Additive antiproteinuric effect of pentoxifylline in patients with diabetic nephropathy under angiotensin receptor blockade: A short-term, randomized, and controlled trial

Background: The ever-increasing prevalence of diabetes has led to a higher incidence of progression into complications including nephropathy. Diabetic kidney disease (DKD) is a chronic condition that is managed with renin-angiotensin-aldosterone system blockers which retard its progression. Pentoxifylline as an add-on therapy has been tried for reducing DKD. Aims and Objectives: The aims of this study were to study the safety and efficacy of pentoxifylline added on to an angiotensin II receptor blocker (ARB) to reduce the progression of the disease condition in diabetic nephropathy (DN) patients over 1 year. Materials and Methods: It is a randomized open-label study conducted in the Department of Nephrology, of a tertiary care center for 1 year. Type 2 diabetes patients with DN who satisfied the eligibility criteria were randomized into pentoxifylline added on to ARB or ARB alone and followed up for urine albumin-creatinine ratio (ACR) and serum tumor necrosis factor (TNF)-alpha. Results: Twenty-six patients were recruited and completed the study. Urine ACR was significantly low in the pentoxifylline group compared to the ARB alone group (P = 0.021). Serum TNF-? was decreased in the pentoxifylline group in comparison to the ARB alone group (P = 0.06). Conclusion: Pentoxifylline caused significant lowering of urinary ACR and urine TNF-? for 4 months.

Pentoxifylline-tocopherol-clodronate combination in the treatment of localized temporal bone osteoradionecrosis / 中华放射医学与防护杂志

Objective:To determine the effects of pentoxifylline-tocopherol-clodronate combination (PENTOCLO) protocol in the treatment of localized temporal bone osteoradionecrosis (TBORN).Methods:A retrospective analysis was conducted on the clinical data of 21 patients, who suffered localized TBORN (23 ears) and were treated with the PENTOCLO protocol in Sun Yat-sen Memorial Hospital, Sun Yat-sen University from November 2020 to April 2021. The curative effects of the PENTOCLO protocol were evaluated based on the changes in ear symptoms and the extent of exposed bone before and after treatment.Results:The PENTOCLO protocol was applied for (506 ± 48) d on average. As a result, 19 ears (82.6%) became free of earache and purulent ear discharge, and two ears (8.7%) showed alleviation of symptoms. Moreover, nine ears (39.1%) exhibited re-epithelialization in the ear canal, 11 ears (47.6%) showed a decrease in exposed ear canal bone, and the osteonecrosis of three ears (13.0%) was stable.Conclusions:PENTOCLO has encouraging treatment effects on TBORN, and thus can be used as an effective nonsurgical option for localized TBORN.

Multi-therapeutic strategy targeting parasite and inflammation-related alterations to improve prognosis of chronic Chagas cardiomyopathy: a hypothesis-based approach*

Chagas disease (CD), caused by infection by the protozoan parasite Trypanosoma cruzi, presents as main clinical manifestation the chronic chagasic cardiomyopathy (CCC). CCC afflicts millions of people, mostly in Latin America, and vaccine and effective therapy are still lacking. Comprehension of the host/parasite interplay in the chronic phase of T. cruzi infection may unveil targets for rational trait-based therapies to improve CCC prognosis. In the present viewpoint, I critically summarise a collection of data, obtained by our network of collaborators and other groups on CCC and preclinical studies on pathogenesis, targeting identification for intervention and the use of drugs with immunomodulatory properties to improve CCC. In the last two decades, models combining mouse lineages and T. cruzi strains allowed replication of crucial clinical, histopathological, and immunological traits of CCC. This condition includes conduction changes (heart rate changes, arrhythmias, atrioventricular blocks, prolongation of the QRS complex and PR and corrected QT intervals), ventricular dysfunction and heart failure, CD8-enriched myocarditis, tissue remodeling and progressive fibrosis, and systemic inflammatory profile, resembling "cytokine storm". Studies on Chagas' heart disease pathogenesis begins to unveil the molecular mechanisms underpinning the inflammation-related cardiac tissue damage, placing IFNγ, TNF and NFκB signaling as upstream regulators of miRNAs and mRNAs associated with critical biological pathways as cell migration, inflammation, tissue remodeling and fibrosis, and mitochondrial dysfunction. Further, data on preclinical trials using hypothesis-based tools, targeting parasite and inflammation-related alterations, opened paths for multi-therapeutic approaches in CCC. Despite the long path taken using experimental CD models replicating relevant aspects of CCC and testing new therapies and therapeutic schemes, these findings may get lost in translation, as conceptual and economical challenges, underpinning the valley of death across preclinical and clinical trials. It is hoped that such difficulties will be overcome in the near future.

