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Endogenous prostaglandins selectively mask large arteriole constriction to angiotensin II.

Television microscopy was used to observe the responses of in vivo arterioles and venules of the rat cremaster muscle to the topical application of angiotensin II (10(-8) and 10(-6) M). Neither the first- (A1) or second-order arterioles (A2) nor the first- (V1) or second-order venules (V2) constricted significantly to angiotensin II. However, after the inhibition of local prostaglandin synthesis with either mefenamic acid or indomethacin, both A1 and A2, but not the venules, gave a significant constrictor response to angiotensin II (10(-6) M). Arterioles and venules, which were preconstricted with norepinephrine, dilated to their initial baseline diameters after angiotensin II (10(-6) M), a response not observed when the microvessels were pretreated with either an angiotensin antagonist or a prostaglandin synthesis inhibitor. These observations indicate that endogenous prostaglandins exert a significant dilator influence on the larger arterioles, that this dilator influence appears to oppose the constrictor effect of angiotensin II, and that angiotensin II acts on specific receptors to induce synthesis and/or release of dilator prostaglandins in large arterioles. However, prostaglandins cannot account for the absence of a venular constriction to angiotensin.

Angiotensin II↗

Role of nitric oxide and prostaglandins in the regulation of diaphragmatic arteriolar tone in the rat.

We evaluated by intravital microscopy in rats the relative importance of nitric oxide (NO) and prostaglandins in 1) the maintenance of basal diaphragmatic arteriolar tone and 2) the response of diaphragmatic arterioles to the endothelium-dependent vasodilator acetylcholine (ACh). One hundred two mechanically ventilated rats were studied. Separate applications of N omega-nitro-L-arginine (L-NNA) and mefenamic acid (MA), which are specific inhibitors of NO and prostaglandin synthesis, respectively, elicited a significant reduction in basal diaphragmatic arteriolar diameter. A dramatic potentiation of the effect of each inhibitor was observed when both agents were applied simultaneously. ACh application induced a significant and dose-dependent increase in arteriolar diameter that was not significantly modified by the separate application of L-NNA or MA. Conversely, the simultaneous administration of L-NNA and MA almost completely prevented ACh-induced arteriolar dilatation. Dilatation in response to sodium nitroprusside was not significantly modified in the presence of both inhibitors. These results suggest that NO and prostaglandins act in concert to regulate basal diaphragmatic arteriolar tone and to mediate diaphragmatic arteriolar response to ACh.

Acetylcholine↗

Differential effect of cyclo-oxygenase inhibition on antigen- and ionophore-induced release of slow reacting substance from fragmented guinea-pig lung.

The nonsteroidal anti-inflammatory drugs (NSAID) indomethacin and mefenamic acid, at concentrations ranging from 3 microM to 18 microM, enhanced antigen-induced slow reacting substance of anaphylaxis (SRS-A) release from sensitized fragmented guinea-pig lung. In contrast, these agents had no effect on SRS-A release from nonsensitized guinea-pig lung induced by several concentrations of the calcium ionophore, A23187. Neither increasing preincubation time with the NSAID nor the use of sensitized tissue resulted in an enhancement of A23187-induced SRS-A release by indomethacin. NSAID did not alter histamine release by either stimulus. These results suggest that antigen and A23187 induce SRS-A release from different sources or by different mechanisms in guinea-pig lung.

6-Ketoprostaglandin F1 alpha↗

Long-term induction of a unique C1- current by endothelin-1 in an epithelial cell line from rat lung: evidence for regulation of cytoplasmic calcium.

