Synthesis of Ag/CuS doped mineral magnetite nanocomposite with improved photocatalytic activity against tetracycline and diclofenac pollutants.

The contamination of water sources by pharmaceutical pollutants presents significant environmental and health hazards, making the development of effective photocatalytic materials crucial for their removal. This research focuses on the synthesis of a novel Ag/CuS/Fe3O4 nanocomposite and its photocatalytic efficiency against tetracycline (TC) and diclofenac contaminants. The nanocomposite was created through a straightforward and scalable precipitation method, integrating silver nanoparticles (AgNPs) and copper sulfide (CuS) into a magnetite framework. Various analytical techniques, including X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR),ultraviolet-visible spectrophotometry (UV-Vis) and energy-dispersive X-ray spectroscopy (EDS), were employed to characterize the structural and morphological properties of the synthesized material. The photocatalytic activity was tested by degrading tetracycline and diclofenac under visible light. Results indicated a marked improvement in the photocatalytic performance of the Ag/CuS/Fe3O4 nanocomposite (98%photodegradation of TC 60 ppm in 30 min) compared to both pure magnetite and CuS/Fe3O4. The enhanced photocatalytic efficiency is attributed to the synergistic interaction between AgNPs, CuS, and Fe3O4, which improves light absorption and charge separation, thereby increasing the generation of reactive oxygen species (ROS) and promoting the degradation of the pollutants. The rate constant k of photodegradation was about 0.1 min-1 for catalyst dosages 0.02 g. Also the effect of photocatalyst dose and concentration of TC and pH of solution was tested. The modified photocatalyst was also used for simultaneous photodegradation of TC and diclofenac successfully. This study highlights the potential of the Ag/CuS/Fe3O4 nanocomposite as an efficient and reusable photocatalyst for eliminating pharmaceutical pollutants from water.

Potassium permanganate-modified eggshell biosorbent for the removal of diclofenac from liquid environment: adsorption performance, isotherm, kinetic, and thermodynamic analyses.

This study assess how well diclofenac (DCF) can be separated from aqueous solution using potassium permanganate-modified eggshell biosorbent (MEB). The MEB produced was characterised using XRD, FTIR, and SEM. Batch experiments were conducted to examine and assess the impact of contact time, adsorbent dosage, initial concentration, and temperature on the adsorption capacity of the MEB in the DCF sequestration. The best parameters to obtained 95.64% DCF removal from liquid environment were 0.05 g MEB weight, 50 mg/L initial concentration, and 60 min contact time at room temperature. The maximum DCF sequestration capacity was found to be 159.57 mg/g with 0.05 g of MEB at 298 K. The adsorption isotherm data were more accurately predicted by the Freundlich model, indicating a process of heterogeneous multilayer adsorption. The results of the kinetic study indicated that the pseudo-second-order kinetic models best matched the experimental data. The findings revealed that the dynamic of DCF entrapment is largely chemisorption and diffusion controlled. Based on the values of thermodynamic parameters, the process is both spontaneous and endothermic. The primary processes of DCF sorption mechanism onto the MEB were chemical surface complexation, hydrogen bonding, π-π stacking, and electrostatic interactions. The produced MEB showed effective DCF separation from the aqueous solution and continued to have maximal adsorption capability even after five regeneration cycles. These findings suggest that MEB could be highly efficient adsorbent for the removal of DCF from pharmaceutical wastewater.

Development of Magnetic Nanosystems with Potential for the Treatment of Inner Ear Pathologies.

Hearing loss (HL) affects more than 5% of the global population, with projections indicating an impact of up to 50% on young individuals in the next years. HL treatments remain limited due to the inner ear's hermeticism. HL often involves inflammatory processes, underscoring the need for enhanced delivery of antiinflammatory agents to the inner ear. Our research focuses on the development of a directed therapy based on magnetic nanoparticles (MNPs). We previously synthesized biocompatible folic acid-coated iron oxide-core nanoparticles (MNPs@FA) as potential carriers for the anti-inflammatory Diclofenac (Dfc). This study aims to incorporate Dfc onto MNPs@FA to facilitate targeted drug delivery to the inner ear. Through optimizing the loading procedure, we achieved optimal loading capacity. Dfc release was studied in the simulated target fluid and the administration vehicle. Complete characterization is also shown. In vitro biocompatibility testing ensured the biosafety of the resulting formulation. Subsequent ex vivo targeting assays on murine cochleae validated the nanosystems' ability to penetrate the round window membrane, one of the main HL therapy barriers. These findings serve as validation before continuing to more complex in vivo studies. Together, the data here presented represent an advancement in addressing unmet medical needs in HL therapy.

