The Role of Plant-Based Natural Compounds in Inflammation
Namrita Lall in Medicinal Plants for Cosmetics, Health and Diseases, 2022
Prostanoids are lipid mediators involved in a broad spectrum of physiological and pathological processes. They play a complex role in the normal function of kidneys, lungs, brain, ovaries, uterus, bones or the cardiovascular system. However, their synthesis is increased in inflamed tissue. Prostaglandins E2 (PGE2) and I2 (PGI2) are the main pro-inflammatory prostanoids enhancing edema formation and leukocyte infiltration. Moreover, they alter the threshold for pain perception. The application of COX inhibitors called non-steroidal anti-inflammatory drugs (NSAIDs) decreases prostanoid production. NSAIDs are used to relieve pain, fever and inflammation (Dubois et al., 1998; Smith et al., 2000; Smyth et al., 2009). Currently, NSAIDs belong to the most widely used pharmaceuticals consumed in tens of thousands of tons each year, especially as some of them are available over the counter (Warner and Mitchell, 2004).
Osteoporotic thoracolumbar fractures
Peter V. Giannoudis, Thomas A. Einhorn in Surgical and Medical Treatment of Osteoporosis, 2020
High-quality clinical trials of pain medication use and its effectiveness in this particular cohort are limited. In practice, paracetamol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) are the first analgesics of choice. The inflammatory process that occurs at the periosteum and fracture site contributes to the pain, and NSAIDs are hypothesized to have a role in addressing this. However, this same inflammatory process has been recognized to be crucial in fracture healing, and recent studies have reported an association between NSAID use and fracture nonunion (4). This has led to a number of clinicians becoming cautious on its use in patients with acute fractures. To date, high-quality clinical trials on this is lacking, and pooled analysis of a small number of existing higher-quality studies has not reported on the risk of nonunion (4). It is also uncertain if the risk of nonunion is dependent on the type of bone fractured, as different rates of nonunion have been reported in long bones and vertebral bones (4). Further studies are clearly needed to fully address this particular area of uncertainty. NSAIDs also have to be used with caution due to the risk of gastrointestinal bleeding, kidney injury, and cardiovascular risk. This is even more of a concern in the older population, and any use of NSAIDs has to be for the shortest possible duration.
Evaluation of Anti-ulcer Potential of Sphenodesme involucrata var. paniculata (C.B. Clarke) Munir Leaves on Various Gastric Aggressive Factors
Parimelazhagan Thangaraj in Phytomedicine, 2020
Among the exogenous factors that attack the mucosa, which predispose the formation of gastric ulcers through exposing the gastric epithelium to acid, we can mention smoking, the ingestion of alcohol and diets with food of spicy content, Helicobacter pylori infection, and the continued use of drugs (NSAIDs) that cause adverse effects. NSAIDs are the group of drugs that are used worldwide for pain, inflammation, and fever (Bhandari et al. 2010). About 60% of people who use NSAIDs are continuously prone to develop gastric lesions (Santin et al. 2013). It is known that NSAIDs promote a blockade in the biosynthesis of PGE2 due to the inhibition of COX-1. PGE2 is responsible for secreting mucus, the release of the bicarbonate, and the increase of blood flow of the gastric mucosa, which are the factors essential for gastric protection, and thus their absence/or decrease in production leads to the formation of lesions in stomach (Vane and Botting 1995; Yandrapu and Sarosiek 2015). According to Berstad et al. (2002), NSAIDs have direct effects on the degradation of phospholipids and adhered mucus, reducing hydrophobicity and facilitating the H-ion back diffusion in the gastric mucosa. This ultimately helps the other gastric aggressive agents, such as coffee, smoking, and alcohol to damage the stomach effortlessly by irritating the stomach cells to secrete more gastric acid (Burkitt et al. 2017).