Utilización de pentoxifilina en fase aguda de enfermedad de La Peyronie / Use of Pentoxifylline in the acute phase of Peyronie's disease

INTRODUCCIÓN: existe una gran variedad de tratamientos orales para la Enfermedad de La Peyronie (EP), pero ninguno demostró ser efectivo. En los últimos años se ha propuesto a la Pentoxifilina (PTX) como un potencial agente para su tratamiento. OBJETIVO: evaluar la evolución clínica de los pacientes que recibieron PTX al menos 3 meses durante la fase aguda de la EP. MATERIALES Y MÉTODOS: estudio de cohorte retrospectivo y observacional. Los datos se obtuvieron de las historias clínicas de pacientes con diagnóstico de EP entre enero y octubre de 2017. Para la evaluación objetiva, se utilizaron autofotografías y técnica de Kelami. RESULTADOS: 93 hombres cumplieron con los criterios de inclusión. El tiempo medio de tratamiento con PTX fue de 7,9 meses, y el de seguimiento, 10,8 meses. El 59,1% de los pacientes no tuvo modificaciones en su curvatura, el 9,7% mejoró, mientras que el 31,2% empeoró. De 49 pacientes que penetraban sin dificultad, 34 (69,4%) no tuvieron cambios, 12 (24,5%) pasaron a tener dificultad y 3 (6,1%) se convirtieron en no penetradores (p 0,0001). De los 41 pacientes que tenían dificultad en la penetración, 13 (31,7%) pudieron penetrar sin dificultad, 7 (17,1%) pasaron a no poder hacerlo, mientras que el resto (21 pacientes) se mantuvo sin cambios (p 0,0001). La correlación entre la curvatura inicial y la curvatura luego del tratamiento medido en todos los pacientes fue significativa (p 0,028). CONCLUSIÓN: la PTX podría tener un efecto positivo en estabilizar la enfermedad, y los hombres con EP en fase aguda podrían beneficiarse con el tratamiento.

INTRODUCTION: There is a wide variety of oral treatments for Peyronie's Disease (PD) but none proved to be effective. In recent years, Pentoxifylline (PTX) has been proposed as a potential agent for the treatment. Objective: To evaluate the clinical evolution of patients who received PTX at least 3 months during the acute phase of PD. MATERIALS AND METHODS: Retrospective and observational cohort study. The data were obtained from the clinical records of patients diagnosed with PE between January 2007 and October 2017. For their objective evaluation, autographs and the Kelami technique were used. RESULTS: 93 men met the inclusion criteria. The mean time of treatment with PTX was 7.9 months and the follow-up time was 10.8 months. 59.1% of patients had no changes in their curvature, 9.7% improved, while 31.2% worsened. Of 49 patients who entered without difficulty in penetrating, 34 (69.4%) had no changes, 12 (24.4%) had difficulty and 3 (6.1%) became non-penetrators (p 0.0001). Of the 41 patients who had difficulty in penetrating, 13 (31.7%) could penetrate without difficulty, 7 (17.1%) were unable to do so, while the rest (21 patients) remained unchanged (p. 0.0001). The correlation between initial curvature and curvature after treatment measured in all patients was significant (p 0.028). CONCLUSION: PTX could have a positive effect in stabilizing the disease and men with acute phase PE could benefit with treatment.

Avaliação da pentoxifilina e do sulfato ferroso no tratamento da úlcera varicosa dos membros inferiores / Evaluation of pentoxifylline and ferrous sulfate for treatment of lower limb venous ulcers

Resumo Contexto A úlcera varicosa (UV) é o estágio mais avançado da doença venosa crônica (DVC) dos membros inferiores (MMII), frequentemente associada a episódios de hemorragia que podem provocar anemia crônica (AC) e retardar a sua cicatrização. Não há, na literatura, trabalhos que avaliem a prevalência da AC nos portadores de UV dos MMII, e poucos trabalhos analisam o uso da pentoxifilina no tratamento das UV dos MMII. Objetivos Avaliar a prevalência da AC nos pacientes portadores de UV de MMII e a resposta terapêutica ao sulfato ferroso (SF) e a associação da pentoxifilina com SF no tratamento adjuvante das UV dos MMII. Métodos Foram avaliados 67 pacientes portadores de UV de MMII atendidos no ambulatório de Cirurgia Vascular do Hospital das Clínicas, Recife, PE. Após as avaliações clínica e laboratorial iniciais, os pacientes diagnosticados com AC foram randomizados em dois grupos: o grupo controle, que recebeu SF (900 mg/dia via oral), e o grupo de estudo, tratado com SF (900 mg/dia via oral) e pentoxifilina (1.200 mg/dia). Todos foram reavaliados após 90 dias. Resultados Entre os pacientes avaliados, 27 (40%) apresentavam AC. Após o tratamento, foram observados aumento dos níveis de hemoglobina e de hematócrito e melhora das taxas da cinética do ferro, assim como a diminuição da profundidade e da área das UV em ambos os grupos, sem diferença estatística. Conclusões Foi encontrada alta prevalência de anemia na população estudada. A associação do SF com a pentoxifilina não se mostrou mais eficaz do que o emprego isolado do SF no tratamento adjuvante da UV dos MMII.

