ABSTRACT
Background: IL-17/IL-23 axis plays an important role in the pathogenesis of severalautoimmune diseases such as experimental autoimmune encephalomyelitis [EAE] andmultiple sclerosis [MS]. The immunomodulatory properties of ginger are reported in previous studies
Objective: To evaluate the effects of ginger extract on the expressionof IL-17 and IL-23 in a model of EAE
Methods: EAE was induced in C57BL/6 miceby immunization with myelin oligodendroglial glycoprotein and then treated with PBSor ginger extracts, from day +3 to +30. At day 31, mice were scarificed and theexpression of IL-17 and IL-23 mRNA in spinal cord were determined by using realtime-PCR. The serum levels of cytokines were measured by ELISA
Results: ThemRNA expression of IL-17, IL-23 P19 and IL-23 P40 in CNS and serum levels of IL-17 and IL-23 were significantly higher in PBS-treated EAE mice than non-EAE group[p<0.003, p<0.001, p<0.001, p<0.05 and p<0.01, respectively]. In 200 mg/kg gingertreatedEAE mice the mRNA expression of IL-17, P19 and P40 in CNS and serum IL-23 levels were significantly decreased as compared to PBS-treated EAE mice [p<0.05,p<0.001, p<0.001 and p<0.05, respectively]. Moreover, 300 mg/kg ginger-treated EAEgroup had significantly lower expression of IL-17, P19 and P40 in CNS and lowerserum IL-17 and IL-23 levels than PBS-treated EAE group [p<0.02, p<0.001, p<0.001,p<0.03 and p<0.004, respectively]
Conclusion: Ginger extract reduces the expressionof IL-17 and IL-23 in EAE mice. The therapeutic potential of ginger for treatment ofMS could be considered in further studies
ABSTRACT
Blood loss in spine surgery is an important issue, even though it has been understudied compared with hip and knee arthroplasty. In this study, we evaluated the effect of oral clonidine as premedication on blood loss in lumbar spine fusion surgery under anesthesia with propofol and remifentanil. In this double-blind, randomized clinical trial, 30 patients who were undergoing lumbar spine posterior fusion surgery due to traumatic fracture were allocated randomly into 2 groups. The study group [clonidine group] received a 200-microg oral clonidine tablet 60-90 minutes before anesthesia, and the control group received placebo at the same time. Induction and maintenance of anesthesia and the mean target arterial pressure for controlled hypotension with remifentanil were the same in the 2 groups. We compared the amount of intraoperative blood loss, dose of remifentanil/hour administered, need for nitroglycerine to reach the mean target arterial pressure when remifentanil was insufficient, duration of operation, and surgeon's satisfaction of a bloodless field between groups. There was no statistically significant difference between groups in age [P = 0.115], sex [P = 0.439], weight [P = 0.899], operation time [P = 0.2], or American Society of Anesthesiologists physical status score [P = 0.390]. Intraoperative blood loss and remifentanil dose administered per hour in the clonidine group were significantly less than in the control group [P = 0.002 and P = 0.001, respectively], but there was no significant difference in surgeon's satisfaction between groups [P = 0.169]. As an oral premedication, clonidine can reduce surgical blood loss in lumbar spine posterior fusion surgery, even at the same levels of mean arterial pressure [MAP] with the control group. Its use can be studied in more complicated spine surgeries, such as scoliosis and spinal deformity surgeries