Regular use of ibuprofen reduces rat penile prostaglandins and induces cavernosal fibrosis
Published in Drug and Chemical Toxicology, 2022
Abdel Aaal Elkamshoushi, Passainte Hassaan, Iman Nabil, Heba Ossama, Salma S. Omar
Spontaneous adverse drug reaction reporting systems in the UK have nominated ibuprofen as the safest NSAID (Bushra and Aslam 2010). In spite of its short half-life of 1.8–2 h and rapid metabolism and excretion from the body within 24 h (Ershad and Vearrier 2020), various side effects of NSAIDs are well known such as peptic ulcers, hepatic and renal toxicity, and increased propensity for internal bleeding. Adverse effects result from the inhibition of PG synthesis in different organ systems as PGs modulate several homoeostatic functions in the immune, cardiovascular, gastrointestinal, renovascular, central nervous system, and reproductive systems (Barbagallo and Sacerdote 2019). The impact of NSAIDs on penile PG homeostasis and erectile function, however, still remains unsettled (Peeran et al. 2017).
Boswellia serrata extract shows cognitive benefits in a double-blind, randomized, placebo-controlled pilot clinical trial in individuals who suffered traumatic brain injury
Published in Brain Injury, 2022
Shakila Meshkat, Somayeh Mahmoodi Baram, Shima Rajaei, Fatemeh Mohammadian, Emad Kouhestani, Nasibeh Amirzargar, Abbas Tafakhori, Sajad Shafiee, Melika Meshkat, Laurent Balenci, Alex Kiss, Ali Riazi, Amir Salimi, Vajiheh Aghamollaii, Farzaneh Salmani, Saeed Karima
Many anti-inflammatory drugs (e.g., non-steroidal anti-inflammatory drugs NSAIDs) are commercially available and used to curb inflammation and reduce pain. If taken at high doses and for a long time, NSAIDs may induce side effects. Botanical medicines have gained traction in the research and clinical communities as effective agents with better safety profiles. Boswellia resin extracts and its active compounds such as Boswellic acids (BAs) and other triterpenoids have shown significant anti-inflammatory and immunomodulatory effects in cerebrovascular diseases, brain edema, stroke, osteoarthritis and asthma (17–20). Immunomodulation and anti-inflammatory activities of BAs are mediated by the direct inhibition of both 5-LOX and IκB kinase (IKK), which leads to the inhibition of NF-κB pathway and reduction of inflammatory molecules (21–23). BAs also showed neuroprotective properties and improvement of cognitive function (24,25). Based on these findings, we conducted a randomized, double-blind, placebo-controlled, phase II trial to determine the safety and efficacy of a proprietary extract of Boswellia serrata (1,200 mg/day) on cognitive function of individuals who suffered from TBI.
Can NSAIDs and Acetaminophen Effectively Replace Opioid Treatment Options for Acute Pain?
Published in Expert Opinion on Pharmacotherapy, 2021
Joseph V. Pergolizzi, Peter Magnusson, Jo Ann LeQuang, Frank Breve, Robert Taylor, Charles Wollmuth, Giustino Varrassi
NSAIDs are a broad class of drugs and can be grouped into nonselective NSAIDs, which act as cyclooxygenase (COX) 1 and 2 inhibitors and selective NSAIDS sometimes called coxibs, which preferentially inhibit COX-2. Within those groups, there are numerous products at a variety of doses and formulations. As they are effective pain relievers and some lower-dose NSAIDs are available over the counter as well, they rank among the most frequently taken drugs in the world[48]. Safety concerns exist for all NSAIDs, with nonselective NSAIDs more associated with gastrointestinal adverse events, and coxibs more associated with cardiovascular and renal side effects[48]. Nonselective NSAIDs have been associated with gastrointestinal bleeding, peptic ulcers, and other forms of distress. The gastrointestinal adverse effects of these drugs vary by agent and may be exacerbated by high doses or long-term use of NSAIDs[49]. However, adverse events may occur with even initial use or a brief course.
Related Knowledge Centers
- Antithrombotic
- Myocardial Infarction
- Corticosteroid
- Analgesic
- Antipyretic
- Indication
- Drug Class
- Anti-Inflammatory
- Peptic Ulcer Disease
- Kidney Disease