Abstract Background Venous ulcers (VU) are the most advanced stage of chronic venous disease (CVD) of the lower limbs. They are frequently associated with episodes of hemorrhage that can provoke chronic anemia (CA), delaying healing. There are no studies in the literature analyzing the prevalence of CA among patients with VU of the lower limbs and few studies have analyzed use of pentoxifylline to treat VU of the lower limbs. Objectives To evaluate the prevalence of CA in patients with lower limb VU and responses to treatment with ferrous sulfate (SF) compared with a combination of SF plus pentoxifylline as adjuvant treatment for VU of the lower limbs. Methods A total of 67 patients with lower limb VU were recruited from a Lymphedema and Angiodysplasia Clinic at the Hospital das Clínicas, Recife, PE, Brazil. After initial clinical and laboratory assessments, patients diagnosed with CA were randomized into one of two groups: a control group, given SF (900 mg/day oral route), or a study group, treated with SF (900 mg/day oral route) and pentoxifylline (1,200 mg/day). All were reassessed after 90 days. Results Twenty-seven patients (40%) had CA. After treatment, increases were observed in hemoglobin and hematocrit levels, iron kinetics had improved, and both depth and area of VU had reduced in both groups, without statistically significant differences. Conclusions A high prevalence of anemia was detected in the study population. The combination of SF and pentoxifylline was not more effective than SF alone for adjuvant treatment of VU of the lower limbs.

Tratamiento conservador de osteonecrosis maxilar asociada a medicamentos refractaria mediante el uso de protocolo PENTO: reporte de un caso / Tratamento conservador da osteonecrose maxilar associada a medicamentos refratários usando o protocolo PENTO: relato de um caso / Conservative treatment of refractory medication-related osteonecrosis of the jaw using the PENTO protocol: A case report

Resumen Paciente de 78 años consulta por sangrado sin resolución, a nivel del reborde alveolar maxilar izquierdo. Con antecedentes de metástasis óseas tratadas con ácido zoledrónico endovenoso discontinuado por alta médica y tratamiento quirúrgico previo de osteonecrosis maxilar en sitio afectado. Se observó disrupción de continuidad con inflamación a nivel del reborde óseo, con salida de contenido hemático, purulento y necrótico. Radiográficamente se observó radiolucidez difusa y osteolítica del área afectada y tejido necrótico a nivel microscópico. Se realizó aseo del área afectada, enjuagues de clorhexidina 0,12%, administración de amoxicilina/acido clavulánico y de pentoxifilina 400 mg cada 12 horas y tocoferol 1000 UI cada 24 horas. Se evaluó al mes, donde se discontinua antibioterapia y se mantiene régimen establecido con controles cada 2 semanas. A los 6 meses se evidencia resolución completa, con cicatrización de la mucosa y del tejido óseo sin recidiva.

Resumo Paciente de 78 anos consultado por sangramento sem resolução, ao nível do rebordo alveolar superior esquerdo. Com história de metástases ósseas tratadas com ácido zoledrônico endovenoso descontinuado por alta médica e tratamento cirúrgico prévio de osteonecrose maxilar no local afetado. Foi observada interrupção da continuidade com inflamação ao nível da crista óssea, com extravasamento de sangue, conteúdo purulento e necrótico. Radiograficamente, radioluscência difusa e osteolítica da área afetada e tecido necrótico foram observadas ao nível microscópico. A área afetada foi limpa, enxágue com clorexidina 0,12%, amoxicilina / ácido clavulânico e 400 mg de pentoxifilina a cada 12 horas e 1000 UI de tocoferol a cada 24 horas. Foi avaliado em um mês, quando a antibioticoterapia é descontinuada e um regime estabelecido é mantido com controles a cada 2 semanas. Aos 6 meses, é evidenciada resolução completa, com cicatrização da mucosa e do tecido ósseo sem recorrência.

Abstract A 78-year-old patient seeks care for unresolved bleeding on the left maxillary alveolar ridge. He had a history of bone metastasis treated with IV zoledronic acid, which was discontinued after medical discharge and previous surgical treatment of osteonecrosis of the jaws in the affected site. Continuity disruption with inflammation at the bone ridge was observed, with blood, purulent, and necrotic exudate. The radiograph showed diffuse and osteolytic radiolucency of the affected area, and necrotic tissue was detected at a microscopic level. The affected area was rinsed with 0.12% chlorhexidine, 400 mg amoxicillin/clavulanic acid and pentoxifylline was administered every 12 hours, and tocopherol 1000 IU every 24 hours. The area was evaluated after a month. Antibiotic therapy was discontinued, and the patient continued to be monitored every two weeks. At six months, there is complete resolution, and mucosal and bone tissue healed without recurrence.

