Cong H H, Khaziakhmetova V N, Zigashina L E
Int J Risk Saf Med. 2015;27 Suppl 1:S76-7. doi: 10.3233/JRS-150697.
Non-steroidal anti-inflammatory agents (NSAIDs), steroids and representatives of other pharmacological groups [1, 2] are widely used for pharmacological regulation of inflammation. However, their anti-inflammatory effects are accompanied by serious adverse reactions [3, 4]. There was a hope that newer NSAIDs, selective inhibitors of COX-2, would be safer, but their longer-term use appeared to cause an increased risk of heart attacks and stroke [5]. Carrageenan rat paw oedema model is traditionally used for search and development of new NSAIDs with assessment of effects after 3 to 5 hours after oedema induction [6, 7], neglecting longer-term effects [8].
To compare effects of traditional NSAIDs (indomethacin, naproxen) on the development, duration and intensity of carrageenan rat paw oedema.
Carrageenan paw oedema was induced in 18 rats by sub-plantar injection into the right hind paw of the animals of 0.1 ml of 1% aqueous gel of carrageenan-λ (22049 SIGMA λ-Carrageenan plant-mucopolysaccharide, Sigma-Aldrich). We assessed the intensity of the oedema development and its duration by measurements of rat paw volume using plethysmometer 37140 (UgoBasile, Italy). Measurements were made prior to induction of oedema (base-line volume) and at 1, 2, 3, 4, 5, 24, 48, 72, 96, 120, 144, 168 and 192 hours after sub-plantar carrageenan injection. Calculating the percentage of increase in paw volume assessed the intensity of the oedema. The base-line paw volume was taken for 100%.Animals were divided into 3 groups of 6 rats each; group 1: control (solvent); group 2: naproxen 15 mg/kg and group 3: indomethacin 10 mg/kg. These doses are known as ED50 (effective doses 50) on carrageenan rat paw oedema with single-dose NSAIDs administration [9]. To get the most accurate estimate of the intensity of the simulated by carrageenan inflammatory response and the potential effects of some NSAIDs with their longer-term use we calculated areas under the curve «increase in paw volume - time» using standard method of numerical integration - trapezoidal method. Statistical analysis was performed using Microsoft Office Excel 2007 with the calculation of arithmetic means M, their standard deviations (δ) and standard errors (m). We applied Student's t-test and accepted as significant the differences with P values equal to or less than 0.05.
The inflammatory reaction induced by carrageenan, developed in a form of swelling/oedema with an increase in the rat paw volume up to 55% of the baseline volume. The maximum volume of oedema was observed in the control group at 3 h after the injection of carrageenan, which is in accordance with the literature data on the development of carrageenan paw edema in rats [10, 11]. Naproxen at a dose of 15 mg/kg showed anti-inflammatory activity at 1, 2, 3, 4 and 5 hours after administration of carrageenan with suppression of oedema development by 59, 81, 73, 60 and 39% (p = 0.03; 0.001; 0.001; 0.001 and 0.01), respectively. There was no oedema inhibition by naproxen at later time-points. Indomethacin at a dose of 10 mg/kg showed anti-inflammatory effect at 2, 3, 4, and 5 hours after carrageenan oedema induction with inhibition of oedema development by 54, 54, 54 and 33% (p = 0.01, 0.004, 0.001 and 0.01) respectively. Again there was no oedema inhibition by indomethacin at the later time-points.When comparing the calculated areas under the curve «increase in paw volume - time» we found no differences between the values of control and study groups: naproxen (15 mg/kg) and indomethacin (10 mg/kg). We think that these values of areas under the curve «increase in paw volume - time» represent the total inflammatory reaction induced by carrageenan and need to be used for the assessment of future potential anti-inflammatory agents which should not only produce short-term symptomatic oedema suppression, but change the nature of the oedema response, potentially with alternative mechanisms of action. Our experimental findings are in accordance with the well-known lack of effects of NSAIDs on the outcomes of chronic inflammatory diseases [12]. This may be due to the fact that they suppress the development and symptoms of inflammation at the early stages, but the reaction to inflammatory stimuli develops fully over the longer period of time and takes its full course nonetheless. This proves that traditional modeling approaches to future potential anti-inflammatory agents development needs re-assessment.