1. Using conventional microelectrodes, the perforated patch clamp technique and fluorescence microscopy with fura-2, we investigated the relationship between the cell membrane potential, whole-cell currents and the free cytoplasmic Ca2+ concentration ([Ca2+]i) in response to 10 nM endothelin-1 (ET) in a rat respiratory epithelial cell line (L2). 2. Microelectrode experiments revealed that ET caused an immediate depolarization of the cell membrane potential (Vm) by 25 mV, which was unaffected by Na+ replacement with N-methyl-D-glucamine+ (NMDG+) or by omission of bath Ca2+. In contrast, ET depolarized the cells by 61 mV in the presence of low C1- (6 mM), resulting in a complete breakdown of Vm. 3. In perforated patch clamp experiments, the ET-induced whole-cell current (IET) exhibited a slight outward rectification with a reversal potential (Vrev) of -22.7 mV. IET was reduced by 85 % in low C1- (6 mM), but was unaffected by Ca2+ removal, Na+ replacement with NMDG+, pipette K+ replacement with Cs+ or 1 mM Ni2+ in the bath. 4. IET was unaffected by (+)-isradipine (100 nM), a specific L-type Ca2+ channel (L-VDCC) blocker. Transient inward Sr2+ currents through L-VDCCs were blocked by ET. 5. ET induced a biphasic Ca2+ signal, consisting of a 'peak' and a 'plateau' elevation of [Ca2+]i. Simultaneous patch clamp and fura-2 measurements revealed that IET coincided with intracellular Ca2+ release but clearly outlasted the elevation of [Ca2+]i. When the rise of [Ca2+]i was prevented by pretreatment with thapsigargin in a Ca2+-free bath, both activation time and amplitude of IET were reduced. Under these conditions, ET caused a decrease of [Ca2+]i. 6. The C1- channel blocker mefenamic acid (MFA) had a dual, concentration-dependent effect on both IET and the ET-induced 'plateau' elevation of [Ca2+]i: an increase at 10 microM, but an almost complete block at 100 microM. The effect of MFA on IET preceded the effect on [Ca2+]i. 7. The ET-induced 'plateau' [Ca2+]i fell below control values in a low-C1- (6 mM) solution. 8. These data indicate an amplifying function of intracellular Ca2+ release on an otherwise Ca2+-independent, unique C1- current by ET. Moreover, this C1- current appears to be functionally coupled with dihydropyridine (DHP)-insensitive Ca2+ entry, suggesting a modulatory role for long-lasting effects of ET.

Animals↗

Prostaglandin synthesis inhibition and postprandial intestinal hyperemia.

The effect of prostaglandin synthesis inhibition on the postprandial intestinal hyperemia was examined in the jejunum of anesthetized dogs. Both intravenous and intra-arterial infusion of the cyclooxygenase inhibitors indomethacin and mefenamic acid reduced resting jejunal blood flow and markedly enhanced the food-induced jejunal hyperemia. The jejunal vascular response to food did not change after either intravenous or intra-arterial infusion of the carrier solutions or intra-arterial infusion of angiotensin II. The enhancement of the jejunal hyperemia was associated with an increase in the food-induced increase in jejunal oxygen consumption. Infusion of the cyclooxygenase inhibitors increased the mean amplitude of the monophasic intestinal contractions; however, this did not appear to play a role in the enhancement of the food-induced hyperemia. The study indicates that inhibition of prostaglandin synthesis has a marked effect on the postprandial intestinal hyperemia and that this may be due to its enhancement of the jejunal metabolic response to food. The prostaglandins involved and their mechanism of action are unknown.

Animals↗

Determinations of fluoroquinolones and nonsteroidal anti-inflammatory drugs in urine by extractive spectrophotometry and photoinduced spectrofluorimetry using multivariate calibration.

Multivariate calibration methods are chemometric tools that may be applied to the analysis of spectroscopic data with multichannel detection. Two procedures, based on spectrophotometric and fluorimetric signals, are reported for the simultaneous determination of two fluoroquinolones (ciprofloxacin and ofloxacin) and two nonsteroidal anti-inflammatory drugs (diclofenac and mefenamic acid) using first- and second-order multivariate calibration methods. In the spectrophotometric method, an extractive procedure into chloroform using trioctylmethylammonium chloride-adogen as counter ion was optimized, with the object of extracting the analytes from urine samples and eliminating matrix interferences. After separation, the absorption spectrum of the organic phase was used as the analytical signal in a partial least squares method. A photoinduced spectrofluorimetric (PIF) method using excitation-emission fluorescence matrices, is proposed, to apply three-way chemometric calibration, with the aim of analyzing ofloxacin, ciprofloxacin, and diclofenac in urine samples without the previous extractive sample-cleaning step. For both procedures, recoveries around 100% were found for all the analytes. However, the PIF three-way chemometric method provides the most sensitive and selective procedure as the urine interferences are modulated using the three-way chemometric technique.

Anti-Inflammatory Agents, Non-Steroidal↗

Pediatric posterior reversible leukoencephalopathy syndrome and NSAID-induced acute tubular interstitial nephritis.

