高选择性环氧化酶—2抑制剂的进展与评价

目的 :介绍高选择性环氧化酶 - 2抑制剂———昔布类药物进展 ,并评价其临床疗效 ,以供临床参考。方法 :查阅国内、外近期相关文献进行分析、评价。结果与结论 :昔布类高选择性环氧化酶 - 2抑制剂进展十分迅速 ,对环氧化酶 - 2的选择性高 ,在治疗骨关节炎和类风湿性关节炎、关节痛、术后疼痛和肿瘤上展现了良好的治疗前景     

选择性环氧化酶-2抑制剂对心血管影响的研究进展

目的 综述选择性环氧化酶-2抑制剂在心血管方面的安全性及其作用机制.方法 通过查阅国内外相关文献,分别比较归纳了不同选择性环氧化酶-2抑制剂引发心血管事件的风险性,并总结了罗非昔布、塞来昔布等对心血管的作用机制.结果 对选择性环氧化酶-2抑制剂引发心血管不良反应的研究进展进行了比较全面的总结.结论 不同选择性环氧化酶-2抑制剂在心血管安全性方面有明显差别,比较几种昔布类药物,塞来昔布相对安全,与小剂量阿司匹林联合服用可降低心血管风险性.     

环氧化酶-2选择性抑制剂的研究与开发

综述环氧化酶-2选择性抑制剂的分子基础及其构效关系。甾体抗炎药的有效治疗作用源于对环氧化酶-2的抑制作用，其副作用则是由于对环氧化酶-1的抑制作用所致，因此寻找高效环氧化酶-2选择性抑制剂成为甾体抗炎药的研究热点。     

塞来昔布抗乳腺癌的临床应用

目前研究发现环氧化酶-2（COX-2）与乳腺癌的发生有密切联系.COX-2及其催化产物前列腺素（PGs）参与炎症的多种过程,且可通过多种致病机制参与多种实体瘤的发生、发展过程.塞来昔布作为新型非甾体类抗炎药（NASIDs）,是一种高选择性的COX-2抑制剂,国内外的研究表明,其对上皮组织癌有一定的抑制作用.该文就塞来昔布抗乳腺癌的机制及其临床研究进行了综述.     

塞来昔布治疗急性肾绞痛的疗效评价

目的:研究选择性COX-2(环氧化酶)抑制剂类药物在治疗急性肾绞痛中的疗效。方法:采用单盲法对急性肾绞痛的病人随机采用选择性COX-2抑制剂类药物塞来昔布(西乐葆)口服联合654-2肌注和强痛定肌注联合654-2肌注两种方法,比较两种方法的疗效。结果:两种方法在镇痛效果方面无统计学差异,在药物副作用方面存在统计学差异。结论:选择性COX-2抑制剂类药物口服联合654-2肌注方法缓解肾绞痛效果明显,副作用发生率低,适合作为治疗急性肾绞痛的首选方法。     

罗非考昔对手术后痛疼有效

美国的研究者报道 ,手术前服用环氧化酶 - 2抑制剂罗非考昔可减少对阿片样物质的需求并可提高膝关节替换外科手术后的临床结果。随机安排 70名成年患者进行选择性地最初全膝盖关节成形术 ,在手术前 2 4h和 12h口服罗非考昔5 0mg ,手术后 5 0mg/d ,共 5d及 2 5mg/d ,共 8d(n =35     

环氧化酶-2及其抑制剂的研究进展

本文综述了近年关于环氧化酶-2及及其抑制剂研究进展的国内外文献,侧重于环氧化酶-2及其抑制剂的药理学新进展和不良反应的内容.     

特异性环氧化酶-2抑制剂对胃肠道、肾脏及心血管系统的安全性

目的：探讨特异性环氧化酶-2抑制剂的安全性。方法：查阅国外近几年的部分相关文献。结果：特异性环氧化酶-2抑制剂与传统非甾体抗炎药相比有较高的胃肠道安全性，目前研究显示两者对肾脏和心血管的作用相似。结论：发生肾脏或心血管不良事件危险性较高的患者使用特异性环氧化酶-2抑制剂治疗时应注意安全。     

环氧合酶-2和5-脂氧化酶双重抑制剂的研究进展

传统的非甾体抗炎药和选择性环氧合酶-2(COX-2)抑制剂在治疗炎症过程中引发胃肠道及肾脏不良反应,制约了其临床应用。COX-2和5-脂氧化酶(5-LOX)双重抑制剂同时抑制前列腺素(PGs)和炎症介质白三烯类(LTs)的生物合成,比单一的抑制剂抗炎效果好、安全性高,是一类有发展前景的新型非甾体抗炎药。笔者简要介绍COX-2/5-LOX双重抑制剂的研究进展,并讨论其作用机制及构效关系     

5,6-二芳基-2,3-二氢-1-吡咯里嗪酮类化合物与环氧化酶的分子对接研究

目的探讨5,6-二芳基-2,3-二氢-1-吡咯里嗪酮类化合物的作用机制.方法以化合物ZZ-122为例,应用分子对接方法模拟化合物与环氧化酶-1(COX-1)和环氧化酶-2(COX-2)的作用.结果从ZZ-122与COX-1和COX-2的结合模式,形成复合物的分子间相互作用能及相应原子间形成氢键的能力表明,ZZ-122易于与COX-2结合,而不易与COX-1结合.结论ZZ-122可能是一个COX-2选择性抑制剂,但尚需酶结合实验进一步验证.     

