Pharmacological properties and related constituents of stem bark of Pterocarpus erinaceus Poir. (Fabaceae)

ObjectiveTo screen methanol and dichloromethane extracts of stem bark of Pterocarpus erinaceus for anti-inflammatory, analgesic, in vitro antioxidant activities and phytochemical analysis.MethodsAnti-inflammatory activity was determined by using carrageenan induced-edema of mice paw and croton oil-induced edema of mice ear; analgesic effect was evaluated using acetic acid-induced writhing. Phytochemical screening of extracts was performed by thin layer chromatography. The chromatographic fractionation led to the isolation of main active components as friedelin, lupeol and epicathechin. The structures were established by TLC and nuclear magnetic resonance studies.ResultsBoth methanol and dichloromethane extracts, friedelin, lupeol and epicatechin showed a significant anti-inflammatory effect using croton oil induced-ear edema. Furthermore, the action of dichloromethane extract was more important. At the doses of 100 and 200 mg/kg, the methanol extract was able to reduce the carrageenan induced-hind paw edema, while at the doses of 100, 200 and 400 mg/kg, it showed an important analgesic effect against writhing induced by acetic acid injection of 38.8%, 68.0% and 74.3%, respectively. Antioxidative properties of methanol extract and its dichloromethane and ethyl acetate fractions were assessed by using the 1,1-diphenyl-2-picrylhydrazyl method. The methanol extract showed the stronger radical scavenging activity than dichloromethane and ethyl acetate fractions, with an antiradical power of 5, 3.5 and 2 respectively. The main components isolated from these extracts as friedelin, lupeol and epicathechin were responsible of these activities.ConclusionsThe results suggest that the stem bark extracts of Pterocarpus erinaceus possessed important anti-inflammatory, analgesic activities and strong antioxidant properties, therefore, they could be used as natural potential ingredients for pharma ceutical industry.     

Analgesic and anti-inflammatory activities of Passiflora foetida L

ObjectiveTo investigate the analgesic and anti-inflammatory activities of ethanol extract of Passiflora foetida (P. foetida) leaves.MethodsEthanol extract of P. foetida leaf was evaluated for analgesic action by acetic acid-induced writhing and hot plate method in albino mice. The anti-inflammatory property of ethanolic leaf extract was tested by carrageenan induced acute paw edema and histamine induced acute paw edema in rats.ResultsThe dose 200 mg/kg of P. foetida leaf extract exhibited highest significant analgesic activity [(13.50±0.43) min] at a reaction time of 20 min in hot plate method in mice. The ethanol extract of leaf dose 100 mg/kg produced a highly significant anti inflammatory effect [(1.302±0.079) mL] in rats.ConclusionsIt is very clear that P. foetida also has analgesic and anti-inflammatory activities for the pharmaceuticals.     

Intestinal anti-inflammatory activity of the Serpylli herba extract in experimental models of rodent colitis

IntroductionNowadays, there is an increasing interest for alternative options in the treatment of inflammatory bowel diseases (IBDs) that combine efficacy and an adequate safety profile.MethodsThe intestinal anti-inflammatory effects of Serpylli herba, the officinal drug in the European Pharmacopeia composed by the aerial parts of wild thyme (Thymus serpyllum), were evaluated in the trinitrobenzenesulfonic acid (TNBS)-induced rat colitis and dextran sodium sulfate (DSS)-induced mouse colitis, which are well characterized experimental models with some resemblance to human IBD.ResultsS. herba extract exerted an intestinal anti-inflammatory effect in both experimental models of colitis, as evidenced both histologically, since it facilitated the tissue recovery of the damaged colon, and biochemically as showed by the improvement of the different inflammatory markers evaluated, including myeloperoxidase activity, glutathione content, and leukotriene B₄ levels as well as the expression of the inducible proteins iNOS and COX-2. This beneficial effect was associated with the reduction in the expression of different cytokines, like TNFα, IL-1β, IFNγ, IL-6 and IL-17, the chemokine MCP-1, and the adhesion molecule ICAM-1, thus ameliorating the altered immune response associated with the colonic inflammation.ConclusionS. herba extract displays an anti-inflammatory effect on different models of rodent colitis that could be attributed to its immunomodulatory properties.     