Reversible posterior leukoencephalopathy syndrome is a recently described disorder with typical radiologic findings in the posterior regions of the cerebral hemisphere and cerebellum. The symptoms include headache, nausea, vomiting, visual disturbances, focal neurologic deficits, and seizures. A 10-year-old male was hit on his back, resulting in backache. He was medicated with sodium diclofenate and mefenamic acid. The next day, he had edema and oliguria. By the third day, his blood pressure increased and he began to experience restlessness and worsening mental status. He then complained of headache and visual disturbances and had a seizure. A magnetic resonance imaging scan revealed abnormalities in the posterior regions of the cerebral hemisphere and cerebellum. The patient was treated with antiepileptics and calcium antagonists. His hypertension and seizures were well controlled. On the 22nd day, he was discharged without any neurologic or renal deficits. Reversible posterior leukoencephalopathy syndrome does not occur frequently in childhood, and this is the first case report of reversible posterior leukoencephalopathy syndrome related to nonsteroidal anti-inflammatory drugs. One should consider reversible posterior leukoencephalopathy syndrome as a side effect of nonsteroidal anti-inflammatory drug use in daily medical treatment.

Acute Disease↗

Neuroprotective effects of non-steroidal anti-inflammatory drugs by direct scavenging of nitric oxide radicals.

Recently, it has been reported that inflammatory processes are associated with the pathophysiology of Alzheimer's disease and that treatment of non-steroidal anti-inflammatory drugs reduce the risk for Alzheimer's disease. In the present study, we examined nitric oxide radical quenching activity of non-steroidal anti-inflammatory drugs and steroidal drugs using our established direct in vitro nitric oxide radical detecting system by electron spin resonance spectrometry. The non-steroidal anti-inflammatory drugs, aspirin, mefenamic acid, indomethacin and ketoprofen directly and dose-dependently scavenged generated nitric oxide radicals. In experiments of nitric oxide radical donor, NOC18-induced neuronal damage, these four non-steroidal drugs significantly prevented the NOC18-induced reduction of cell viability and apoptotic nuclear changes in neuronal cells without affecting the induction of inducible nitric oxide synthase-like immunoreactivity. However, ibuprofen, naproxen or steroidal drugs, which had less or no scavenging effects in vitro, showed almost no protective effects against NOC18-induced cell toxicity. These results suggest that the protective effects of the former four non-steroidal anti-inflammatory drugs against apoptosis might be mainly due to their direct nitric oxide radical scavenging activities in neuronal cells. These direct NO. quenching activities represent novel effects of non-steroidal anti-inflammatory drugs. Our findings identified novel pharmacological mechanisms of these drugs to exert not only their anti-inflammatory, analgesic, antipyretic activities but also neuroprotective activities against neurodegeneration.

Alzheimer Disease↗

Peritoneal dialysis solutions contract arteries through endothelium-independent prostanoid pathways.

Conventional peritoneal dialysis solution (PDS) relaxes visceral and parietal peritoneal arterioles (microvessels) by unclear mechanisms. The present study was originally designed to investigate the mechanisms of PDS-mediated vascular reactivity. Surprisingly, our preliminary data indicated that PDS induces contraction in large vessels such as the aorta. That result contrasts with the relaxation observed in the microvasculature. We therefore extended the study to (1) determine the effect of PDS on the superior mesenteric artery (SMA), (2) confirm the PDS-induced contraction in the aorta, and (3) determine if a prostanoid and nitric oxide are involved in the observed PDS-induced vessel response. Rat SMA rings with intact endothelium and aortic rings with and without endothelium were prepared and placed in baths filled with a non vasoactive physiologic salt solution (PSS), or with PSS plus mefenamic acid (MFA, a cyclo-oxygenase inhibitor), or PSS plus NG-monomethyl-L-arginine (L-NMMA, an inhibitor of nitric oxide synthase) under a force transducer. We recorded changes in tension throughout the protocols. After equilibration, the baths were filled with a conventional glucose-based PDS (Delflex 2.5%: Fresenius Medical Care, Bad Homburg, Germany) with and without MFA or L-NMMA for 30 minutes. The rings were then washed, contracted with phenylephrine, and relaxed with acetylcholine to verify the presence or absence of endothelium. In both SMA and aorta, PDS induced contraction. That contraction was suppressed by MFA [SMA: 0.57 g vs. 0.13 g (+/- 0.035 g); aorta: 0.88 g vs. 0.27 g (+/- 0.035 g); p < 0.05 by analysis of variance (ANOVA)]. Aortic contraction induced by PDS was not altered by L-NMMA. Conventional PDS induces contraction in large vessels, in contrast to its action of relaxation in microvessels. Vascular reactivity in large vessels involves the production of a constrictor prostanoid in the vascular smooth muscle. Peritoneal dialysis solutions do not induce NO in aortic endothelium. Peritoneal dialysis solution-induced, prostanoid-mediated contraction of smooth muscle may contribute to a worsening of hypertension and the premature uterine contractions observed in the rare cohort of pregnant uremic patients on peritoneal dialysis.

