Investigation of the salting-in/-out, hydrotropic and surface-active behavior of plant-based hormone and phenolic acid salts.

HYPOTHESIS: The role of hormones and polyphenolic acids in communication and regulation of biological processes can be linked to their physical-chemical interaction with target compounds and water. Further, the variety of polyphenolic acids suggests adjustable hydrotropic properties of these natural compounds. EXPERIMENTS: Phase transition temperature (PTT) measurements of binary water/di(propylene glycol) n-propyl ether (DPnP) or propylene glycol n-propyl ether (PnP) systems with sodium dehydroepiandrosterone sulfate (NaDHEAS), indole-3-acetate (NaIAA), indole-3-butyrate (NaIBA) - common hormones -, and sodium polyphenolates should unravel their salting-in/-out properties. Their salting-in/-out behavior was compared to the compounds' surface-active and structuring properties via surface tension, dynamic light scattering (DLS) and Nuclear magnetic resonance (NMR) experiments. FINDINGS: All hormone salts were revealed as salting-in agents. PTT, surface tension and DLS measurements indicated surfactant-like behavior of the hormone NaDHEAS, and hydrotropic behavior of NaIAA and NaIBA. The salting-in/-out properties of sodium polyphenolates - in an (anti-)hydrotrope range - are adjustable with functional groups. The (i) absence of nano-structuring in pure water, (ii) the reduction of the DPnP nano-structuring in water in presence of sodium polyphenolates and (iii) the absence of a slope change of the PTT curves at the critical aggregation concentration showed that the DPnP/polyphenolate interactions are of molecular hydrotropic and not of micellar/aggregative nature.

Beneficial effects of galanin system on diabetic peripheral neuropathic pain and its complications.

Diabetic peripheral neuropathic pain (DPNP) is a distal spontaneous pain, caused by lesion of sensory neurons and accompanied by depression and anxiety frequently, which reduce life quality of patients and increase society expenditure. To date, antidepressants, serotonin-noradrenaline reuptake inhibitors and anticonvulsants are addressed as first-line therapy to DPNP, alone or jointly. It is urgently necessary to develop novel agents to treat DPNP and its complications. Evidences indicate that neuropeptide galanin can regulate multiple physiologic and pathophysiological processes. Pain, depression and anxiety may upregulate galanin expression. In return, galanin can modulate depression, anxiety, pain threshold and pain behaviors. This article provides a new insight into regulative effects of galanin and its subtype receptors on antidepressant, antianxiety and against DPNP. Through activating GALR1, galanin reinforces depression-like and anxiogenic-like behaviors, but exerts antinociceptive roles. While via activating GALR2, galanin is referred to as anti-depressive and anti-anxiotropic compounds, and at low and high concentration facilitates and inhibits nociceptor activity, respectively. The mechanism of the galanin roles is relative to increase in K+ currents and decrease in Ca2+ currents, as well as neurotrophic and neuroprotective roles. These data are helpful to develop novel drugs to treat DPNP and its complications.

Efficacy and safety of duloxetine and Pregabalin in Iranian patients with diabetic peripheral neuropathic pain: a double-blind, randomized clinical trial.

PURPOSE: Diabetic peripheral neuropathic pain (DPNP) is one of the most sufferings, disabling, and dominant complications of diabetes. Duloxetine (DLX) and Pregabalin (PGB) are among first-line therapy and the most prescribed drugs for DPNP relief. The effectiveness-risk profile of drugs may differ from region to region due to variations in genetic and health situation of populations. This study aims to evaluate the efficacy and safety of DLX and PGB in a sample of Iranian population with DPNP. METHODS: A double-blind, randomized clinical trial was conducted on 180 type-2 diabetic patients with DPNP≥40 mm according to Visual Analogue Scale (VAS), with other eligibility criteria throughout twelve weeks. We divided the patients randomly into two equal groups: DLX and PGB. Each patient received ten days placebo as a washout period, then blind capsules of DLX (group 1) or PGB (group 2). We assessed the efficacy and safety of drugs by VAS and recorded the Adverse Drug Reactions (ADRs) during the study. RESULTS: In the DLX group, sixty-six and the PGB group, seventy-eight patients completed the study. The intensity of patients' pain was improved by both drugs significantly (p˂0.001), but there was no significant difference between the two groups. Average daily doses of DLX and PGB were 42.5 and 235.5 mg, respectively. In the DLX group, 74% of patients and the PGB group, 37% reported ADRs. The discontinuation rates due to ADRs were 19% and 7% correspondingly. CONCLUSION: We found that in Iranian patients, the mean effective doses of these drugs are different in comparison with several other studies. Surprisingly intolerance and discontinuation of DLX in our patients were attributed to mild and severe Serotonin Syndrome, which had not much occurred in other studies. Accordingly, despite the same efficacy, PGB was better tolerated than DLX in our patients. Thus we would recommend PGB for DPNP treatment in Iranian patients.

Impact of comorbidities on pharmacotherapy of painful diabetic neuropathy in clinical practice.

AIMS: We evaluated the impact of baseline comorbidities on the effectiveness of duloxetine and anticonvulsants (pregabalin/gabapentin) in patients with painful diabetic neuropathy in clinical care. METHODS: Outcomes from a 6-month, observational study with 2575 patients initiating/switching DPNP treatment were analyzed post-hoc. Propensity scoring was used to adjust for baseline factors influencing treatment choice in 1523 patients receiving duloxetine or anticonvulsants. Analysis of covariance models with fixed effects for baseline pain, treatment, propensity score, baseline characteristics or comorbidities, and their interaction with treatment were used to estimate LSmean effects on Brief Pain Inventory (BPI) average pain and interference scores. RESULTS: 89.5% of patients reported comorbidities, including hypertension (70.5%), hyperlipidemia (39.2%), and depression (24.8%). Macrovascular complications (37.0%) and 'other chronic pain' (41.5%), particularly joint pain had an impact on both pain treatments, i.e. less improvement of average pain and interference of pain. Better treatment responses with duloxetine vs. anticonvulsants were observed in patients with depression, those with high baseline BPI total interference score, especially general activity, and in patients with joint pain. CONCLUSIONS: Comorbidities such as macroangiopathy and depression as well as pain characteristics should be considered in the treatment of DPNP as they may predict the effectiveness of duloxetine and anticonvulsants.