Granuloma Anular diseminado: a propósito de un caso / Disseminated annular granuloma: on the purpose of a case

RESUMEN El granuloma anular es un trastorno relativamente frecuente, se desconoce la prevalencia exacta, tiene mayor frecuencia en niños y adultos jóvenes. Se caracteriza por pequeñas pápulas agrupadas, en configuración anular, a menudo con distribución simétrica y acra. La mayor parte los casos se resuelve en forma espontánea dentro de los 2 años, pero la tasa de recidivas es del 40%. Presentamos el caso clínico de una paciente de 72 años de edad con granuloma anular diseminado, tratado con pentoxifilina, con buen resultado terapéutico.

ABSTRACT Annular granuloma is a relatively frequent disorder, the exact prevalence is unknown, it is more frequent in children and young adults. It is characterized by small grouped papules, in annular configuration, often with symmetric and acrid distribution. Most cases resolve spontaneously within 2 years, but the recurrence rate is 40%. We present the clinical case of a 72-year-old patient with disseminated annular granuloma, treated with pentoxifylline, with good therapeutic results.

Benefits of pentoxifylline for skin flap tissue repair in rats

Abstract Purpose To assess the action of pentoxifylline, administered by subcutaneous route, on skin flap tissue repair in rats, and to verify the histological aspects and biomarkers. Methods Thirty-two male Wistar rats were divided into four groups: control (CT) and treated with pentoxifylline (P1, P3 and P5). Modified McFarlane technique flap was used. Ten days later, the animals were euthanized and the areas of viable and necrotic tissue were evaluated. Hematoxylin/eosin staining was used to assess the morphometric characteristics of the number of vessels and epithelial thickness. Picrosirius red was used to assess collagen density. VEGF and TGF-?1 levels on the skin flap and serum of the animals were measured by the ELISA method. Results The macroscopic evaluation of the skin flap dimensions showed reduced necrotic tissue in the pentoxifylline (p < 0.05) treated groups. There was an increase in angiogenesis and reepithelization, demonstrated by analyses with an increased number of vessels (p < 0.05), VEGF and epithelial thickness. Fibrogenic effect showed decreased collagen density and TGF-β1 in the skin flap and serum. Conclusion The benefits of pentoxifylline administered by subcutaneous route, at dose 100 mg/kg, which was effective to improve the survival of skin flap by acting on tissue repair components, stimulating angiogenesis and reepithelization, in addition to reducing fibrogenesis

The effects of pentoxifylline and tocopherol in jaw osteomyelitis

OBJECTIVES: Pentoxifylline (PTX) is a methylxanthine derivative that has been implicated in the pathogenesis of peripheral vessel disease and intermittent lameness. The purpose of this study was to investigate the effect of PTX and tocopherol in patients diagnosed with osteoradionecrosis (ORN), bisphosphonate-related osteonecrosis of the jaw (BRONJ), and chronic osteomyelitis using digital panoramic radiographs.MATERIALS AND METHODS: This study was performed in 25 patients who were prescribed PTX and tocopherol for treatment of ORN, BRONJ, and chronic osteomyelitis between January 2014 and May 2018 in Seoul National University Dental Hospital. Radiographic densities of the dental panorama were compared prior to starting PTX and tocopherol, at 3 months, and at 6 months after prescription. Radiographic densities were measured using Adobe Photoshop CS6 (Adobe System Inc., USA). Blood sample tests showing the degree of inflammation at the initial visit were considered the baseline and compared with results after 3 to 6 months. Statistical analysis was performed using the Mann–Whitney test and repeated measurement ANOVA using IBM SPSS 23.0 (IBM Corp., USA).RESULTS: Eight patients were diagnosed with ORN, nine patients with BRONJ, and the other 8 patients with chronic osteomyelitis. Ten of the 25 patients were men, average age was 66.32±14.39 years, and average duration of medication was 151.8±80.65 days (range, 56–315 days). Statistically significant increases were observed in the changes between 3 and 6 months after prescription (P<0.05). There was no significant difference between ORN, BRONJ, and chronic osteomyelitis. Only erythrocyte sedimentation rate (ESR) was statistically significantly lower than before treatment (P<0.05) among the white blood cell (WBC), ESR, and absolute neutrophil count (ANC).CONCLUSION: Long-term use of PTX and tocopherol can be an auxiliary method in the treatment of ORN, BRONJ, or chronic osteomyelitis in jaw.

