor agonists differ in anti-inflammatory mechanisms. METHODS: We investigated effects of these drugs on superoxide anion generation by stimulated human polymorphonuclear leukocytes in vitro using chemiluminescence. RESULTS: At high concentrations, fenoterol significantly inhibited both N-formylmethionyl-leucyl-phenylalanine- and phorbol myristate acetate-induced superoxide generation by neutrophils. In contrast, salbutamol or procaterol partially inhibited generation with the former stimulus but not the latter. Inhibition by salbutamol or procaterol was completely reversed by either propranolol, a nonselective beta-adrenoceptor antagonist, or ICI-118551, a beta2-adrenoceptor-selective antagonist. In contrast, the effect of fenoterol at concentrations exceeding 10(-6) M against superoxide generation with the former stimulus was only partially reversed by antagonists, and the effect of high concentrations of fenoterol against generation with the latter stimulus was not reversed. No drugs scavenged superoxide at the highest concentration used (10(-5) M). CONCLUSIONS: Fenoterol at high concentrations has an inhibitory effect on superoxide generation that includes a component not mediated via beta2-adrenoceptors. Direct inhibition at or downstream from protein kinase C may be involved.

Adrenergic beta-Agonists↗
PubMed2002

Postischemic acute renal failure is reduced by short-term statin treatment in a rat model.

Postischemic acute renal failure (ARF) is common and often fatal. Cellular mechanisms include cell adhesion, cell infiltration and generation of oxygen free radicals, and inflammatory cytokine production. Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors ("statins") directly influence inflammatory mechanisms. The hypothesis that ischemia-induced ARF could be ameliorated with statin treatment was investigated and possible molecular mechanisms were analyzed in a uninephrectomized rat model. Male Sprague-Dawley rats were pretreated with cerivastatin (0.5 mg/kg) or vehicle for 3 d. Ischemic ARF was induced by left renal artery clipping for 45 min, while the right kidney was being removed. After 24 h of ARF, serum creatinine levels were increased 7.5-fold in vehicle-treated control animals with ARF, compared with sham-operated animals (P < 0.005). Statin treatment reduced the creatinine level elevation by 40% (P < 0.005). Simultaneously, ischemia-induced severe decreases in GFR were significantly ameliorated by statin treatment (sham operation, 0.95 +/- 0.09 ml/min, n = 13; ischemia without treatment, 0.06 +/- 0.02 ml/min, n = 9; ischemia with statin pretreatment, 0.21 +/- 0.03 ml/min, n = 11; P < 0.001). Furthermore, statin pretreatment prevented the occurrence of tubular necrosis, with marked loss of the brush border, tubular epithelial cell detachment, and tubular obstruction in the S3 segment of the outer medullary stripe. In addition, monocyte and macrophage infiltration was almost completely prevented, intercellular adhesion molecule-1 upregulation was greatly decreased, and inducible nitric oxide synthase expression was reduced. Fibronectin and collagen IV expression was reduced, approaching levels observed in sham-operated animals. In vehicle-treated rats with ARF, mitogen-activated protein kinase extracellular activated kinase-1/2 activity was increased and the transcription factors nuclear factor-kappaB and activator protein-1 were activated. Statin treatment reduced this activation toward levels observed in sham-operated rats. The data suggest that hydroxy-3-methylglutaryl coenzyme A reductase inhibition protects renal tissue from the effects of ischemia-reperfusion injury and thus reduces the severity of ARF. The chain of events may involve anti-inflammatory effects, with inhibition of mitogen-activated protein kinase activation and the redox-sensitive transcription factors nuclear factor-kappaB and activator protein-1.

Acute Kidney Injury↗