Efficacy and safety of diclofenac suppository for postoperative pain relief after diagnostic hystero-laparoscopy and dye test: A double-blind, placebo-controlled, randomized trial.

Objective: To determine the efficacy and safety of rectal diclofenac for relieving postoperative pain following diagnostic hystero-laparoscopy and dye test (dHLD). Methods: A prospective, double-blind, placebo-controlled, randomized trial was conducted among women who underwent dHLD to evaluate fertility. The women received either rectal diclofenac with intramuscular pentazocine or intramuscular pentazocine with rectal placebo for postoperative analgesia. The median pain scores at different time points were assessed as the primary outcome measures using the Numerical Rating Scale for pain. The secondary outcome measures were analgesic consumption, time at which first analgesic was requested, satisfaction with pain relief and any adverse events. Results: In total, 108 participants were analysed (54 in each group, 1:1 ratio). The median score for postoperative pain was lower for the diclofenac group compared with the placebo group at 4 h (52.53 vs 56.47; p = 0.507), 6 h (50.48 vs 58.52; p = 0.174), 8 h (51.42 vs 57.65; p = 0.296), 10 h (51.35 vs 57.65; p = 0.285) and 12 h (52.45 vs 56.55; p = 0.485) post surgery, although the difference was not significant (p > 0.05). Seventeen participants required rescue analgesia with 30 mg of pentazocine: 11 at 4 h post surgery [5 (62.5 %) vs 6 (66.7 %)], three at 6 h post surgery [2 (25.0 %) vs 1 (11.1 %)], two at 8 h post surgery [1 (12.5 %) vs 1 (11.1 %)], and one at 12 h post surgery [0 vs 1 (11.1 %)] for the diclofenac and placebo groups respectively (p = 0.713). There were no significant differences in postoperative adverse effect profiles, overall patient satisfaction, and need for rescue analgesia between the two groups (p > 0.05). Conclusions: Postoperative use of rectal diclofenac and pentazocine is safe, but did not significantly improve pain scores, patient satisfaction and need for rescue analgesia following dHLD, compared with patients who received pentazocine and placebo. While a multi-modal approach to pain relief following dHLD does not appear to be significantly beneficial, a multi-centre study is needed to confirm or refute these findings.

Drug-Induced Angioedema Without Urticaria: A Case Report.

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for various conditions but are associated with numerous adverse drug reactions (ADRs). Understanding these ADRs is necessary to reduce morbidity and mortality. NSAID-induced angioedema, although rare, can be life-threatening and is often due to increased leukotriene production from COX pathway inhibition. Mast cells and basophil degranulation play vital roles in its pathogenesis. Prompt recognition and immediate cessation of the culprit drug, along with the administration of corticosteroids and antihistamines, are essential. Here, we report a case of angioedema caused by diclofenac administration, which needs prompt vigilance and a rapid therapeutic response.

Thunbergia's Flowers Secondary Metabolites a Natural Armor Against Kidney Damage by Diclofenac.

Nephrotoxicity is a common side effect arising from exposure to drugs or toxins. The study investigates the therapeutic effects of Thunbergia alata and Thunbergia erecta flowers on diclofenac-induced renal injury. Secondary metabolite characterization by positive mode high-resolution-ESI (LC-HR-ESI-MS) was followed by assessing their renal protection against diclofenac-induced damage and molecular docking studies. Using positive LC-HR-ESI-MS, 18 compounds from T. erecta and T. alata were identified. Diclofenac administration induced significant deterioration of all parameters in the kidney in addition to renal tissue contents of several inflammatory markers. The flower extracts of T. alata and T. erecta showed a clear improvement in the treated groups compared to the diclofenac-control group. The results were confirmed by histopathological examinations followed by immunohistochemical determination of vascular endothelial growth factor (VEGF), nuclear factor erythroid 2-related factor 2 (Nrf2), and transforming growth factor beta 1 (TGF-ß1) expression. Furthermore, a protein-protein network to understand the complex interplay between the target proteins and their counterparts was done in addition to a molecular docking study of the de-replicated compounds in the active sites of NF-κB, TGF-ß1, and VEGFR.