Analysis of the effect of pentoxifylline on oxidative stress in brains of epileptic rats based on Nrf2-ARE signaling pathway / 医学研究生学报

ObjectiveTo investigate the effects of pentoxifylline (PTX) on oxidative stress in brains of epileptic (EP) rats based on the nuclear factor E2 related factor 2 (Nrf2) antioxidant response element (ARE) signal pathway.MethodsThirty-six healthy and adult male Wistar rats were included in the experiment and were divided into blank control group (peritoneal injection of isotonic saline), EP control group (induced EP episode), and PTX group (induced EP episode ＋ PTX pretreatment) according to a completely random method, then 12 rats in each group. The behavioral changes of rats in each group were monitored, and the EP attack rate and seizure latency were recorded. The rats were sacrificed to collect substantia nigra and hippocampus for testing oxidative stress indicators and expression levels of Nrf2 ARE signaling pathway-related proteins.ResultsNo abnormal reaction was observed in the control group after treatment. The EP attack rate in the EP control group reached 83.33%. The EP attack rate (33.3%) and the attack level ((2.14±0.40) vs (3.09±0.58)) in the PTX group were significantly lower than those in the EP control group, and the seizure latency was significantly longer than that in the EP control group (P0.05) ). The expression of substantia nigra tissue was significantly higher than that of the blank control group (P<0.05).ConclusionPTX can inhibit EP seizure and improve the oxidative stress in the brain of rats at the early stage of EP. The possible mechanism is that PTX can specifically activate Nrf2 ARE signaling pathway.

Adequacy of phosphodiesterase inhibitor in prevention and treatment of LPS induced organ failure in BALB/c mice

Background: Even though with immense improvement and extensive understanding of pathophysiology of sepsis induced organ failure and affected population, it continues to put hundreds of people worldwide to eternal sleep due to lack of targeted therapy. Newer treatment modalities is the dire need of time. The present study was aimed to ascertain the adequacy of phosphodiesterases inhibitor - pentoxifylline (75mg/kg i.p) in endotoxin/LPS induced hepatotoxicity in BALB/c mice.Methods: The number of animals in each group was six. Endotoxin/lipopolysaccharides induced hepatotoxicity was reproduced in mice by giving lipopolysaccharide of serotype E. coli intraperitoneally. To ascertain the Preventive role, pentoxifylline was administered forehand LPS injection whereas therapeutic potential adjuged via post LPS delivering. The extent of liver damage was evaluated through serum alanine aminotransferases (ALT) and aspartate aminotransferase (AST) estimation along with histopathological examination of liver tissue.Results: Results set forth that serum ALT, AST levels and histological alteration abated considerably (p ?0.05) both in animals subjected to pentoxifylline pre and post-treatment.Conclusions: Pentoxifylline set up promising results in endotoxin induced hepatotoxicity and can be used therapeutic adjuncts to conventional treatment strategies in sepsis induced liver failure.

Hypertonic saline and pentoxifylline enhance survival, reducing apoptosis and oxidative stress in a rat model of strangulated closed loop small bowel obstruction

OBJECTIVES: Intestinal obstruction has a high mortality rate when therapeutic treatment is delayed. Resuscitation in intestinal obstruction requires a large volume of fluid, and fluid combinations have been studied. Therefore, we evaluated the effects of hypertonic saline solution (HS) with pentoxifylline (PTX) on apoptosis, oxidative stress and survival rate. METHODS: Wistar rats were subjected to intestinal obstruction and ischemia through a closed loop ligation of the terminal ileum and its vessels. After 24 hours, the necrotic bowel segment was resected, and the animals were randomized into four groups according to the following resuscitation strategies: Ringer's lactate solution (RL) (RL-32 ml/kg); RL+PTX (25 mg/kg); HS+PTX (HS, 7.5%, 4 ml/kg), and no resuscitation (IO-intestinal obstruction and ischemia). Euthanasia was performed 3 hours after resuscitation to obtain kidney and intestine samples. A malondialdehyde (MDA) assay was performed to evaluate oxidative stress, and histochemical analyses (terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling [TUNEL], Bcl-2 and Bax) were conducted to evaluate kidney apoptosis. Survival was analyzed with another series of animals that were observed for 15 days. RESULTS: PTX in combination with RL or HS reduced the MDA levels (nmol/mg of protein), as follows: kidney IO=0.42; RL=0.49; RL+PTX=0.31; HS+PTX=0.34 (p<0.05); intestine: IO=0.42; RL=0.48; RL+PTX=0.29; HS+PTX=0.26 (p<0.05). The number of labeled cells for TUNEL and Bax was lower in the HS+PTX group than in the other groups (p<0.05). The Bax/Bcl-2 ratio was lower in the HS+PTX group than in the other groups (p<0.05). The survival rate on the 15th day was higher in the HS+PTX group (77%) than in the RL+PTX group (11%). CONCLUSION: PTX in combination with HS enhanced survival and attenuated oxidative stress and apoptosis. However, when combined with RL, PTX did not reduce apoptosis or mortality.

