Molecular docking and pharmacological/toxicological assessment of a new compound designed from celecoxib and paracetamol by molecular hybridization.

Nonsteroidal anti-inflammatory drugs are commonly used worldwide; however, they have several adverse effects, evidencing the need for the development of new, more effective and safe anti-inflammatory and analgesic drugs. This research aimed to design, synthesize and carry out a pharmacological/toxicological investigation of LQFM-102, which was designed from celecoxib and paracetamol by molecular hybridization. To evaluate the analgesic effect of this compound, we performed formalin-induced pain, hot plate and tail flick tests. The anti-inflammatory effect of LQFM-102 was evaluated in carrageenan-induced paw oedema and pleurisy tests. The biochemical markers indicative of toxicity-AST, ALT, GSH, urea and creatinine-as well as the index of gastric lesion after prolonged administration of LQFM-102 were also analyzed. In addition, the interaction of LQFM-102 with COX enzymes was evaluated by molecular docking. In all experimental protocols, celecoxib or paracetamol was used as a positive control at equimolar doses to LQFM-102. LQFM-102 reduced the pain induced by formalin in both phases of the test. However, this compound did not increase the latency to thermal stimuli in the hot plate and tail flick tests, suggesting an involvement of peripheral mechanisms in this effect. Furthermore, LQFM-102 reduced paw oedema, the number of polymorphonuclear cells, myeloperoxidase activity and TNF-α and IL-1ß levels. Another interesting finding was the absence of alterations in the markers of hepatic and renal toxicity or lesions of gastric mucosa. In molecular docking simulations, LQFM-102 interacted with the key residues for activity and potency of cyclooxygenase enzymes, suggesting an inhibition of the activity of these enzymes.

In vitro and in vivo assessment of meadowsweet (Filipendula ulmaria) as anti-inflammatory agent.

ETHNOPHARMACOLOGICAL RELEVANCE: Meadowsweet (Filipendula ulmaria (L.) Maxim, Rosaceae) has been traditionally used in most European countries for the treatment of inflammatory diseases due to its antipyretic, analgesic, astringent, and anti-rheumatic properties. However, there is little scientific evidence on F. ulmaria anti-inflammatory effects regarding its impact on cyclooxygenases enzymatic activity and in vivo assessment of anti-inflammatory potential. This study aims to reveal the anti-inflammatory activity of methanolic extracts from the aerial parts (FUA) and roots (FUR) of F. ulmaria, both in in vitro and in vivo conditions. MATERIALS AND METHODS: The characteristic phenolic compounds in F. ulmaria extracts were monitored via high performance thin layer chromatography (HPTLC). The in vitro anti-inflammatory activity of F. ulmaria extracts was evaluated using cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzyme assays, and an assay for determining COX-2 gene expression. The in vivo anti-inflammatory effect of F. ulmaria extracts was determined in two doses (100 and 200 mg/kg b.w.) with hot plate test and carrageenan-induced paw edema test in rats. Inflammation was also evaluated by histopathological and immunohistochemical analysis. RESULTS: FUA extract showed the presence of rutoside, spiraeoside, and isoquercitrin. Both F. ulmaria extracts at a concentration of 50µg/mL were able to inhibit COX-1 and -2 enzyme activities, whereby FUA extract (62.84% and 46.43% inhibition, respectively) was double as effective as the root extract (32.11% and 20.20%, respectively). Extracts hardly inhibited the level of COX-2 gene expression in THP-1 cells at a concentration of 25µg/mL (10.19% inhibition by FUA and 8.54% by FUR). In the hot plate test, both extracts in two doses (100 and 200mg/kg b.w.), exhibited an increase in latency time when compared with the control group (p<0.05). In the carrageenan-induced acute inflammation test, FUA at doses of 100 and 200mg/kg b.w., and FUR at 200mg/kg, were able to significantly reduce the mean maximal swelling of rat paw until 6h of treatment. Indomethacin, FUA, and FUR extracts significantly decreased inflammation score and this effect was more pronounced after 24h, compared to the control group (p<0.05). CONCLUSIONS: The observed results of in vitro and, for the first time, in vivo anti-inflammatory activity of meadowsweet extracts, provide support of the traditional use of this plant in the treatment of different inflammatory conditions. Further investigation of the anti-inflammatory compounds could reveal the mechanism of anti-inflammatory action of these extracts.

Patient-independent variables affecting the assessment of aspirin responsiveness by serum thromboxane measurement.