From Waste to Water Purification: Textile-Derived Sorbents for Pharmaceutical Removal.

The presence of pharmaceuticals or their active metabolites in receiving waters is a sign of the inefficient removal of bioactive substrates from wastewater. Adsorption seems to be the most effective and inexpensive method of their removal. Waste management aimed at sorbents is a promising way to sustain several sustainable development goals. In the presented paper, the removal of the two most widely used drugs in the wastewater was examined. Diclofenac and carbamazepine were removed from water and wastewater using textile waste-derived sorbents. Their removal efficiency was verified by testing several process parameters such as the time of the sorption, the presence of interfering inorganic ions, the presence of dissolved organic matter, the initial pH and ionic strength of the solution, and various water matrices. The adsorption capacity was noted for diclofenac (57.1 mg/g) and carbamazepine (21.25 mg/g). The tested process parameters (pH, presence of inorganic ions, dissolved organic matter, ionic strength, water matrix) confirmed that the presented waste materials possessed a great potential for pharmaceutical removal from water matrices.

Preparation of silver-based metal-organic framework and chitosan hybrid material for removing drug and dye.

Pharmaceuticals and personal care products and dyes have low biodegradability and high toxicity, seriously threaten the human health and ecological environment. Therefore, seeking effective removal methods has become the focus of research. In this study, silver-based metal-organic framework (Ag-MOF) and chitosan (CS) hybrid adsorbent (Ag-MOF-CS) was synthesized via solvothermal one-pot synthesis to remove diclofenac sodium (DCF) and acid Red 1 (AR1) from water for the first time. The morphology and structure of Ag-MOF-CS were confirmed by various characterizations. The effect on adsorption was investigated by changing the adsorbent dosage, pH and other conditions. The adsorption kinetics, adsorption isotherms and thermodynamics were analyzed. Ag-MOF-CS showed a high adsorption capacity. And the maximum adsorption capacity of Ag-MOF-CS for DCF and AR1 was 351.75 mg/g and 678.83 mg/g, respectively. The adsorbent bound to DCF and AR1 may via electrostatic forces, π-π interactions, hydrogen bonding. Even after four cycles of Ag-MOF-CS, the DCF removal can still be higher than 80 %. The eco-friendly Ag-MOF-CS demonstrated significant potential for utilization in treating wastewater.

Phytoremediation of diclofenac and sulfamethoxazole in Arabidopsis thaliana cells and seedlings.

Diclofenac (DLF), a widely recognized non-steroidal anti-inflammatory drug (NSAID), and sulfamethoxazole (SMX), a broad-spectrum sulfonamide antibiotic, are commonly prescribed medications that have raised concerns as significant contributors to pharmaceutical pollution in natural ecosystems despite their clinical effectiveness. This study investigates the potential phytoremediation pathways for these two drugs in plant systems by tracking and quantifying the fate of the parent compounds and their metabolites in Arabidopsis thaliana using cell and seedling cultures. Results indicated significant differences in the dissipation of DLF according to the treatment and time interaction within the cell cultures. Viable plant cells showed complete dissipation of DLF from an initial concentration of 2758 ng/mL in 96 h, whereas non-viable cells and blank solutions remained stable. The dissipation of SMX was comparable across viable, non-viable, and blanks, showing a minor decrease from 842 to 799 ng/mL over 120 h following the treatment of viable cells. DLF metabolites including 4'-hydroxy-diclofenac, 5-hydroxy-diclofenac, acyl-glutamatyl-diclofenac, 1-(2,6-dichlorophenyl)-5-hydroxy-2-indolinone, 5-sulfooxy-diclofenac, 5-glucopyranosyloxy-diclofenac, 1-(2,6-dichloro-4-hydroxyphenyl)-2-indolinone, and 4'-glucopyranosyloxy-diclofenac were recognized, likely formed through acylation, glutamyl conjugation, hydroxylation, dehydration, cyclization, sulfonation, and glucosidation. While for SMX, metabolites including sulfamethoxazole-glucuronide, nitroso-sulfamethoxazole, N4-acetylsulfamethoxazole, and N4-acetyl-5-OH-sulfamethoxazole were identified, potentially produced through glucuronidation, nitrosation, acetylation, and hydroxylation. Phase I metabolite concentrations of DLF and SMX peaked earlier than those of phase II metabolites. Hydroponic A. thaliana demonstrated comparable efficiencies in the phytoremediation of DLF and SMX, with concentrations varying from 1 mg/L to 10 mg/L. Detectable levels of both parent compounds and their metabolites confirmed successful absorption and metabolism within the plant system. This study provides valuable insights into the potential of phytoremediation as a sustainable approach for reducing the environmental toxicity of DLF and SMX and suggests comparable metabolic efficiency. These findings contribute to the growing body of knowledge on phytoremediation and its application in addressing pollution from pharmaceuticals and personal care products.