Clinical effect of glucocorticoids versus pentoxifylline in patients with severe alcoholic liver disease: A Meta-analysis / 临床肝胆病杂志

ObjectiveTo systematically review the clinical effect of glucocorticoids used alone or in combination with pentoxifylline in patients with severe alcoholic liver disease. MethodsPubMed, Embase, Chinese Scientific Journal Full-Text Database, CBM, China Scientific Journal Database, and Chinese Medical Association Digital Journal Database were searched for related articles published up to November 2018, and related journals and collected papers from conferences were searched manually. The clinical effect of glucocorticoids versus placebo, glucocorticoids versus pentoxifylline, and glucocorticoids combined with glucocorticoids versus glucocorticoids alone was analyzed. The effect of glucocorticoids and pentoxifylline used alone or in combination on 28-day survival rate and hepatorenal syndrome in patients with severe alcoholic liver disease was assessed. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate outcome indicators. RevMan 5.3 software was used for data analysis. ResultsA total of 22 studies were included, with 1956 patients in total. The glucocorticoid group had a significantly lower 28-day mortality rate than the control group (25.12% vs 30.67%, OR=0.71, 95%CI: 0.55-0.93, P=0.01). Subgroup analysis showed that there was a significant difference in 28-day mortality rate between the glucocorticoid group and the pentoxifylline group (OR=0.68, 95%CI: 0.48-0.97, P=0.03), while there was no significant difference between the glucocorticoid+pentoxifylline group and the glucocorticoid group (OR=0.92, 95%CI: 0.66-1.29, P=0.64). Compared with the glucocorticoid group, the glucocorticoid+pentoxifylline group had a significantly lower incidence rate of hepatorenal syndrome (3.94% vs 803%, OR=0.45, 95%CI: 0.24-0.83, P=0.01). Funnel plots showed no publication bias. ConclusionGlucocorticoids combined with pentoxifylline can reduce the incidence rate of hepatorenal syndrome in patients with severe alcoholic liver disease.

Differential Effects of Pentoxifylline on Learning and Memory Impairment Induced by Hypoxic-ischemic Brain Injury in Rats

OBJECTIVE: Hypoxic-ischemic (HI) brain injury in the human perinatal period often leads to significant long-term neurobehavioral dysfunction in the cognitive and sensory-motor domains. Using a neonatal HI injury model (unilateral carotid ligation followed by hypoxia) in postnatal day seven rats, the present study investigated the long-term effects of HI and potential behavioral protective effect of pentoxifylline. METHODS: Seven-day-old rats underwent right carotid ligation, followed by hypoxia (FiO2 = 0.08). Rats received pentoxifylline immediately after and again 2 hours after hypoxia (two doses, 60–100 mg/kg/dose), or serum physiologic. Another set of seven-day-old rats was included to sham group exposed to surgical stress but not ligated. These rats were tested for spatial learning and memory on the simple place task in the Morris water maze from postnatal days 77 to 85. RESULTS: HI rats displayed significant tissue loss in the right hippocampus, as well as severe spatial memory deficits. Low-dose treatment with pentoxifylline resulted in significant protection against both HI-induced hippocampus tissue losses and spatial memory impairments. Beneficial effects are, however, negated if pentoxifylline is administered at high dose. CONCLUSION: These findings indicate that unilateral HI brain injury in a neonatal rodent model is associated with cognitive deficits, and that low dose pentoxifylline treatment is protective against spatial memory impairment.

Effectiveness of Pentoxifylline in the treatment of oral submucous fibrosis patients: a case-control study

Background: Oral submucous fibrosis (OSMF) is a potentially malignant disorder largely seen in the South-Asian countries where areca nut is found to be the main predisposing factor. Pentoxifylline, a methylxanthine derivative, has vasodilating properties and is believed to increase the vascularity of the mucosal layer. This study was designed to determine the effect of pentoxifylline (Trental) on the clinical progression of oral submucous fibrosis. Aim: The present study was aimed to evaluate the effectiveness of drug pentoxifylline in the management of OSMF and to correlate the clinical parameters evaluated before and after treatment. Methods: Study Design: This investigation was conducted as a case-control study incorporating a Control Group in comparison to a Study Group where pentoxifylline 400 mg was administered 3 times daily, as coated, sustainedrelease tablets for prescribed for 3 months. The stipulated period for the study was 8 months and a total of 80 cases of oral submucous fibrosis (40 test subjects and 40 controls) were included in this study and 100% acquiescence was reported at the end of the test period. Results: Mild dizziness and gastric irritation were the only untoward symptoms reported in 2 of the volunteers in the study group during this trial. These were managed by diet protocols. A review of the patients and controls was done at an interval of every 4 weeks for 3 months. The subjective and objective measurements were recorded. The follow-up data at each visit concerning each other and to base-line values were calibrated using nonparametric tests of the Chi-Square test and Mann-Whitney. Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (u value =1.137, p = 0.260), tongue protrusion (u value = 0.262, p = 0.794 and cheek flexibility (u value =0.990, p = 0.326). Subjective symptoms of burning sensation of mouth (U value = 2.673, p = 0.008), pain on opening the mouth (U value = 4.320, p < 0.0001), difficulty in swallowing and difficulty in the speech were also recorded. Conclusion: This study showed the effectiveness of pentoxifylline as an additional therapy in the routine management of oral submucous fibrosis.