Pharmacognostic study and anti – inflammatory activity of Phyllanthus reticulatus Poir. fruit

ObjectiveTo study pharmacognostic evaluation and anti – inflammatory activity of Phyllanthus reticulatus Poir. (P. reticulatus) fruit.MethodsThe fruit sample was studied by macroscopical, microscopical and other WHO recommended methods for standardisation. The hydroalcoholic extract of ripe fruit was also screened for anti-inflammatory activity by carrageenan induced left hind paw oedema in rat at doses of 200 mg/kg and 400 mg/kg, orally.ResultsTransverse section of fruit and powder study showed the presence of epicarp, mesocarp, endocarp, fibres and sclereids. Hydroalcoholic extract of fruit showed significant (P < 0.01) reduction of paw volume when compared with diclofenac sodium. The extract showed anti – inflammatory activity at 200 mg/kg and 400 mg/kg and was comparable with diclofenac sodium.ConclusionsPharmacognostic profile of Phyllanthus reticulatus provides the simplest and quickest means to establish the identity and purity and thereby assure the quality of sample. The hydroalcoholic extract shows significant anti – inflammatory activity at both doses when compared with standard drug diclofenac sodium (100 mg/kg).     

Investigation of antioxidant and anti-inflammatory activity of leaves of Dalbergia paniculata (Roxb)

ObjectiveTo investigate the antioxidant and anti-inflammatory activity of orally administered methanolic leaf extract of Dalbergia paniculata (D. paniculata) in Carrageenan induced inflammation in rats.MethodsIn vitro antioxidant activity was evaluated for superoxide radical, Hydroxyl radical and DPPH radical scavenging activity. Three doses 200 mg/kg, 400 mg/kg and 800 mg/kg of D. paniculata were tested for anti-inflammatory activity in Carrageenan induced rat paw edema model and paw thickness was measured every one hour up to 6 h.ResultsThe methanolic leaf extract of D. paniculata produced dose dependent inhibition of Superoxide radical, Hydroxyl radical and DPPH radicals. In Carrageenan induced inflammation model, all three doses produced significant percentage inhibition of rat paw edema and 800 mg/kg dose produced maximum percent inhibition of rat paw edema (47.83%) at 3h compared to control group.ConclusionsIn the present study we found that methanolic leaf extract of D. paniculata showed good in vitro antioxidant activity and in vivo anti-inflammatory activity in rats.     

In vivo antiinflammatory activity and chemical composition of Hypericum scabroides

ObjectiveTo evaluate the methanolic extracts of aerial parts of Hypericum scabroides (HSM) (200 mg/kg, p.o.) for in vivo anti-inflammatory activity.MethodsThe anti-inflammatory activity of HSM was tested in mice weighting (25±5) g. Either vehicle (control group), the methanolic extracts (200 mg/kg) or diclofenac (50 mg/kg), was administered (p.o.) for 60 min before an edema was induced in the mice paw by subcutaneous injection of carrageenin. The mouse-paw volume was measured 1 h, 3h and 6 h after injection of carrageenin.ResultsThe HSM showed significant reduction of edema in carrageenan induced mice paw edema model at 1 h and 3 h for (78.03±15.54)% and (40.44±16.36)%, respectively. The diclofenac 50 mg/kg exhibited % reduction in paw volume (31.00±11.52)%, (0.80±0.09)% and (9.39±1.99)% after 1 h, 3 h and 6 h, respectively compared to control group. The obtained results revealed that HSM has significant anti inflammatory activity. Furethermore, the chemical composition of HSM was analyzed by using high performance liquid chromatography–diode array dedector. The plant contained pseudohypericin (trace) hypericin (trace), chlorogenic acid (0.014 0±0.000 5)%, rutin (0.005 0±0.000 6)%, hyperoside (0.016±0.005)%, isoquercitrin (0.034 0±0.000 5)% and kaempferol (trace).ConclusionsThe obtained results of the present investigation revealed that methanol extract of Hypericum scarbroides has significant anti-inflammatory activity.     

Anti-inflammatory effects of Morninga oleifera lam extract in rats

ObjectiveTo investigate the acute and delayed anti-inflammatory effects of Morning oleifera lam (MOL) crude methanolic extract.MethodsCompared the anti-inflammatory effects of MOL with that of standard anti-inflammatory agents like indomethacin and hydrocortisone using Air Pouch Model.ResultsIn both acute and delayed inflammation, the MOL extract produced dose dependent anti-inflammatory effect [acute IC₅₀= (399.30 ±5.43) mg/kg; delayed IC₅₀= (510.26±4.53) mg/kg]. The order of anti-inflammatory potency for the three drugs was hydrocortisone> indomethacin > MOL.ConclusionsThese observations indicate that MOL possesses potential anti-inflammatory property.     