Investigation of pharmaceutical bioaccumulation in Daphnia sp. living in a wastewater treatment plant.

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used pharmaceuticals. Their presence in natural waters is due to the low removal efficiency in conventional wastewater treatment plants (WWTPs). Interestingly, certain zooplankton species can survive the mixture of pollution and abnormal water conditions in WWTPs. In our study, for the first time, we tested the in-situ bioaccumulation of NSAIDs and their metabolites in Daphnia pulex, which were obtained in high numbers in one WWTP during the summer. It was found that diclofenac (DCF) and 4-hydroxy DCF were present in the studied clarifiers and ponds. Among these chemicals, only DCF was detected in daphnia. The bioaccumulation factor of DCF in daphnia was below 36 L kg-1ww and was lower than those obtained under experimental conditions for Daphnia magna. The tested daphnia adapted to chronic exposure to mixtures of drugs in µg L-1 level and could be implemented in biobased WWTPs. According to our data, there is a need to supplement the risk assessment of anthropogenic pollutants with in-situ cases to demonstrate the adaptation possibilities of wild-living organisms.

Real-world evidence evaluation on consumer experience and prescription journey of diclofenac gel in Sweden.

OBJECTIVES: The aim of this study was to understand profiles of topical Voltaren gel diclofenac (VGD) 2.32 and 1.16% consumers through analyzing prescription patterns and to characterize treatment satisfaction, functional impairment, and pain relief after over-the-counter (OTC) VGD use in Sweden under real-world conditions. METHODS: This observational, real-world study conducted in Sweden had retrospective and prospective segments. The retrospective secondary data segment utilized 12-month diclofenac gel prescription data from the Swedish eHealth Agency (E-hälsomyndigheten). The prospective segment included electronic surveys completed at baseline and weeks 4 and 12 by adult consumers who purchased OTC VGD to treat their pain. RESULTS: Secondary data analyses (n = 12,145) showed that 56.7% of patients receiving diclofenac gel were females ≥70 years old. Most patients did not switch pain treatments; the mean time between diclofenac gel refills was about 2.5 months. From the surveys (n = 264), VGD provided pain relief, indicated by improvement in 11-point pain numeric rating scale scores. Average pain severity at baseline was 5.8 - improving by a mean of 1.3 and 1.9 points at weeks 4 and 12, respectively. The majority of consumers reported improvement in daily functioning (i.e., health-related quality of life [HRQoL]), and most were at least somewhat satisfied with VGD treatment results. CONCLUSIONS: This real-world study provides important insights into the prescription patterns of diclofenac gel and the consumer experience with OTC VGD in Sweden. Patients rarely switched to other topical nonsteroidal anti-inflammatory drugs, and VGD consumers reported pain relief and improved HRQoL compared to baseline - resulting in treatment satisfaction.

Efficient photocatalytic degradation of diclofenac drug using the Zn1-x-yPrxAlyO photocatalyst under UV light irradiation.