Further studies on the involvement of the arachidonic acid cascade in the acute dependence produced by mu, kappa and delta opioid agonists in isolated tissues.

The effects of phospholipase A2, cyclooxygenase-1, cyclooxygenase-2, and 5-lipoxygenase inhibitors on acute opiate withdrawal induced by selective mu, kappa and delta receptor agonists was investigated in vitro. After a 4 min in vitro exposure to D-Ala2-N-methyl-Phe-Gly5-ol)enkephalin (DAMGO; a highly selective mu agonist) and trans(+/-)-3,4-dichloro-N-methyl-N-(2(1pyrrolidynyl)-cyclohexyl)-+ ++benzeneacetamid (U50-488H; a highly selective K agonist) a strong contraction of the guinea pig isolated ileum was observed after the addition of naloxone. This effect was also observed when rabbit isolated jejunum was pretreated with deltorphin (a highly selective delta agonist). Mepacrine (a phospholipase A2 inhibitor), tolmetin (a selective cyclooxygenase-1 inhibitor) and meloxicam (a selective cyclooxygenase-2 inhibitor) treatment before or after DAMGO or U50-488H were able to both prevent and reverse the naloxone-induced contraction after exposure to the opioid agonists, in a concentration-dependent fashion. In addition, nordihydroguaiaretic acid (a 5-lipooxygenase inhibitor) was able to block the naloxone-induced contraction following exposure to DAMGO or U50-488H if injected either before or after the opioid agonist. In contrast, mepacrine, tolmetin, meloxicam and nordihydroguaiaretic acid did not affect the naloxone-induced contraction after exposure to deltorphin. The results of the present study confirm and extend a previous study performed with morphine indicating that arachidonic acid and its metabolites (prostaglandins and leukotrienes) are involved in the development of opioid withdrawal induced by selective mu and kappa opioid agonists whereas no effects were observed on withdrawal induced by the selective delta opioid agonist deltorphin.     

Possible participation of cyclooxygenase-2 in the recurrence of allergic inflammation in rats

In the recurrence of allergic inflammation in a rat air pouch model, pouch fluid volume, prostaglandin E₂ concentration in the pouch fluid, leukocyte infiltration into the pouch fluid, and granulation tissue weight were markedly increased by the antigen challenge. To clarify the role of cyclooxygenase-2 in the recurrence of allergic inflammation, the time-course of changes in protein levels of cyclooxygenase-1 and cyclooxygenase-2 in the granulation tissue and in the infiltrated leukocytes was examined by Western blot analysis. It was shown that cyclooxygenase-1 levels in the granulation tissue and in the infiltrated leukocytes were not changed by the antigen challenge, but cycoloxygenase-2 levels were increased. Furthermore, treatment with the selective cyclooxygenase-2 inhibitor, NS-398 ([N-2(cyclohexyloxy-4-nitrophenyl]-methanesulfonamide), suppressed the recurrence of allergic inflammation as did the non-selective cyclooxygenase-1/cyclooxygenase-2 inhibitor, indomethacin. The steroidal anti-inflammatory drug, dexamethasone, inhibited the induction of cyclooxygenase-2, and suppressed the allergic inflammation. These findings strongly suggested that cyclooxygenase-2 induced by the antigen challenge plays a role in the recurrence of inflammation induced by the allergic mechanism.     

Formation of 8-isoprostaglandin F2alpha and prostaglandin E2 in carrageenan-induced air pouch model in rats

To investigate a possible role of 8-isoprostaglandin F2alpha in inflammation, 8-isoprostaglandin F2alpha and prostaglandin E2 levels were determined by enzyme immunoassay (EIA) in carrageenan-induced air pouch model in rats. In this model, 8-isoprostaglandin F2alpha and prostaglandin E2 levels were found to be increased significantly. To evaluate whether this increase was due to the development of inflammation or solely to cyclooxygenase-2 induction, a lipopolysaccharide-induced air pouch model, in which only cyclooxygenase-2 induction occurs without inflammation, was used. In this model, 8-isoprostaglandin F2alpha was also found to be increased parallel to the increase in prostaglandin E2 level. Cyclooxygenase-dependent formation of 8-isoprostaglandin F2alpha was investigated in carrageenan-induced air pouch model by administrating nonselective cyclooxygenase inhibitor indomethacin, selective cyclooxygenase-1 inhibitor valeryl salicylate or selective cyclooxygenase-2 inhibitor SC-582368 (4-(5-(4-chlorophenyl)-3-3-trifluoromethyl)-1H-pyrazol-1-yl)benzenesulfonanmide) 1 h before carrageenan injection. All these inhibitors significantly inhibited the production of 8-isoprostaglandin F2alpha and prostaglandin E2. These findings show that 8-isoprostaglandin F2alpha can be formed in carrageenan-induced air pouch model in rats. The formation of 8-isoprostaglandin F2alpha in lipopolysaccharide-induced air pouch model and the inhibition of its production by various cyclooxygenase inhibitors provide evidence for cyclooxygenase-dependent formation of isoprostanes in this model.     