Animals↗

Survival of severe amlodipine intoxication due to medical intensive care.

We report the case of attempted suicide with amlodipine, chlorthalidone and mefenamic acid and subsequent medical intensive care measures which resulted in total recovery of a 42-year-old male. After admission to the medical intensive care unit the intoxicated patient was deeply hypotensive and needed fluid replacement, dobutamine and norepinephrine. Additionally insulin and calcium gluconate were given. Since hypotension persisted and the patient developed oliguria, terlipressin was applied and finally showed an effect on blood pressure and on urinary output. A volume overload of 7 L in the first 24 h resulted in a pulmonary edema. The patient was started on non-invasive ventilation with continuous positive airway pressure (CPAP) and frusemide was added to the therapy with good success. Quantitative determination of amlodipine in plasma samples was performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The highest amlodipine concentrations was measured in the plasma sample collected approximately 8 h after ingestion of the drug, and was 393 microg/L. Four days later, it was possible to stop the treatment with catecholamines, at that time the amlodipine plasma concentration had declined to 132 microg/L, still tenfold higher than therapeutic (5-18 microg/L). Elimination half-life of amlodipine is approximately 55 h. After 6 days in the intensive care unit the patient was transferred to psychiatric treatment. Intensive care management and plasma levels in this intoxication case are compared to data from literature on other cases.

Adult↗

[New esters of N-arylanthranilic acids].

A series of acyloxy- and alkyloxymethyl esters of meclofenamic, flufenamic and mefenamic acids has been synthesized and its antiinflammatory, analgesic and antipyretic activities have been compared with those of the corresponding acids and the methyl, beta,gamma-isopropylidene-dioxypropyl, N,N-diethylaminoethyl esters. The acyloxy- and alkyloxymethyl esters are the most interesting compounds, because they possess pharmacological activity of the same order as that of the corresponding acids and a lower toxicity. The ethoxymethyl ester of the N-(2,6-dichloro-m-tolyl)anthranilic acid is presently under clinical investigation.

Analgesics↗

Influence of anti-inflammatory agents on rat liver mitochondrial ATPase.

Several classes of anti-inflammatory agents including acetyl-salicylic acid, salicylic acid, flufenamic acid, phenyl-butazone, indometacin, oxyphenyl-butazone, and mefenamic acid were found to be inhibitors of rat liver mitochondrial ATPase in both intact and freeze-ruptured mitochondria. The freeze-ruptured mitochondrial ATPase was found to be Mg2+- and ATP-concentration dependent. The standard uncoupler, 2,4-dinitrophenol, not possessing anti-inflammatory activity, activates the enzyme in both preparations. A number of compounds of various structural classes possessing no anti-inflammatory property in vivo were found to have no inhibitory effect on the enzyme. This inhibition of ATPase by anti-inflammatory agents could be used as an in vitro test method for the primary screening of potential anti-inflammatory agents.

Adenosine Triphosphatases↗

Pharmaceutical chemicals and endocrine disrupters in municipal wastewater in Tokyo and their removal during activated sludge treatment.

We measured six acidic analgesics or anti-inflammatories (aspirin, ibuprofen, naproxen, ketoprofen, fenoprofen, mefenamic acid), two phenolic antiseptics (thymol, triclosan), four amide pharmaceuticals (propyphenazone, crotamiton, carbamazepine, diethyltoluamide), three phenolic endocrine disrupting chemicals (nonylphenol, octylphenol, bisphenol A), and three natural estrogens (17beta-estradiol, estrone, estriol) in 24-h composite samples of influents and secondary effluents collected seasonally from five municipal sewage treatment plants in Tokyo. Aspirin was most abundant in the influent, with an average concentration of 7300 ng/L (n = 16), followed by crotamiton (921 ng/L), ibuprofen (669 ng/L), triclosan (511 ng/L), and diethyltoluamide (503 ng/L). These concentrations were 1 order of magnitude lower than those reported in the USA and Europe. This can be ascribed to lower consumption of the pharmaceuticals in Japan. Aspirin, ibuprofen, and thymol were removed efficiently during primary + secondary treatment (> 90% efficiency). On the other hand, amide-type pharmaceuticals, ketoprofen, and naproxen showed poor removal (< 50% efficiency), which is probably due to their lower hydrophobicity (logKow < 3). Because of the persistence of crotamiton during secondary treatment, crotamiton was most abundant among the target pharmaceuticals in the effluent. This is the first paper to report ubiquitous occurrence of crotamiton, a scabicide, in sewage. Because crotamiton is used worldwide and it is persistent during secondary treatment, it is a promising molecular marker of sewage and secondary effluent.