Herein, we report the efficient photocatalytic degradation of the diclofenac drug using the Zn1-x-yPrxAlyO photocatalyst [x, y] = (0.00, 0.00), (0.03, 0.01), (0.03,0.03) under UV light irradiation. The analysis of the structure reveals that the Pr3+ and Al3+ cations insertion into the ZnO lattice leads to a decrease in the lattice constant (a and c), Zn-O bond length, strain lattice, and crystallite size. These alterations are linked to the high degree of atomic disorder triggered by the dopants, which produce stress and strain in the ZnO structure. The Raman measurements confirmed the structural phase and showed changes in the position and intensity of the E2High mode, associated with oxygen vibrations and material crystallinity. The presence of the dopants reduces the concentration of VZn and VO++ type defects while increasing the levels of VO, VO+, and Oi defects, as observed from the fitting of the Photoluminescence spectra. Furthermore, it was noted that de Pr3+ and Al3+ cations insertion into ZnO increases the optical band gap, which is associated with the Moss-Burstein effect. The micrograph images show that dopants transform the morphology from quasi-spherical particles to irregular cluster structures. The textural analysis indicated that an increase in the concentration of Al3+ in the ZnO lattice led to a higher surface area, likely enhancing photocatalytic activity. The sample containing 3% Pr3+ and 3% Al3+ showed the highest photocatalytic activity and degraded up to 71.42% of diclofenac. In addition, experiments with scavengers revealed that hydroxyl radicals are the main species involved in the drug's photodegradation mechanism. Finally, the Zn1-x-yPrxAlyO compound is highly recyclable and stable.

Protective role of melatonin against diclofenac-induced acute kidney injury.

Diclofenac (DF), a non-steroidal anti-inflammatory drug, is commonly used to relieve pain and inflammation. High doses of DF might induce acute kidney injury (AKI), particularly in elderly, a known vulnerable population. AIM: We aimed to assess the protective role of melatonin (Mel) on DF-induced AKI in aged rats and to highlight the underpinning mechanisms include, oxidative stress and inflammation focusing on microRNA-34a (miR-34a), nuclear factor erythroid-2-related factor-2/hemeoxygenase-1 (Nrf2/HO-1) and NLR family-pyrin domain containing-3 (NLRP3) inflammasome pathways, and to elucidate the possibility of epithelial sodium channel (ENaC) involvement. MATERIALS AND METHODS: Thirty old male Wistar rats were allocated randomly into 3 groups: Control, DF and Mel-DF groups. KEY FINDINGS: Melatonin provided nephroprotective effects against DF-induced AKI via attenuating the expression of renal miR-34a and subsequently promoting the signaling of Nrf2/HO-1 with elevation of the antioxidant defense capacity and suppressing NLRP3 inflammasomes. Melatonin alleviated DF-induced hypernatremia via decreasing the ENaC expression. Renal histopathological examination revealed significant reduction in vascular congestion, mononuclear infiltration, glomerulo-tubular damage, fibrosis and TNF-α optical density. SIGNIFICANCE: It can be assumed that melatonin is a promising safe therapeutic agent in controlling DF-induced AKI in elderly.

Portable on-off visual-mode detection using intrinsic fluorescent zinc-based metal-organic framework for detection of diclofenac in pharmaceutical tablets.

On-site, robust, and quantitative detection of diclofenac (DCF) is highly significant in bioanalysis and quality control. Fluorescence-based metal-organic frameworks (MOFs) play a pivotal role in biochemical sensing, offering a versatile platform for detecting various biomolecules. However, conventional fluorescent MOF sensors often rely on lanthanide metals, which can pose challenges in terms of cost, accessibility, and environmental impact. Herein, an intrinsic blue fluorescent zinc-based metal-organic framework (FMOF-5) was prepared free from lanthanide metals. Coordination-induced emission as an effective strategy was followed wherein a non-fluorescent ligand is converted to a fluorescent one after insertion in a framework. Conventional fluorometry and smartphone-assisted visual methods were employed for the detection of DCF. The fluorescence emission of the FMOF-5 was effectively quenched upon the addition of the DCF, endowing it an "off" condition, which permits the construction of a calibration curve with a wide linear range of 30-670 µM and a detection limit of about 4.1 µM. Other analytical figures of merit, such as linearity, sensitivity, selectivity, accuracy, and precision were studied and calculated. Furthermore, the proposed sensor was successfully applied to quantify DCF in pharmaceutical tablets with reliable recovery and precision. Importantly, the elimination of lanthanide metals from the fluorescence detection system enhances its practicality and sustainability, making it a promising alternative for DCF detection in pharmaceutical analysis applications.