The serum TXB2 (sTXB2) assay reflects the pharmacodynamics of platelet inhibition by low-dose aspirin. However, different studies reported variable sTXB2 values. sTXB2 assay requires whole blood incubation at 37 °C as a condition for optimal thrombin generation, arachidonic acid release and its metabolism by platelet cyclooxygenase-1 to form TXA2. Access to 37 °C incubation may be variably delayed, and different methods to quantitate sTXB2 may contribute to variable results between different Centers. We investigated whether delaying 37 °C incubation and/or analytical issues affect sTXB2 concentrations, biasing the assessment of aspirin responsiveness. Sixty-eight samples from 54 volunteers, on- and off-aspirin, were incubated at 37 °C immediately after sampling (reference sample) or after 5, 10, 15, 20, 30 or 60 minutes at room temperature (RT); 8 samples remained at RT 60 minutes, without subsequent incubation; 314 sera were measured by enzyme immunoassay (EIA) and liquid chromatography-tandem mass-spectrometry (LC/MS-MS) methods. sTXB2 concentrations decreased exponentially as a function of the delay before 37 °C incubation, ranging from 94 ± 11 % at 5 minutes to 23 ± 22 % of the reference sample after 60 minutes at RT. There was high agreement between EIA and LC/MS-MS. Moreover, we simulated the influence of a 15- or 30-minute delayed incubation on 300 sTXB2 measurements from previously-studied, aspirin-treated patients. Delayed incubation reduced the percentage of aspirin 'non-responders' by 22 % to 52 %, depending on the response threshold. In conclusion, a variable delay in the 37 °C incubation of blood samples may affect the assessment of platelet cyclooxygenase-1 inhibition by aspirin and confound the characterization of the determinants of aspirin responsiveness.

Assessment of long-term storage on antimicrobial and cyclooxygenase-inhibitory properties of South African medicinal plants.

In traditional medicine, plant materials are often stored by traditional healers, plant gatherers and traders before they are eventually consumed or sold. The critical point is whether stored medicinal plants are as active as freshly harvested dried material. We evaluated the effects of long-term storage (12 or 16 years) on the antimicrobial (microplate dilution method) and anti-inflammatory (COX-1 and COX-2 inhibition) potencies of 21 extensively used traditional medicinal plants in treating pain and infection-related ailments. The minimum inhibitory concentration (MIC) values obtained against Staphylococcus aureus and Pseudomonas aeruginosa in the stored plant materials were generally either lower or roughly the same as in the fresh material. Most of the stored plant material had comparable minimum microbicidal concentration (MMC) values as the fresh material against S. aureus and P. aeruignosa. Similarly, the majority (71%) of the stored plant material had similar MIC and/or MMC values as fresh material against the fungus Candida albicans. The percentage inhibition of COX-1 by the majority (88%) of the stored material was not significantly different when compared to those freshly collected. Stored material of Clausena anisata, Ekebergia capensis and Trichilia dregeana showed a significantly higher COX-1 inhibition than the fresh material. The therapeutic and conservation implications of the results are discussed.

Different methods for testing potential cyclooxygenase-1 and cyclooxygenase-2 inhibitors.

The need for the development of selective agents, which only inhibit the mainly "harmful" cyclooxygenase-2 (COX-2) while leaving physiological COX-1 mostly unaffected, still remains, especially after the recent issues related to cardiovascular toxicity caused by some COX-2 selective agents. Thus there is still a demand for sensitive and rapid methods to assay for COX-2 selective agents. Among several in vitro testing systems the whole blood assay (WBA) is a well-known method to examine non-steroidal anti-inflammatory drugs (NSAIDs) in view of their potency to inhibit COX activity. This assay has some major advantages over enzyme-based or isolated cell assays. Emergence of artifacts due to cell separation steps is kept to a minimum and substances, even in disproportional high concentrations, can be examined outside the body in a physiological environment resembling most closely the in vivo conditions in living humans, i.e., 37 degrees C, homeostasis, presence of all blood compounds and cell-cell interactions remain intact. While COX-1 human whole blood assays are performed within less than 2 h, for established COX-2 assays one still has to allow for an overnight incubation step before gaining the desired plasma. The aim of the assay described in this chapter is to characterize an optimized human whole blood assay (hWBA). We present a simple, fast and reliable method to examine the capacity of NSAIDs at inhibiting COX-2 activity that can be applied for rapid and routine screening purposes.

Population pharmacodynamic modelling of aspirin- and Ibuprofen-induced inhibition of platelet aggregation in healthy subjects.