Design and synthesis of new 1,3-benzdiazinan-4-one derivatives as selective cyclooxygenase (COX-2) inhibitors

A new group of regioisomeric 2,3-diaryl-1,3-benzdiazinan-4-ones, possessing a methyl sulfonyl pharmacophore, were synthesized and their biological activities were tested for cyclooxygenase-2 (COX-2) inhibitory activity. In vitro COX-1/COX-2 inhibition studies identified 3-(p-fluorophenyl)-2-(4-methylsulfonylphenyl)-1,3-benzdiazinane-4-one (2b) as a potent and highly selective (IC(50) = 0.07 μM; selectivity index = 572.8) COX-2 inhibitor.     

CoMFA and coMSIA 3d qsar studies on pimarane cyclooxygenase-2 (COX-2) inhibitors

Comparative molecular field analysis and comparative molecular similarity indices analysis were performed on twenty five analogues of pimarane COX-2 inhibitor to optimize their cyclooxygenase-2 (COX-2) selective anti-inflammatory activities.     

Arachidonic acid and its metabolites are involved in the expression of morphine dependence in guinea-pig isolated ileum

The effects of phospholipase A₂, cyclooxygenase-1, cyclooxygenase-2 and 5-lipoxygenase inhibitors were investigated on the naloxone-precipitated withdrawal contracture of the acute morphine-dependent guinea-pig ileum in vitro. Mepacrine (a phospholipase A₂ inhibitor), tolmetin (selective cyclooxygenase-1 inhibitor) and meloxicam (selective cyclooxygenase-2 inhibitor) treatment before or after morphine was able to both prevent and reverse the naloxone-induced contracture after exposure to morphine in a concentration-dependent fashion. Also, nordihydroguaiaretic acid (5-lipooxygenase inhibitor) was able to block the naloxone-induced contracture following exposure to morphine when injected before or after the opioid agonist. The results of the present study suggest that arachidonic acid and its metabolites (prostaglandins and leukotrienes) are involved in the development of opioid withdrawal.     

Nimesulide limits kainate-induced oxidative damage in the rat hippocampus

Kainate induces a marked expression of cyclooxygenase-2 after its systemic administration. Because cyclooxygenase-2 activity is associated to the production of reactive oxygen species, we investigated the effects of nimesulide, a selective cyclooxygenase-2 inhibitor, on kainate-induced in vivo oxidative damage in the rat hippocampus. A clinically relevant dose of nimesulide (6 mg/kg, i.p.) was administered three times following kainate application (9 mg/kg, i.p.). After 24 h of kainate administration, the drastic decrease in hippocampal glutathione content and the significant increase in lipid peroxidation were attenuated in nimesulide-treated rats, suggesting that the induction of cyclooxygenase-2 is involved in kainate-mediated free radicals formation.     

Angiogenesis, cell proliferation and apoptosis in gastric ulcer healing. Effect of a selective cox-2 inhibitor

To elucidate the role of cyclooxygenase-2, we compared the effects of rofecoxib, a selective cyclooxygenase-2 inhibitor, and ibuprofen, a nonselective cyclooxygenase inhibitor, on the evolution of acetic-acid-induced gastric ulcers in rats, evaluating growth factor expression, the angiogenic process, cell proliferation and cell apoptosis. Levels of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF), angiogenesis and cell proliferation were analysed by immunohistochemical methods, and apoptosis was evaluated by an enzyme immunoassay. Both growth factors and microvessels appeared to be abundant in the granulation tissue of the ulcer bed. Rofecoxib (2.5 mg/kg/day) and ibuprofen (100 mg/kg/day) delayed ulcer healing, but only rofecoxib treatment provoked a reduction of bFGF expression and inhibition of the development of new microvessels. No changes in VEGF expression were detected. Results also showed that proliferation and apoptosis were increased in control ulcerated animals. Rofecoxib reduced significantly both processes. These findings demonstrate that a reduction of bFGF expression and an antiangiogenic action, as well as proliferation/apoptosis inhibition, are some of the mechanisms possibly implicated in the delay in ulcer healing seen after the administration of the highly selective COX-2 inhibitor rofecoxib.