Effect of boschniakia rossica on expression of GST-P, p53 and p21ras proteinsin early-stage chemical hepatocarcinogenesis and its anti-inflammatoryactivities in rats

AIM To investigate the effect of boschniakia rossica (BR) extract on expression of GST-P, p53 and p21fasproteins in early-stage chemical hepatocarcinogenesis in rats and its anti-inflammatory actions.METHODS The expression of tumor marker, placental form glutathione S-transferase (GST-P), p53 and p21ras proteins were investigated by immunohistochemical techniques and ABC method. Anti-inflammatoryactivities of BR were observed by xylene and croton oil-induced mouse ear edema, carrageenin, histamineand hot scald-induced rat pow edema, adjuvant-induced rat arthritis and cotton pellet-induced mousegranuloma formation methods.RESULTS The 500 mg/kg of BR-H2O extract fractionated from BR-Methanol extract had inhibitory effecton the formation of DEN-induced GST-P-positive foci in rat liver and the expression of mutant p53 and p21fasprotein was lower than that of hepatic preneoplastic lesions. Both CH2Cl2 and H2O extract from BR haveinhibitory effect in xylene and croton oil-induced mouse ear edema. BR-H2O extract exhibited inhibitoryeffect in carrageenin, histamine and hot scald-induced hind paw edema and adjuvant-induced arthritis in ratsand cotton pellet-induced granuloma formation in mice.CONCLUSION BR extract exhibited inhibitory effect on formation of preneoplastic hepatic foci in earlystage of rat chemical hepatocarcinogenesis. Both CH2Cl2 and H2O extract from BR exerted anti-inflammatory effect in rats and mice.     

The anti-inflammatory activity of garden egg (Solanum aethiopicum) on egg albumin-induced oedema and granuloma tissue formation in rats

ObjectiveTo evaluate the possible anti-inflammatory effect of garden egg [Solanum aethiopicum (S. aethiopicum)] using experimentally induced inflammatory models in rats.MethodsOedema was induced on the rat hind paw by the injection of 0.1 mL undiluted fresh egg albumin (philogistic agent) into the subplantar surface of the rat paw. Tissue granuloma was induced in the rats by the implantation of two autoclaved cotton pellets (30 mg) under the flank of previously shaved back of anaesthetised rats. Garden egg extract doses were administered to the rats for seven consecutive days. On day 8, the animals were killed and the pellets surrounded by granuloma tissue were dissected out and dried.ResultsExtracts of garden egg significantly (P<0.05) reduced the fresh egg albumin-induced rat paw oedema and also significantly (P<0.05) reduced the granuloma tissue formation in the treated groups when compared to the control.ConclusionsThis study shows that the fruits of garden egg (S. aethiopicum) have anti-inflammatory activity in the models studied.     

Antinociceptive and anti-inflammatory activities of crude extracts of Ipomoea involucrata leaves in mice and rats

ObjectiveTo investigate antinociceptive and anti-inflammatory activities of crude extract from Ipomoea involucrata leaves (Convolvulaceae) in mice and rats.MethodsThe antinociceptive activity was tested using acetic acid-induced abdominal writhing test in mice. The anti-inflammatory activity was evaluated using egg albumin induced oedema of rat paw.ResultsPhytochemical screening showed the presence of alkaloids, flavonoids, saponins, terpenoids and tannin. At the doses of 25–100 mg/kg, Ipomoea involucrata exhibited dose-dependent and significant increase in pain threshold in acetic acid –induced writhing test of mice (P<0.05, student t-test) The administration of Ipomoea involucrata leaf extract (25–100 mg/kg) showed dose-dependent decreases in paw volume of egg albumin induced oedema in rats and a significant higher anti-inflammatory activity compared to the standard control (Aspirin).ConclusionsThese results support the claims on the traditional use of the of Ipomoea involucrata leaves in the treatment of toothache, rheumatic pains and other inflammatory conditions. Studies on the isolation and structural elucidation of the active principle are still needed being carried out.     

Analgesic and anti-inflammatory activities of Piper nigrum L.