OBJECTIVE: The objective of this study was to develop a mechanism-based pharmacodynamic model that characterizes the antiplatelet effects of aspirin (acetylsalicylic acid) and ibuprofen alone and in combination. METHODS: Ten healthy volunteers were enrolled in a single-blinded, randomized, three-way crossover study. Treatments consisted of single doses of oral aspirin (325 mg) and ibuprofen (400 mg) and concomitant administration of aspirin (325 mg) and ibuprofen (400 mg). Ex vivo whole blood platelet aggregation induced by collagen (1 microg/mL) or arachidonic acid (0.5 mmol/L) was measured by impedance aggregometry. Model development and population parameter estimation were performed using nonlinear mixed-effects modelling implemented in NONMEM. RESULTS: Relatively complete inhibition of platelet aggregation was achieved following aspirin treatment (approximately 77% inhibition within 2 hours), and return to baseline values occurred within 72-96 hours after dosing. In contrast, treatment with ibuprofen alone or in combination with aspirin produced transient inhibition of platelet aggregation, with complete recovery observed in 6-8 hours. The final pharmacodynamic model was based on the turnover of cyclo-oxygenase-1 (COX-1) enzyme, and incorporated irreversible inhibition by aspirin and reversible binding and antiplatelet effects of ibuprofen. The temporal response profiles from all three study arms were well described by the final model, and the parameters were estimated with good precision. The apparent turnover rate constant for COX-1 (kout) and the irreversible inhibition rate constant for aspirin (K) were estimated to be 0.0209 h(-1) and 0.152 (mg/L)(-1).h(-1), with interindividual variability of 30.6% and 26.2%, respectively. Simulations were used to evaluate the influence of clinically relevant ibuprofen regimens on the antiplatelet effect of aspirin, confirming clinical reports that the antiplatelet effect of aspirin would be blocked when multiple daily doses of ibuprofen are given, even if taken after aspirin administration. CONCLUSIONS: A mechanism-based pharmacodynamic model has been developed that characterizes the antiplatelet effects of aspirin and ibuprofen, alone and concomitantly, and predicts a significant inhibition of aspirin antiplatelet effects in the presence of a typical ibuprofen dosing regimen.

Hospitalization for gastrointestinal adverse events attributable to the use of low-dose aspirin among patients 50 years or older also using non-steroidal anti-inflammatory drugs: a retrospective cohort study.

BACKGROUND: Use of aspirin with non-steroidal anti-inflammatory drugs increases the risk of gastrointestinal ulcers; however, it is not clear if this risk varies with the non-steroidal anti-inflammatory drug used. AIM: To assess the risk of gastrointestinal hospitalizations attributable to aspirin in patients 50 years or older also using non-steroidal anti-inflammatory drugs. METHODS: Administrative data of patients 50 years or older who received a non-steroidal anti-inflammatory drug or acetaminophen prescription between 1998 and 2004 were used. RESULTS: Study patients received 7,412,992 non-steroidal anti-inflammatory drug prescriptions and 5,614,044 acetaminophen prescriptions among which 23% and 32%, respectively, were dispensed to aspirin users. Time-dependent Cox regression models revealed that, compared to patients using acetaminophen (without aspirin), the adjusted hazard ratio (95% CI) among non-users of aspirin were: rofecoxib 1.3 (1.2, 1.5), celecoxib 0.7 (0.6, 0.8), diclofenac 1.5 (1.2, 1.7), ibuprofen 0.9 (0.6, 1.4), naproxen 2.5 (2.1, 3.0) and piroxicam 1.5 (0.8, 2.8); among users of aspirin: rofecoxib 3.2 (2.8, 3.7), celecoxib 1.8 (1.5, 2.1), diclofenac 2.8 (2.2, 3.5), ibuprofen 1.4 (0.8, 2.7), naproxen 2.2 (1.6, 3.0) and piroxicam 2.0 (0.8, 5.4). The risk attributable to aspirin varied from none with naproxen to 61% (53%, 68%) with celecoxib. CONCLUSION: The increase in gastrointestinal hospitalization attributable to aspirin differed with the non-steroidal anti-inflammatory drug used, and seemed higher with cyclo-oxygenase-2 inhibitors than with non-selective non-steroidal anti-inflammatory drugs.

Perspective assessment of COX-1 and COX-2 selectivity of nonsteroidal anti-inflammatory drugs from clinical practice: use of genetic function approximation.