Pentoxifylline - A Boon In Medical Management Of Oral Submucous Fibrosis ??

AIM- OSMF is very prevalent and most premalignant condition in South East Asian population especially in India now days. There is numerous management modalities documented but still it is challenging to come up with definitive treatment of OSMF. In the wake of searching the effective medical management of OSMF here we have compare the two drugs Pentoxifylline and Antioxident over 50 affected individuals

Osmf: Long Term Study Of Treated Patients

Background and Objective: Oral Submucous fibrosis (OSMF) is a chronic debilitating disease and a well recognized premalignant condition of oral cavity. The exact pathogenesis is not well established but the cause is believed to be multifactorial. The most commonly used treatment regimen is combination of Hydrocortisone acetate or Triamcinolone Acetonide with hyaluronidase and recently oral Pentoxifylline, but studies of its long term effect are lacking. The present study was therefore conducted to evaluate the long term effectiveness of afore said drugs. Material & methods: In the present study 60 previously treated patients of OSMF were registered. Out of which 34 patients had received Inj. Hydrocortisone acetate (1.5ml) mixed with Hyaluronidase (1500 I.U.) at weekly interval for 22 weeks, 15 patients had received Inj. Triamcinolone Acetonide (10mg/ml) mixed with Hyaluronidase (1500 I.U.) at biweekly interval for 22 weeks and 11 patients were given Tab Pentoxifylline (Trental) 400mg three times daily for a period of 7 months. Long term outcome was evaluated on the basis of symptom score and sign score. Results: There was statistically significant improvement between long term follow up score and immediate Post-treatment symptom score ( p value < 0.05 ) Interpretation and Conclusion: It was concluded that the improvement in symptoms and signs following treatment increased further or maintained in long term follow up

Comparison of Efficacy of Pentoxifyllin with Standard Regimens Dexamethasone and Hyaluronidase in Patients with Oral Submucous Fibrosis

Aims and objectives The purpose of the study was to clinically evaluate the efficacy of oral pentoxifylline 400mg tablets in comparison to intra-lesional injections of dexamethasone (4 mg/ml), hyaluronidase 1, 500 IU and 0.5 ml of lignocaine 2% and a combination of the two in the management of oral sub-mucous fibrosis (OSF) patients. Materials and methods The study population consisted of randomly selected 75 patients with OSF. Patients were divided into three groups. A total of 25 patients were allocated each in dexamethasone group, dexamethasone and pentoxifylline group and pentoxifylline group. Dexamethasone group received weekly intra-lesional injections of dexamethasone (4 mg/ml), hyaluronidase 1, 500 IU and 0.5 ml of lignocaine 2% for a period of 12 weeks. Pentoxifylline group received oral pentoxifylline 400-mg tablets thrice daily for 12 weeks. Dexamethasone and pentoxifylline group received both the drugs. Parameters taken in the study were burning sensation and mouth opening. Results In the present study, improvement in the patients symptomatic parameters were statistically significant (p < 0.001) within groups (intra-group comparison), but not significant (p > 0.001) when compared between the groups (inter-group comparison). Conclusion Study found that the parameters like burning sensation and mouth opening showed statistically significant improvement for all the drug groups. The drug pentoxifylline showed similar improvement in the clinical parameters as that of dexona. For this reason, pentoxifylline can be indicated as a good alternative treatment for OSF in patients in whom dexamethasone is contraindicated, or those who cannot make frequent visits for intra-lesional injections.