ObjectiveTo evaluate and compare the analgesic and anti-inflammatory activity of pure compound, piperine along with hexane and ethanol extracts of Piper nigrum L. fruit in mice and rats.MethodsThe analgesic activity was determined by tail immersion method, analgesy-meter, hot plate and acetic acid induced writhing test. While the anti-inflammatory activity was evaluated by carrageenan-induced paw inflammation in rats.ResultsPiperine at a dose of 5 mg/kg and ethanol extract at a dose of 15 mg/kg after 120 min and hexane extract at a dose of 10 mg/kg after 60 min exhibited significant (P<0.05) analgesic activity by tail immersion method, in comparison to ethanol extract at a dose of 10 mg/kg using analgesy-meter in rats. However, with hotplate method, piperine produced significant (P<0.05) analgesic activity at lower doses (5 and 10 mg/kg) after 120 min. A similar analgesic activity was noted with hexane extract at 15 mg/kg. However, in writhing test, ethanol extract significantly (P<0.05) stopped the number of writhes at a dose of 15 mg/kg, while piperine at a dose of 10 mg/kg completely terminated the writhes in mice. In the evaluation of anti-inflammatory effect using plethysmometer, piperine at doses of 10 and 15 mg/kg started producing anti-inflammatory effect after 30 min, which lasted till 60 min, whereas hexane and ethanol extracts also produced a similar activity at a slightly low dose (10 mg/kg) but lasted for 120 min.ConclusionsIt is concluded from the present study that Piper nigrum L possesses potent analgesic and anti-inflammatory activities.     

Phytochemical screening and evaluation of anti-inflammatory activity of methanolic extract of Abroma augusta Linn

ObjectiveTo evaluate the Phytochemical and anti-inflammatory property of the different parts of methanolic extracts of Abroma augusta Linn.Materials and methodsAbroma augusta Linn (Family-Malvaceae) commonly known as Ulatkambal in Hindi and Devil's cotton in English, found in tropical Asia, South and eastern Africa, and Australia. It is mainly used for dysmenorrhoea, ammenorrhoea, sterlilty and other menstrual disorder. The present study aimed at evaluation of Phytochemical and anti-inflammatory study of different parts of Abroma augusta Linn methanolic extract by the carrageenan induced rat paw oedema method.ResultsThe result showed significant anti-inflammatory property of different parts of Abroma augusta Linn methanolic extract.ConclusionsThe methanolic extract of different parts of Abroma augusta Linn showed potent activity comparing with the standard drug diclofenac sodium perhaps due to the alkaloids and flavonoids present in the plant.     

Galactagogue effects of Musa x paradisiaca flower extract on lactating rats

ObjectiveTo investigate the potential of Musa x paradisiaca (M. x paradisiaca) flower extracts in promoting milk production of lactating rats and its effects on growth of the suckling pups.MethodsGalactagogue activity was evaluated in terms of quantity of milk produced from the rats treated with petroleum ether, ethanol or water extracts of the flower. Lactating rats (n = 5) of Spraque Dawley with six pups each were administered with the extracts in the amount of 500 mg/kg body weight, while the control rats were given an equivalent amount of distilled water. The rats were daily administered via oral feeding starting from Day 5 until Day 14 and the performance of milk production was measured along the experimental period by weight-suckle-weight method. Results were statistically analyzed using SPSS by means of ANOVA at 0.05 and was expressed as their mean?standard deviation. The rates of pups' growth were measured as the weight gain along the experimental period.ResultsThe rats treated with aqueous extract produced higher milk than control and ethanol groups. Aqueous extract was identified to increase milk production by 25%, while petroleum ether extract by 18%. The mean of yields produced by the rats during suckling period for aqueous, petroleum ether, ethanol and control were 4.62±2.45, 4.37±1.93, 3.65±1.89 and 3.69±1.79, respectively. Growth rates of pups for the rats treated with control, aqueous, ethanol extract and petroleum ether were (1.85±0.49), (1.78±0.56), (1.65±0.46) and (1.56±0.42) g/pup, respectively.ConclusionsThe present study reveals the potential of M. x paradisiaca flower to enhance milk production of nursing mothers which could be exploited for commercialization of the isolated extract.     