The beneficial action of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with the inhibition of cyclooxygenase-2 (COX-2), whereas their harmful side effects are associated with the inhibition of COX-1. In order to understand a meaningful comparison of both classical NSAIDs and newer COX-2 drugs, a series of molecules from varied classes of COX-2 inhibitors was studied by the application of three-dimensional quantitative structure-activity relationships (3D-QSAR) using molecular descriptors obtained by genetic function approximation. The features responsible for the dual inhibition of COX-1 and COX-2 and the selective inhibition of COX-2 with factors contributing to the maintenance of optimum selectivity were identified. The QSAR models revealed the importance of thermodynamic, electronic, structural, and molecular shape analysis parameters, which can reasonably modulate the selectivity pattern to avoid unsolicited side effects. An improved understanding to rationalize the COX-1 and COX-2 binding profiles could be gained to develop safe drug design methods.

Assessment of celecoxib pharmacodynamics in pancreatic cancer.

Cyclooxygenase-2 (COX-2) inhibitors are being developed as chemopreventive and anticancer agents. This study aimed to determine the biological effect of the COX-2 inhibitor celecoxib in pancreatic cancer as an early step to the further development of the agent in this disease. Eight patients scheduled for resection of an infiltrating adenocarcinoma of the pancreas were randomized to receive celecoxib at a dose of 400 mg twice daily or placebo for 5 to 15 days before the surgery. In addition, carcinomas from nine additional patients were xenografted in nude mice, expanded, and treated with vehicle or celecoxib for 28 days. Celecoxib markedly decreased the intra-tumor levels of prostaglandin E2 in patient carcinomas and in the heterotransplanted xenografts. However, this effect did not result in inhibition of cell proliferation or microvessel density (as assessed by Ki67 and CD31 staining). In addition, a panel of markers, including bcl-2, COX-1, COX-2, and VEGF, did not change with treatment in a significant manner. Furthermore, there was no evidence of antitumor effects in the xenografted carcinomas. In summary, celecoxib efficiently inhibited the synthesis of prostaglandin E2 both in pancreatic cancer surgical specimens and in xenografted carcinomas but did not exert evident antitumor, antiproliferative, or antiangiogenic effect as a single agent. The direct pancreatic cancer xenograft model proved to be a valuable tool for drug evaluation and biological studies and showed similar results to those observed in resected pancreatic cancer specimens.

Free energy perturbation approach to the critical assessment of selective cyclooxygenase-2 inhibitors.

The discovery of selective cyclooxygenase-2 (COX-2) inhibitors represents a major achievement of the efforts over the past few decades to develop therapeutic treatments for inflammation. To gain insights into designing new COX-2-selective inhibitors, we address the energetic and structural basis for the selective inhibition of COX isozymes by means of a combined computational protocol involving docking experiment, force field design for the heme prothetic group, and free energy perturbation (FEP) simulation. We consider both COX-2- and COX-1-selective inhibitors taking the V523I mutant of COX-2 to be a relevant structural model for COX-1 as confirmed by a variety of experimental and theoretical evidences. For all COX-2-selective inhibitors under consideration, we find that free energies of binding become less favorable as the receptor changes from COX-2 to COX-1, due to the weakening and/or loss of hydrogen bond and hydrophobic interactions that stabilize the inhibitors in the COX-2 active site. On the other hand, COX-1-selective oxicam inhibitors gain extra stabilization energy with the change of residue 523 from valine to isoleucine because of the formations of new hydrogen bonds in the enzyme-inhibitor complexes. The utility of the combined computational approach, as a valuable tool for in silico screening of COX-2-selective inhibitors, is further exemplified by identifying the physicochemical origins of the enantiospecific selective inhibition of COX-2 by alpha-substituted indomethacin ethanolamide inhibitors.

The practice implications of cardiovascular risks in NSAIDs.

Non-steroidal anti-inflammatory drugs (NSAIDs) are useful medications for the management of pain. However, Cox-2 NSAIDs have been associated with an increased risk of cardiovascular side-effects and there are now concerns that this increased risk may extend to all NSAIDs. This article outlines the action of NSAIDs and discusses the evidence for a link with increased cardiovascular risk.

An overview of the recent developments in analytical methodologies for determination of COX-2 inhibitors in bulk drugs, pharmaceuticals and biological matrices.

An extensive survey of the literature published in various analytical and pharmaceutical chemistry related journals has been conducted and the instrumental analytical methods which were developed and used for determination of COX-2 inhibitors in bulk drugs, formulations and biological fluids have been reviewed. This review covers the time period from 1995 to 2004 during which 138 analytical methods including all types of spectrophotometric and chromatographic techniques were reported. HPLC with UV detection was found to be the technique of choice for many workers and more than 100 methods were based on LC and UV. A critical analysis of the reported data has been carried out and the present state-of-art of the analytical techniques for determination of celecoxib, rofecoxib, etoricoxib, etodolac, nimesulide and meloxicam has been discussed.