The expression of endothelial and inducible nitric oxide synthase and apoptosis in intestinal ischemia and reperfusion injury under the action of ischemic preconditioning and pentoxifylline

Abstract Purpose: To investigate the expression of nitric oxide synthase (NOS) and apoptosis associated with ischemic preconditioning (IPC) and pentoxifylline (PTX) in intestinal ischemia (I) and reperfusion (R) injury. Methods: Thirty male rats were assigned to 5 groups: (CG), no clamping of the superior mesenteric artery (90 minutes); (IR-SS) saline + ischemia (30 minutes) + reperfusion (60 minutes); (IR-PTX) PTX + ischemia (30 minutes) + reperfusion (60 minutes); (IPC-IR-SS) 5 minutes of ischemia + 5 minutes of reperfusion (IPC) + saline + I(30 minutes)+R(60 minutes); and (IPC-IR-PTX) IPC + PTX + I(30 minutes)+ R(60 minutes). Results: The application of IPC and PTX showed a significantly lower immunohistochemistry reaction for active caspase-3 (P<0.05) compared to IR+SS. The number of cells immunoreactive to BCL-2 was higher in the IR-PTX group (P>0.05). The NOS-2 expression (qRTPCR) in the IR-PTX group (P<0.05) was higher than the values for the IPC+IR-SS and IPC-IR-PTX groups. The NOS-3 expression was significantly upper in the IPC-IR-PTX group than in the CG (P<0.05), the IR-SS (P<0.05) and the IR-PTX (P<0.05) groups. Conclusions: The BCL-2 and active caspase-3 showed beneficial effects on PTX and IPC. The expression of NOS-2 and NOS-3 in the IPC and IPC-PTX groups showed no synergistic effect.

Effects of dimethylsulfoxide and pentoxifylline in the vitality of cutaneous flaps in rats / Efeitos do dimetilsulfóxido e da pentoxifilina na vitalidade de retalhos cutâneos em ratos

ABSTRACT Objectives: to verify the influence of dimethylsulfoxide and pentoxifylline on the vitality of cutaneous flaps in rats and the tissue repair process. Methods: were studied 30 Wistar rats, submitting them to a 2cm wide by 8cm long dorsal cutaneous flap, of caudal base. We distributed the animals in three groups: Control Group (n=10) with application gauze moistened with 0.9% Saline in the flap bed for 30 seconds; Dimethylsulfoxide group (n=10), with administration of 1ml of 5% dimethylsulfoxide divided into five injections of 0.2ml in the transition of the flap segments; Pentoxifylline group (n=10), with administration of pentoxifylline 20mg/kg, diluted to 1ml and divided into five injections of 0.2ml in the transition of the flap segments. Drugs were administered intraoperatively, in a single dose and subcutaneously. We observed the skin flaps for changes in color and texture. On the 10th postoperative day, we checked the dimensions of viable and necrotic tissues, followed by excision of the specimen for histological analysis. Results: the measurements of length of the viable and necrotic tissues between groups showed no differences. Histological analysis showed that the Dimethylsulfoxide group presented neovascularization, inflammatory infiltrate with leukocytes and more structured conjunctival stroma. The Pentoxifylline group showed neovascularization and inflammatory infiltrate, with moderate to intense granulation. The control group evolved with a higher rate of necrosis in the distal segment. Conclusion: dimethylsulfoxide and pentoxifylline influenced the vitality of the flap and the tissue repair process. However, they did not prevent necrosis macroscopically.

RESUMO Objetivos: verificar a influência do dimetilsulfóxido e da pentoxifilina na vitalidade e no processo de reparo tecidual de retalhos cutâneos em ratos. Método: foram estudados 30 ratos Wistar, nos quais foi confeccionado retalho cutâneo dorsal de 2cm de largura por 8cm de comprimento, de base caudal, e distribuídos em três grupos: Grupo Controle (n=10) com aplicação de gaze umedecida com solução salina a 0,9%, no leito do retalho, por 30 segundos; Grupo dimetilsulfóxido (n=10) com injeção de 1ml de dimetilsulfóxido a 5% divididos em cinco injeções de 0,2ml na transição dos segmentos do retalho; Grupo pentoxifilina (n=10) com injeção de 1ml pentoxifilina 20mg/kg, divididos em cinco injeções de 0,2ml na transição dos segmentos do retalho. Os fármacos foram administrados no transoperatório, em dose única e por via subcutânea. Os retalhos cutâneos foram observados quanto às alterações de cor e textura. No décimo dia de pós-operatório aferiu-se a dimensão do tecido viável e de necrose, seguido da exérese da peça para análise histológica. Resultados: a medida da dimensão de tecido viável e de necrose dos grupos não apresentou diferenças. A análise histológica mostrou que o grupo dimetilsulfóxido apresentou neovascularização, infiltrado inflamatório com leucócitos e estroma conjuntivo mais estruturado. O grupo pentoxifilina, mostrou neovascularização e infiltrado inflamatório com granulação moderada e intensa. O grupo controle evoluiu com maior índice de necrose no segmento distal. Conclusão: dimetilsulfóxido e pentoxifilina influenciaram na vitalidade do retalho e no processo de reparo tecidual. Entretanto, não evitaram a necrose macroscopicamente.