Antimalarial activity of Ageratum conyzoides in combination with chloroquine and artesunate

ObjectiveTo determine the suppressive and curative activity of aqueous leaf extract of Ageratum conyzoides (A. conyzoides) in combination with chloroquine and artesunate, respectively against Plasmodium berghei infection in mice.MethodsUsing malaria (Plasmodium berghei) infected albino mice of both sexes, aqueous extracts of A. conyzoides in combination with chloroquine and artesunate were tested for antimalarial activity, respectively. Four-day suppressive test and Rane's curative test were carried out.ResultsSuppressive tests showed significant dose dependent reduction in parasitemia level produced by the extract-chloroquine and extract-artesunate combinations. Suppressive activities of both extract-drug combinations were greater than the individual drugs alone. Extract-chloroquine (100:5) produced the highest suppressive effect (98% suppression). Curative tests showed absolute survival in two extract-drug combinations. Two extract-drug combinations produced higher curative effects than the individual drugs alone. The highest dose combinations of extract-chloroquine (100:5) and extract-artesunate (100:5) produced absolute parasitemia clearance (cure) in the infected mice.ConclusionsThe study indicated that aqueous extract of A. conyzoides had the ability to potentiate the antimalarial activity of chloroquine and artesunate against induced plasmodiasis in mice. It contributes a lot in the malaria endemic and poverty stricken tropics.     

Phytochemical screening and comparative antimicrobial potential of different extracts of Stevia rebaudiana Bertoni leaves

ObjectiveTo evaluate in vitro antimicrobial potential and phytochemical screening of the crude extracts of leaves of Stevia rebaudiana Bertoni.MethodsThe essential oil and crude extracts were prepared by using different usual method. Antimicrobial and antifungal activities were measured by the well established methods.ResultsHighest antifungal index [(12.13±0.08) mm)] and lowest antifungal index [(9.13±0.04) mm] as well as highest antibacterial index [(11.89±0.07) mm] and lowest antibacterial index [(7.24±0.03) mm] were obtained for extracts B, H, A and F, respectively. Invariably extract C, E, I, J and H did not show antimicrobial activity. The extract F showed all antifungal and antibacterial activity except Bacillus cereus and Bacillus megaterium.ConclusionsThe above findings support the idea that plant extracts of Stevia rebaudiana Bertoni leaves may have a role to be used as pharmaceuticals or preservatives.     

亮叶杨桐叶乙酸乙酯部位抗炎镇痛作用的研究

目的观察亮叶杨桐叶乙酸乙酯部位(LY)的抗炎和镇痛作用,为进一步开发亮叶杨桐叶的药用价值提供参考。方法以巴豆油致小鼠耳肿胀法、冰醋酸致小鼠腹腔毛细血管通透性亢进法和大鼠棉球肉芽肿慢性炎症法,观察LY的抗炎作用;以小鼠热板法、大鼠足趾机械刺痛法和大鼠尾部辐射热刺激法,观察LY的镇痛作用。结果与模型组比较,LY(0.42 g/kg)能显著抑制化学刺激引起的小鼠耳肿胀(P0.05)和小鼠腹腔毛细血管通透性增高(P0.01),同时能显著抑制大鼠棉球肉芽组织增生(P0.01);与模型组比较,LY(0.42 g/kg)可明显抑制热刺激(P0.05)和机械刺激引起的疼痛(P0.05),对尾部辐射热刺激引起的疼痛无明显抑制作用(P0.05)。结论 LY对急慢性炎症和高位中枢参与的疼痛有良好的抑制作用。     

Inhibitory effect of two Indian medicinal plants on aldose reductase of rat lens in vitro

ObjectiveTo assesse the inhibitory effect of alcoholic extract of two Indian medicinal plants namely Ceasalpinia digyna Rottler and, Alangium lamarckii Thwaits on aldose reductase (AR) of rat lens.MethodsRats lens were enucleated through posterior approach and their homogenate was prepared and centrifuged to obtain a clear supernatant for the determination of AR activity and protein content.ResultsThe alcoholic extract of Ceasalpinia digyna and Alangium lamarckii had a potent inhibitory effect on the lens AR enzyme. The IC₅₀ values of alcoholic extract of the selected plants were calculated and were (46.29±11.17) and (106.00±5.11) μg/mL, respectively. Quercetin was used as a positive control and its IC₅₀ value was (2.95±1.53) μg/mL.ConclusionsThus, it is concluded that alcoholic extracts of the selected plant exhibit significant inhibitory effects on AR in the rat lens in vitro.     

