Cyclizine induces cytotoxicity and apoptosis in macrophages through the extrinsic and intrinsic apoptotic pathways.

Cyclizine, an over-the-counter and prescription antihistamine, finds widespread application in the prevention and treatment of motion sickness, encompassing symptoms such as nausea, vomiting, dizziness, along with its effectiveness in managing vertigo. However, the overuse or misuse of cyclizine may lead to hallucinations, confusion, tachycardia, and hypertension. The molecular mechanisms underlying cyclizine-induced cytotoxicity and apoptosis remain unclear. During the 24 h incubation duration, RAW264.7 macrophages were exposed to different concentrations of cyclizine. Cytotoxicity was assessed through the lactate dehydrogenase assay. Flow cytometry employing annexin V-fluorescein isothiocyanate and propidium iodide was utilized to evaluate apoptosis and necrosis. Caspase activity and mitochondrial dysfunction were evaluated through a fluorogenic substrate assay and JC-1 dye, respectively. Flow cytometry employing fluorogenic antibodies was utilized to evaluate the release of cytochrome c and expression of death receptor, including tumor necrosis factor-α receptor and Fas receptor. Western blotting was utilized to evaluate the expression of the Bcl2 and Bad apoptotic regulatory proteins. The findings unveiled from the present study demonstrated that cyclizine exerted a concentration-dependent effect on RAW264.7 macrophages, leading to the induction of cytotoxicity, apoptosis, and necrosis. This compound further activated the intrinsic apoptotic pathway by inducing mitochondrial dysfunction, Bcl2/Bad exchange expression, cytochrome c liberation, and activation of caspases contained caspase 3, 8, and 9. Moreover, the activation of the extrinsic apoptotic pathway was observed as cyclizine induced the upregulation of death receptors and increased caspase activities. Based on our investigations, it can be inferred that cyclizine prompts cytotoxicity and apoptosis in RAW264.7 macrophages in a concentration-dependent manner by triggering both the intrinsic and extrinsic apoptotic pathways.

Cyclizine-induced proinflammatory responses through Akt-NFκB pathway in macrophages.

Cyclizine exhibits sedation and treatment of nausea, vomiting, and motion sickness due to antihistaminic and antimuscarinic effects. Cyclizine has the potential for abuse due to the hallucinogenic and euphoric effect. The response of overdose and illegal abuse of cyclizine includes confusion, tremors, chest pain, ataxia, seizures, and lead to suicide. Macrophage plays the important role in the innate immunity. However, over activation of macrophages results in pro-inflammatory responses in peripheral tissues. In the present study, cyclizine was found to enhanced the generation of pro-inflammatory cytokines, including tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, and IL-6. We further found that secretion of nitrogen oxide (NO) induced by cyclizine via expression of inducible nitric oxide synthases (iNOS). Cyclizine exhibited parallel stimulation of phosphorylation of nuclear factor-κB (NFκB) p65, and its up-stream factor Akt. These results indicated that the expression of pro-inflammatory cytokines, pro-inflammatory mediators, and adhesion molecules would be induced by cyclizine via activation of Akt-NFκB pathway in macrophages.

[Cyclizine is sold in Denmark as an over-the-counter drug and has serious side effects when overdosed].

Cyclizine is sold in Denmark as an over-the-counter drug and affects not only histaminergic but also muscarinergic, serotonergic and α-adrenergic receptors, with side effects such as respiratory depression and cardiac arrhythmias, leading to fatalities. Due to the numerous side effects, it raises questions concerning the status of cyclizine as an over-the-counter drug. Data of healthcare contacts because of cyclizine intoxication in the 2014-2016 period should be analyzed to further illuminate the health risk of cyclizine poisoning.

Effect of H1 blockers alone and in combination with morphine to produce antinociception in mice.

Antinociception was assessed in male CD-1 mice by a modification of Haffner's tail-clamp procedure. The H1 blockers, including an ethylenediamine (pyrilamine), an ethanolamine (diphenhydramine), a phenothiazine (methdilazine), a piperazine (cyclizine) and an alkylamine (chlorpheniramine), all produced antinociception when given alone to mice and also caused potentiation when combined with morphine.

Structure-activity relationships of alkylamines that inhibit rat liver hydroxysteroid sulfotransferase activities in vitro.

Tetraalkylammonium salts having n-propyl to n-amyl side chains inhibited rat liver sulfotransferase (ST) activities toward dehydroepiandrosterone and cortisol, but not ST activity toward 2-naphthol, whereas trialkylamines having ethyl to n-amyl side chains inhibited ST activity toward dehydroepiandrosterone, but not ST activities toward cortisol and 2-naphthol. A comparison of I50 values, which represent inhibitor concentration resulting in 50% inhibition of dehydroepiandrosterone ST activity, revealed that the values for the tetraalkylammonium salts were 0.015 to 0.017 mM, whereas the values for the trialkylamines were 0.20 to 0.33 mM. Introduction of hydrophilic groups such as hydroxyl, thiol, nitrile and acetamide groups or substitution by methyl and allyl groups in the alkyl side chains markedly diminished the inhibitory effect of triethylamine. These data indicate that ethyl to n-amyl side chains are a prerequisite for the alkylamine-type inhibitor. Tertiary amine drugs such as imipramine, dimenhydrinate, cyclizine, chlorpromazine and promethazine inhibited ST activities toward dehydroepiandrosterone and cortisol similar to the tetraalkylammonium salts, although the drugs were weaker inhibitors of hydroxysteroid ST activities. These results imply that in addition to trialkylamine side chains, the other portion of the drugs may participate in the inhibition of hydroxysteroid ST activities.

Cyclizine-induced chorea. Observations on the influence of cyclizine on dopamine-related movement disorders.