Single-dose administration of naproxen (15 mg/kg) or indomethacin (10 mg/kg) exerts decrease in rat paw oedema volume at no later than 5 hours after oedema induction by carrageenan. Evaluating anti-inflammatory activity by the areas under the curve «increase in paw volume - time» proves that a single-dose NSAID's administration has no effect on the inflammatory response when evaluated not by single time-point index (at 3 or 5 hours), but by assessing the oedema development and duration over 192 hours (8 days).
非甾体抗炎药(NSAIDs)、类固醇及其他药理学组别的代表药物[1,2]被广泛用于炎症的药理学调节。然而,它们的抗炎作用伴随着严重的不良反应[3,4]。曾有人希望新型NSAIDs,即COX-2选择性抑制剂,会更安全,但长期使用它们似乎会增加心脏病发作和中风的风险[5]。角叉菜胶诱导的大鼠足肿胀模型传统上用于新NSAIDs的研发,并在诱导肿胀后3至5小时评估效果[6,7],而忽略了长期影响[8]。
比较传统NSAIDs(吲哚美辛、萘普生)对角叉菜胶诱导的大鼠足肿胀的发展、持续时间和强度的影响。
通过向18只大鼠右后足跖下注射0.1 ml 1%角叉菜胶-λ水凝胶(22049 SIGMA λ-角叉菜胶植物黏多糖,Sigma-Aldrich)诱导角叉菜胶性足肿胀。使用37140体积描记仪(意大利UgoBasile公司)测量大鼠足体积,评估肿胀发展的强度及其持续时间。在诱导肿胀前(基线体积)以及足跖下注射角叉菜胶后1、2、3、4、5、24、48、72、96、120、144、168和192小时进行测量。通过计算足体积增加的百分比来评估肿胀的强度,将基线足体积视为100%。动物分为3组,每组6只;第1组:对照组(溶剂);第2组:萘普生15 mg/kg;第3组:吲哚美辛10 mg/kg。这些剂量是单剂量NSAIDs给药时角叉菜胶诱导的大鼠足肿胀的已知半数有效剂量(ED50)[9]。为了最准确地估计角叉菜胶模拟的炎症反应强度以及某些NSAIDs长期使用的潜在影响,我们使用数值积分的标准方法——梯形法计算“足体积增加-时间”曲线下面积。使用Microsoft Office Excel 20,07进行统计分析,计算算术平均值M、标准差(δ)和标准误(m)。我们应用Student's t检验,将P值等于或小于0.05的差异视为显著差异。
角叉菜胶诱导的炎症反应以肿胀/水肿形式出现,大鼠足体积增加至基线体积的55%。对照组在注射角叉菜胶后3小时观察到最大水肿体积,这与关于大鼠角叉菜胶性足水肿发展的文献数据一致[10,11]。剂量为15 mg/kg的萘普生在给予角叉菜胶后1、2、3、4和5小时显示出抗炎活性,分别抑制水肿发展59%、81%、73%、60%和39%(p = 0.03;0.001;0.001;0.001和0.01)。在后期时间点萘普生没有抑制水肿。剂量为10 mg/kg的吲哚美辛在角叉菜胶性水肿诱导后2、3、4和5小时显示出抗炎作用,分别抑制水肿发展54%、54%、54%和33%(p = 0.01、0.004、0.001和0.01)。同样,在后期时间点吲哚美辛没有抑制水肿。当比较计算出的“足体积增加-时间”曲线下面积时,我们发现对照组与研究组(萘普生15 mg/kg和吲哚美辛10 mg/kg)的值之间没有差异。我们认为这些“足体积增加-时间”曲线下面积的值代表角叉菜胶诱导的总炎症反应,需要用于评估未来潜在的抗炎药物,这些药物不仅应产生短期的症状性水肿抑制,还应改变水肿反应的性质,可能具有替代作用机制。我们的实验结果与NSAIDs对慢性炎症性疾病结局缺乏作用的已知情况一致[12]。这可能是因为它们在早期阶段抑制炎症的发展和症状,但对炎症刺激的反应在较长时间内充分发展并仍会完全发展。这证明未来潜在抗炎药物开发的传统建模方法需要重新评估。
单剂量给予萘普生(15 mg/kg)或吲哚美辛(10 mg/kg)在角叉菜胶诱导水肿后不迟于5小时使大鼠足水肿体积减小。通过“足体积增加-时间”曲线下面积评估抗炎活性证明,当不是通过单时间点指标(3或5小时)评估,而是通过评估192小时(8天)内的水肿发展和持续时间时,单剂量NSAIDs给药对炎症反应没有影响。