Repurposing celecoxib as adjuvant therapy in patients with Parkinsonian disease: a new therapeutic dawn: randomized controlled pilot study.

IF 4.6 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2024-12-01 Epub Date: 2024-09-28 DOI:10.1007/s10787-024-01567-z

Mohannad O Khrieba, Sahar K Hegazy, Wessam Mustafa, Sahar M El-Haggar

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引用次数: 0

Abstract

Background: The clinical presentations of Parkinson's disease (PD), a chronic neurodegenerative condition, include bradykinesia, hypokinesia, stiffness, resting tremor, and postural instability. Recently, neuroinflammation is involved in pathogenesis of PD. Application of nonsteroidal anti-inflammatory drugs captured attention to treat these neuroinflammation.

Aim: To investigate the possible effectiveness of celecoxib in patients with PD treated with conventional treatment.

Methods: Sixty outpatients who fulfilled the inclusion requirements for PD were enrolled in this randomized, prospective, and controlled study. The patients were allocated into two groups at random (n = 30); the control group received standard PD treatment, consisting of levodopa/carbidopa, and the celecoxib group received standard PD treatment plus celecoxib. A neurologist evaluated each patient at the beginning of the treatment and after 6 months. Assessment of Unified Parkinson's disease rating scale (UPDRS) for each patient. Before and after treatment, α -synuclein (α-Syn), tumor necrosis factor alpha (TNF-α), Toll like receptors-4 (TLR-4), nuclear factor erythroid 2-related factor 2 (Nrf-2) and brain-derived neurotropic factor (BDNF) were assessed. Paired and unpaired t tests were used to assess statistical significance within and between groups respectively.

Results: The celecoxib group exhibited a significant and statistical reduction in the level of measured parameters by unpaired t test as followed: TLR-4 (p = 0.004), TNF-α (p = 0.042), and α-Syn (p = 0.004) apart from a significant increase in BDNF (p = 0.0005) and Nrf-2 (p = 0.004), in comparison with the control group. Also, UPDRS was significantly decreased in celecoxib group (p < 0.05).

Conclusion: Celecoxib could be a promising adjuvant therapy in managing patients with PD.

Trial registration number: NCT05962957.

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将塞来昔布重新用作帕金森病患者的辅助治疗：新的治疗曙光：随机对照试验研究。

背景：帕金森病（PD）是一种慢性神经退行性疾病，其临床表现包括运动迟缓、运动减弱、僵硬、静止性震颤和姿势不稳。最近，神经炎症参与了帕金森病的发病机制。目的：研究塞来昔布对接受常规治疗的帕金森病患者可能产生的疗效：这项随机、前瞻性对照研究招募了60名符合PD纳入要求的门诊患者。患者被随机分为两组（n = 30）；对照组接受左旋多巴/卡比多巴组成的标准帕金森病治疗，塞来昔布组接受标准帕金森病治疗加塞来昔布。神经科医生在治疗开始时和6个月后对每位患者进行了评估。对每位患者进行帕金森病统一评分量表（UPDRS）评估。在治疗前后，对α-突触核蛋白（α-Syn）、肿瘤坏死因子α（TNF-α）、Toll样受体-4（TLR-4）、核因子红细胞2相关因子2（Nrf-2）和脑源性神经营养因子（BDNF）进行了评估。采用配对和非配对 t 检验分别评估组内和组间的统计学意义：结果：通过非配对 t 检验，塞来昔布组的测量参数水平显著降低，具体情况如下：TLR-4（p = 0.004）、TNF-α（p = 0.042）和α-Syn（p = 0.004），与对照组相比，BDNF（p = 0.0005）和Nrf-2（p = 0.004）显著增加。此外，塞来昔布组的UPDRS也明显降低（p 结论：塞来昔布是一种有效的抗癫痫药物：塞来昔布可能是治疗帕金森病患者的一种很有前景的辅助疗法：NCT05962957.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]