Cyclizine was observed to induce generalized chorea in a patient with mild lingual-facial-buccal dyskinesias. The mechanism for this action was shown to be cyclizine's central anticholinergic activity. This was consistent with previous findings that acetycholine antagonists can lower the threshold for appearance of abnormal choreatic movements related to dopaminergic mechanisms by alteration of the dopamine/acetylcholine balance in the corpus striatum. Furthermore, our study was supportive of the hypothesis that spontaneous lingual-facial-buccal dyskinesias in the elderly may be the mildest manifestations of senile chorea.

Efficacy of various locally applied chemicals as contragestational agents in rats.

PIP: Test agents were selected because of previous evidence of contragestationaal activity when administered systemically or because of known local effects which would be likely to cause endometrial changes having an adverse effect on pregnancy. A group of virgin female Sprague-Dawley rats were treated on Day 3 of pregnancy (preimplantation) and another group on Day 7 of pregnancy (postimplantation). Injections of .05 ml were made directly into the lumen of each uterine horn. Sodium chloride .9% was used on 1 side and the test agent on the other side. Implantation sites were counted before injections on Day 7. The number of corpora lutea indicated the expected number of conceptions of those injected on Day 3. On Day 15 rats were sacrificed and corpora lutea, viable conceptuses, and absorption sites were counted. Ethanol at 100, 80, 70, and 63% was a highly effective contragestational agent when given on Day 3. Formaldehyde 7-.5% was also highly effective when given on Day 3 but higher concentrations produced maternal toxicity and death. Silver nitrate, iodine, rivanol, cyclizine, urea, and 17beta-bromoacetoxy-19-nortestosterone produced no maternal toxicity but were all effective in reducing the number of viable fetuses. Prostaglandin (PGF2alpha), indomethacin, and ergonovine had no observable effect on preimplantation embryos. Methotrexate reduced survival when injected on Day 3 and more so when given on Day 7 but a systemic toxic effect was also noted. When injected on Day 7 all of the compounds except methotrexate were markedly less effective. Survival of fetuses in the control horns varied from 50% to 100%. Ethanol produced sloughing and necrosis but the endometrium appeared to be normal after 96 hours. Fecundity had not returned after 4-5 estrous cycles. The other compounds produced no histologically evident long-lasting effects. Superficial endometrial damage seemed to be the mechanism of action of compounds that were effective on Day 3. The discrepancies noted between results obtained and the documented efficiency of PGF2alpha and of urea as abortifacients in humans raises the question of the suitability of the rat as a model for predicting abortifacient activity in humans. However, the action of these 2 substances may be different in later gestational phases.^ieng

Effects of antiemetics on the acquisition and recall of radiation- and lithium chloride-induced conditioned taste aversions.

A series of experiments were run to evaluate the effect of antiemetics on the acquisition and recall of a conditioned taste aversion induced by exposure to ionizing radiation or by injection of lithium chloride. Groups of male rats were exposed to 100 rad gamma radiation or 3 mEq/kg lithium chloride following consumption of a 10% sucrose solution. They were then injected with saline or with one of three antiemetics (prochlorperazine, trimethobenzamide, or cyclizine) at dose levels that have been reported to be effective in attenuating a previously acquired lithium chloride-induced taste aversion. The pretreatments with antiemetics had no effect on the acquisition or recall of either the lithium chloride- or radiation-induced taste aversion. The data suggest that antiemetics do not disrupt lithium chloride-induced taste aversions as previously reported, nor do they effect radiation-induced taste aversion learning.

The effects of scopolamine and cyclizine on visual-vestibular interaction in humans.

The aim of the present study was to investigate the effects of scopolamine (1.5 mg, transdermal patch) and cyclizine (50 mg tablet), at the doses usually used for the relief of motion sickness, on postural sway, optokinetic nystagmus (OKN) and circularvection (CV) in humans, using a within-subjects, double-blind, placebo-controlled design. Scopolamine and cyclizine were found to have no significant suppressive effect on these aspects of visual-vestibular interaction. Postural sway and CV were not significantly affected by either drug treatment; OKN SPV was significantly increased (p < 0.05), although OKN amplitude and frequency were unaffected. These results suggest that scopolamine and cyclizine, at doses used for the relief of motion sickness, may have minimal suppressive effects on these aspects of visual-vestibular interaction.

Inhibitory effect of homochlorcyclizine on melanogenesis in α-melanocyte stimulating hormone-stimulated mouse B16 melanoma cells.

The histamine receptor H1 antagonist homochlorcyclizine (HC) has been widely used as an antihistamine agent for the treatment of allergies. However, the effect of HC on skin pigmentation is not known. In the present study, we investigated the inhibitory effect of HC on melanogenesis in mouse B16 melanoma cells. Our results showed that HC inhibited melanogenesis in either α-melanocyte stimulating hormone (α-MSH)- or 3-isobutyl-1-methylxanthin (IBMX)-stimulated B16 cells in a dose-dependent manner. Despite the strong inhibition of melanogenesis by HC, it was surprisingly found that HC did not reduce either cellular or melanosomal tyrosinase activity in α-MSH-stimulated B16 cells. In addition, HC also did not directly inhibit either murine or mushroom tyrosinase activity in the cell-free system. Moreover, western blotting and reverse-transcription polymerase chain reaction (RT-PCR) analyses respectively confirmed that HC did not downregulate levels of tyrosinase protein and its mRNA in α-MSH-stimulated B16 cells. These results clearly demonstrated that HC inhibits melanogenesis of B16 cells by a mechanism other than reduction of the cellular tyrosinase activity. From the present study, HC was proven to be a good candidate as a skin-whitening agent for treatment of skin hyperpigmentation, and this generic drug might be suitable for use in combination with other depigmenting agents due to its unique inhibition mechanism.