Phytochemical and pharmacological evaluation of prop roots of Pandanus fascicularis Lam

ObjectiveTo evaluate the anti-inflammatory and analgesic activities of the ethanol and aqueous extracts of prop roots of Pandanus fascicularis (P. fascicularis) Lam (pandanaceae). And provide experimental evidence for its traditional use such as rheumatoid arthritis and spasmodic.MethodsThe anti-inflammatory activity was observed by carrageenan-induced edema of the hind paw of rats. Analgesic activities of prop roots of P. fascicularis were determined using acetic acid induced writhing model and tail clip method in mice and rat, respectively. The ethanol fraction was then subjected to chromatographic analysis and a compound has been isolated and characterized by IR, ¹H-NMR and mass spectroscopy.ResultsEdema suppressant effect of ethanol extract was found to be 37.03% inhibition whereas aqueous extract was found to be 63.22% inhibition after 3 h which was nearly equivalent to that of 10 mg/kg of indomethacin (67.81%). Percentage inhibition of writhing compared to control were 63.15%, 54.38%, 14.90% for aspirin, aqueous extract and ethanolic extract, respectively. Both ethanol and aqueous extracts show significant activity against appropriate controls after 60 min of treatment on tail clip method. The structure of the isolated compound is may be characterized as Hepta deca-5-ene-1-ol by analysis it's IR, ¹H-NMR and mass spectroscopy data.ConclusionsThe extracts of prop roots of P. fascicularis produce significant analgesic and anti-inflammatory activities, supporting the traditional application of this herb in treating various diseases associated with inflammation and pain.     

Evaluation of in vivo and in vitro anti-inflammatory activity of Ajuga bracteosa Wall ex Benth

Ethnopharmacological relevance: Ajuga bracteosa Wall Ex Benth. (Labiateae) is described in Ayurveda for the treatment of rheumatism, gout, palsy and amenorrhea.ObjectivePresent study was aimed to investigate the in vivo and in vitro anti-inflammatory activity of Neelkanthi (whole plant) and to support its traditional use.MethodsMethanolic extract of plant Ajuga bracteosa (ABE) was investigated for its anti-inflammatory activity in carrageenan induced rat paw oedema, egg albumin induced inflammation in rats and the study was further supported with in vitro anti-inflammatory study by using Human red blood cell membrane stabilization (HRBC) method. Three doses of the extract (ABE-250, 500 and 750 mg/kg, i.p.) were used in the study and diclofenac sodium (5mg/kg, i.p.) was used as standard.ResultsABE (500 and 750 mg/kg, i.p.) significantly (P < 0.05) reduced increased in paw volume induced by carrageenan and egg albumin. ABE also showed significant stabilization toward HRBC membrane.ConclusionsABE at the dose of 500 and 750 mg/kg showed potent action on comparison with the standard drug diclofenac sodium.     

Standard-Volume Plasma Exchange Improves Outcomes in Patients With Acute Liver Failure: A Randomized Controlled Trial

BackgroundHigh volume plasma-exchange (HVPE) improves survival in patients with acute liver failure (ALF), but apprehension regarding volume overload and worsening of cerebral edema remain.MethodsIn an open-label randomized controlled trial, 40 consecutive patients of ALF were randomized 1:1 to either standard medical treatment (SMT) or SMT with standard-volume plasma-exchange (SVPE). SVPE was performed using centrifugal apheresis [target volume of 1.5 to 2.0 plasma volumes per session] until desired response was achieved. Cerebral edema was assessed by brain imaging. Results were analyzed in an intention-to-treat analysis. Primary outcome was 21-day transplant-free survival. The levels of cytokines, damage-associated molecular patterns (DAMPs) and endotoxins were analyzed at baseline and day 5.ResultsALF patients [aged 31.5 ± 12.2 years, 60% male, 78% viral, 83% hyperacute, 70% with SIRS were included. At day 5, SVPE [mean sessions 2.15 ± 1.42, median plasma volume replaced 5.049 L] compared to SMT alone, resulted in higher lactate clearance (p = .02), amelioration of SIRS (84% vs. 26%; P = .02), reduction in ammonia levels [(221.5 ± 96.9) vs.(439 ± 385.6) μg/dl, P = .02) and SOFA scores [9.9(±3.3) vs. 14.6(±4.8); P = .001]. There were no treatment related deaths. SVPE was associated with a higher 21-day transplant free-survival [75% vs. 45%; P = .04, HR 0.30, 95%CI 0.01-0.88]. A significant decrease in levels of pro-inflammatory cytokines and an increase in anti-inflammatory cytokines along with a decrease in endotoxin and DAMPs was seen with SVPE.ConclusionIn ALF patients with cerebral edema, SVPE is safe and effective and improves survival possibly by a reduction in cytokine storm and ammonia. ClinicalTrial.gov (identifier: NCT02718079)