Endocrine Disruptors↗

The immunomodulatory effect of CCA (N-(2-carboxyphenyl)-4-chloroanthranilic acid disodium salt) on IgG antibody response in mice immunized with ovalbumin.

CCA(N-(2-carboxyphenyl)-4-chloroanthranilic acid disodium salt is a new synthetic compound which structurally resembles mefenamic acid. CCA induces inhibition of the adjuvant arthritis in rats and has been reported as activator of suppressor T lymphocytes. These findings stimulated to us to elucidate whether or not CCA possesses inhibitory effects on immunoglobulin E (IgE) production, an immunological system in which T suppressor cells play a cardinal role. Mice F1 (BALB/c x C57BL/6J) and C3H/A were immunized using the procedure of several s.c. injections with low dose of ovalbumin and aluminium hydroxide gel. CCA (5 mg/kg and 50 mg/kg) was administered to mice several weeks by oral route. The titers of IgE were compared in controls and treated animals using the method of passive cutaneous anaphylaxis (PCA) in rats. At a dose of 5 mg/kg CCA reduced partially the titers of IgE in treated animals with respect to controls and at a dose of 50 mg/kg this inhibition was more pronounced. These results support a potential usefulness of CCA in bronchial asthma and other immediate type allergic disorders.

Animals↗

Interaction of various non-steroidal anti-inflammatories and quinolone antimicrobials on GABA response in rat dissociated hippocampal pyramidal neurons.

Interaction of various non-steroidal anti-inflammatory drugs (NSAIDs) and quinolone antimicrobials with gamma-aminobutyric acid (GABA)A receptor-Cl- channel complex was investigated in rat dissociated hippocampal CA1 neurons by using whole-cell mode patch-clamp technique. Neither NSAIDs nor quinolones alone affected the GABA-induced chloride current (ICl). In the presence of norfloxacin (NFLX), one of quinolones, some NSAIDs suppressed the GABA response in a concentration-dependent manner. The inhibitory potency of NSAIDs was 4-biphenylacetic acid (BPA), a metabolite of fenbufen much greater than indomethacin = naproxen greater than mefenamic acid greater than diclofenac greater than piroxicam. The results suggest that fenbufen, indomethacin and naproxen in the presence of quinolones may induce the epileptogenic neurotoxicities via pharmacological interaction with GABAA receptor.

4-Quinolones↗

Prediction of human analgesic dosages of nonsteroidal anti-inflammatory drugs (NSAIDs) from analgesic ED50 values in mice.

The oral analgesic activities (ED50's) of 15 NSAIDs were determined in the phenylquinone-induced writhing test in mice. ED50 values (mg/kg) were: acetylsalicylic acid (182), fenclofenac (168), phenylbutazone (129), ibuprofen (82.2), diflunisal (55.6), benoxaprofen (25.4), naproxen (24.1), mefenamic acid (20.7), indomethacin (19.0), meclofenamate sodium (9.60), sulindac (7.20), fenoprofen calcium (3.70), tolmetin (1.30), zomepirac sodium (0.70), and piroxicam (0.44). Significant linear correlations were found between mouse ED50 values and the various recommended human analgesic or anti-inflammatory dosages. Thus, analgesic ED50 values (mg/kg p.o.) in mice (X) may be used to predict human dosages (Y) of NSAIDs according to the equation Y = 8.26X + 535, where Y is the projected human daily dosage (mg).

Administration, Oral↗

Synthesis of new thieno [2,3-d]pyrimidine-2,4(1H,3H)-diones with analgesic and anti-inflammatory activities.

A series of new 1,3-disubstituted thieno[1,3-d]pyrimidine-2,4(1H,3H)-diones were prepared to investigate their analgesic and anti-inflammatory properties. The analgesic and anti-inflammatory activities of synthesized compounds were investigated by the phenylquinone-induced writhing syndrome test, carrageenan rat paw oedema test and acetic acid-induced peritonitis assay. Most of the new compounds were found to be superior to mefenamic acid, as they were devoid of any ulcerogenic activity.

Animals↗