Non-Steroidal Anti-Inflammatory Drugs Administered Intra-Articularly in Temporomandibular Joint Disorders: A Systematic Review and Meta-Analysis.

Objectives: This systematic review was designed to summarize randomized controlled trials of intra-articular administration of non-steroidal anti-inflammatory drugs (NSAIDs) for temporomandibular disorders. Methods: Randomized controlled trials regarding intra-articular injections of non-steroidal anti-inflammatory drugs for temporomandibular disorders were included in the review. The final search was conducted on 16 June 2024 in the Bielefeld Academic Search Engine, PubMed, and Scopus databases. Results: Of the 173 identified studies, 6 were eligible for review. In trials comparing arthrocentesis alone to arthrocentesis with NSAIDs, slight differences in joint pain were noted. For tenoxicam, differences were under 1 point on a 0-10 scale after 4 weeks, with inconsistent results. Piroxicam showed no significant difference, and pain levels were minimal in both groups. For maximum mouth opening (MMO), tenoxicam showed no significant difference. Piroxicam increased MMO by nearly 5 mm, based on one small trial with bias concerns. Conclusions: Currently, there is no strong scientific evidence supporting the injection of NSAIDs into the temporomandibular joint to relieve pain or increase jaw movement. Preliminary reports on piroxicam with arthrocentesis and tenoxicam or diclofenac without rinsing justify further research.

Exploring Vacuum Compression Molding as a Preparation Method for Flexible-Dose Pediatric Orodispersible Films.

In recent years, solid dosage forms have gained interest in pediatric therapy because they can provide valuable benefits in terms of dose accuracy and stability. Particularly for orodispersible films (ODFs), the literature evidences increased acceptability and dose flexibility. Among the various available technologies for obtaining ODFs, such as solvent casting, hot-melt extrusion, and ink printing technologies, the solvent-free preparation methods exhibit significant advantages. This study investigated Vacuum Compression Molding (VCM) as a solvent-free manufacturing method for the preparation of flexible-dose pediatric orodispersible films. The experimental approach focused on selecting the appropriate plasticizer and ratios of the active pharmaceutical ingredient, diclofenac sodium, followed by the study of their impacts on the mechanical properties, disintegration time, and drug release profile of the ODFs. Additional investigations were performed to obtain insights regarding the solid-state properties. The ODFs obtained by VCM displayed adequate quality in terms of their critical characteristics. Therefore, this proof-of-concept study shows how VCM could be utilized as a standalone method for the production of small-scale ODFs, enabling the customization of doses to meet the individual needs of pediatric patients.

Proteome profiling, biochemical and histological analysis of diclofenac-induced liver toxicity in Yersinia enterocolitica and Lactobacillus fermentum fed rat model: a comparative analysis.

Diclofenac is a hepatotoxic non-steroidal anti-inflammatory drug (NSAID) that affects liver histology and its protein expression levels. Here, we studied the effect of diclofenac on rat liver when co-administrated with either Yersinia enterocolitica strain 8081 serotype O:8 biovar 1B (D*Y) or Lactobacillus fermentum strain 9338 (D*L). Spectroscopic analysis of stool samples showed biotransformation of diclofenac. When compared with each other, D*Y rats lack peaks at 1709 and 1198 cm-1, while D*L rats lack peaks at 1411 cm-1. However, when compared to control, both groups lack peaks at 1379 and 1170 cm-1. Assessment of serum biomarkers of hepatotoxicity indicated significantly altered activities of AST (D*Y: 185.65 ± 8.575 vs Control: 61.9 ± 2.607, D*L: 247.5 ± 5.717 vs Control: 61.9 ± 2.607), ALT (D*Y: 229.8 ± 6.920 vs Control: 70.7 ± 3.109, D*L: 123.75 ± 6.068 vs Control: 70.7 ± 3.109), and ALP (D*Y: 276.4 ± 18.154 vs Control: 320.6 ± 9.829, D*L: 298.5 ± 12.336 vs Control: 320.6 ± 9.829) in IU/L. The analysis of histological alterations showed hepatic sinusoidal dilation with vein congestion and cell infiltration exclusively in D*Y rats along with other histological changes that are common to both test groups, thereby suggesting more pronounced alterations in D*Y rats. Further, LC-MS/MS based label-free quantitation of proteins from liver tissues revealed 74.75% up-regulated, 25.25% down-regulated in D*Y rats and 51.16% up-regulated, 48.84% down-regulated in D*L experiments. The proteomics-identified proteins majorly belonged to metabolism, apoptosis, stress response and redox homeostasis, and detoxification and antioxidant defence that demonstrated the potential damage of rat liver, more pronounced in D*Y rats. Altogether the results are in favor that the administration of lactobacilli somewhat protected the rat hepatic cells against the diclofenac-induced toxicity.

Alternatives to Conventional Topical Dosage Forms for Targeted Skin Penetration of Diclofenac Sodium.

Skin penetration of an active pharmaceutical ingredient is key to developing topical drugs. This penetration can be adjusted for greater efficacy and/or safety through the selection of dosage form. Two emerging dosage forms, cream-gel and gel-in-oil emulsion, were tested for their ability to deliver diclofenac into the skin, with the target of maximising skin retention while limiting systemic exposure. Prototypes with varying amounts of solvents and emollients were formulated and evaluated by in vitro penetration testing on human skin. Cream-gel formulas showed better skin penetration than the emulgel benchmark drug even without added solvent, while gel-in-oil emulsions resulted in reduced diffusion of the active into the receptor fluid. Adding propylene glycol and diethylene glycol monoethyl ether as penetration enhancers resulted in different diclofenac penetration profiles depending on the dosage form and whether they were added to the disperse or continuous phase. Rheological characterisation of the prototypes revealed similar profiles of cream-gel and emulgel benchmark, whereas gel-in-oil emulsion demonstrated flow characteristics suitable for massaging product into the skin. This study underlined the potential of cream-gel and gel-in-oil emulsions for adjusting active penetration into the skin, broadening the range of choices available to topical formulation scientists.

Topical Diclofenac Reduces Joint Synovitis in Hand Osteoarthritis: A Pilot Investigation Using Fluorescent Optical Imaging.

Purpose: Synovitis, the inflammation of joint synovia, is a prominent feature of osteoarthritis (OA) manifested by enhanced synovial vascularity, endothelial leakage, and perivascular oedema. In this pilot study, we assessed the effect of topical diclofenac in hand OA (HOA) using the established semi-quantitative methods Magnetic Resonance Imaging (MRI) and Ultrasonography (US), and compared them with Fluorescent Optical Imaging (FOI), an emerging imaging modality. Patients and Methods: Ten patients with symptomatic and diagnosed HOA used topical diclofenac for 14 days, with FOI, MRI, US, and subjective pain assessed at Baseline and after 7 (Day 8), and 14 (Day 15) days of treatment. Changes in synovitis were assessed for all 10 joints of the hand (via sum scores), and separately for the two joints most affected by synovitis. A new, fully quantitative approach for objective synovitis assessment based on the FOI images was also developed and applied. Results: The semi-quantitative analysis of the sum scores showed a small decrease in synovitis throughout the treatment duration across the different imaging modalities. The effect of the treatment was more prominent on the two most affected joints, with a synovitis reduction vs Baseline of 21.1% and 34.2% on Day 8 and Day 15, respectively, in the FOI. The quantitative FOI pixel analysis further strengthened the evidence for this effect, with observed reduction of 17.8% and 42.4% for Days 8 and 15, respectively. A similar trend was observed for subjective pain perception, with a reduction of 7.2 and 13.3 mm on Days 8 and 15. Conclusion: This pilot study evidenced the effect of topical diclofenac on reducing synovitis in hand OA in semi- and fully quantitative analyses, with the effect being stronger in the most affected joints. Further, supporting studies are needed to probe the accuracy of the quantitative pixel analysis of FOI images.