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1.
Pain ; 157(10): 2366-2374, 2016 10.
Article in English | MEDLINE | ID: mdl-27385502

ABSTRACT

This double-blind randomized controlled study was designed to evaluate the analgesic effects of topical treatments with clonidine (CLON) and pentoxifylline (PTX) tested alone or as low- and high-dose combinations in a human experimental model of pain. Of 69 healthy subjects aged 18 to 60 years, 23 each were randomly allocated to low-dose (0.04% + 2%) and high-dose (0.1% + 5%) CLON + PTX groups. Both of these groups also received their corresponding placebos in one of 2 treatment periods separated by at least 48 hours. Twenty-three additional subjects received either CLON (0.1%) or PTX (5%) as single drug treatments, in each of 2 treatment periods. Assessment of analgesic efficacy was based on allodynic effects of previous intraepidermal capsaicin injection, as well as postcapsaicin tourniquet-induced pain 50 minutes following capsaicin injection. Visual Analogue Scale (VAS) ratings of pain intensity and the area of dynamic mechanical allodynia were the primary outcome measures, whereas area of punctate mechanical allodynia (PMA) served as a secondary outcome measure. Topical treatments with high- or low-dose combinations significantly reduced VAS ratings compared with corresponding placebo treatments throughout the period of postcapsaicin tourniquet-induced pain. Importantly, the high-dose combination produced lower VAS ratings than CLON alone, which were lower than PTX alone. Results also revealed significant inhibition of postcapsaicin dynamic mechanical allodynia and PMA for the high-dose combination compared with placebo, and of PMA for CLON compared with the low-dose combination. Hence, the present data are supportive of further clinical investigation of the high-dose topical combination of CLON + PTX in complex regional pain syndrome and neuropathic pain patients, for which our preclinical data predict efficacy.


Subject(s)
Analgesics/therapeutic use , Clonidine/therapeutic use , Hyperalgesia/chemically induced , Hyperalgesia/drug therapy , Pain/drug therapy , Pentoxifylline/therapeutic use , Adolescent , Adult , Capsaicin/toxicity , Double-Blind Method , Drug Therapy, Combination , Female , Healthy Volunteers , Humans , Male , Middle Aged , Pain/etiology , Pain Measurement , Pain Threshold/drug effects , Sensory System Agents/toxicity , Tourniquets/adverse effects , Young Adult
2.
Wounds ; 28(2): 40-7, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26891136

ABSTRACT

INTRODUCTION: Necrotizing fasciitis (NF) is a rare and rapidly progressing bacterial infection of soft tissues. Bacterial toxins cause local tissue damage and necrosis, as well as blunt immune system responses. A self-propagating cycle of bacterial invasion, toxin release and tissue destruction can continue until substantial amounts of tissue become necrotic. Neutralization of bacterial toxins should improve the results. MATERIALS AND METHODS: Pure hypochlorous acid (HOCl) (0.01% w/v) with no sodium hypochlorite impurity in saline pH 4-5, which was recently shown to both eradicate bacteria and neutralize bacterial toxins in vitro, was administered via flowthrough instillation to 6 patients with NF 4-6 times daily as needed. Utilizing a vacuum-assisted closure, 5-10 mL of pure 0.01% HOCl with no sodium hypochlorite impurity was instilled and removed frequently to irrigate the wounds. RESULTS: Of the 6 patients, no deaths or limb amputations occurred. All infected areas healed completely without major complications. CONCLUSION: The toxicity and immune dysfunction caused by bacterial toxins and toxins released from damaged cells may be mitigated by flow-through instillation with saline containing pure 0.01% HOCl with no sodium hypochlorite impurity. Randomized controlled clinical trial research of this relatively simple and inexpensive instillation protocol is suggested for identified cases of NF.


Subject(s)
Fasciitis, Necrotizing/drug therapy , Hypochlorous Acid/administration & dosage , Adult , Female , Humans , Instillation, Drug , Male , Middle Aged , Young Adult
3.
Urolithiasis ; 44(3): 247-56, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26282899

ABSTRACT

Long-term use of indwelling urinary catheters can lead to urinary tract infections and loss of catheter patency due to encrustation and blockage. Encrustation of urinary catheters is due to formation of crystalline biofilms by urease-producing microorganisms such as Proteus mirabilis. An in vitro catheter biofilm model (CBM) was used to evaluate current methods for maintaining urinary catheter patency. We compared antimicrobial-coated urinary Foley catheters, with both available catheter irrigation solutions and investigational solutions containing NVC-422 (N,N-dichloro-2,2-dimethyltaurine; a novel broad-spectrum antimicrobial). Inoculation of the CBM reactor with 10(8) colony-forming units of P. mirabilis resulted in crystalline biofilm formation in catheters by 48 h and blockage of catheters within 5 days. Silver hydrogel or nitrofurazone-coated catheters did not extend the duration of catheter patency. Catheters irrigated daily with commercially available solutions such as 0.25 % acetic acid and isotonic saline blocked at the same rate as untreated catheters. Daily irrigations of catheters with 0.2 % NVC-422 in 10 mM acetate-buffered saline pH 4 or Renacidin maintained catheter patency throughout 10-day studies, but P. mirabilis colonization of the CBM remained. In contrast, 0.2 % NVC-422 in citrate buffer (6.6 % citric acid at pH 3.8) resulted in an irrigation solution that not only maintained catheter patency for 10 days but also completely eradicated the P. mirabilis biofilm within one treatment day. These data suggest that an irrigation solution containing the rapidly bactericidal antimicrobial NVC-422 in combination with citric acid to permeabilize crystalline biofilm may significantly enhance catheter patency versus other approved irrigation solutions and antimicrobial-coated catheters.


Subject(s)
Biofilms , Citrates/administration & dosage , Proteus Infections/prevention & control , Proteus mirabilis/physiology , Taurine/analogs & derivatives , Urinary Catheters , Buffers , In Vitro Techniques , Taurine/administration & dosage , Therapeutic Irrigation , Urinary Catheterization , Urinary Catheters/microbiology
4.
Toxicol Pathol ; 40(6): 847-73, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22563012

ABSTRACT

Human exposure to capsaicin, the most abundant pungent chili pepper component, is ubiquitous. Evaluation of capsaicin's carcinogenic potential has produced variable results in in vitro and in vivo genotoxicity and carcinogenicity assays. The capsaicin tested in older studies was often from pepper plant extracts and included other capsaicinoids and diverse impurities. Recent studies utilizing high-purity capsaicin and standardized protocols provide evidence that the genotoxic and carcinogenic potential of capsaicin is quite low and that the purity of capsaicin is important. Several small epidemiological studies suggest a link between capsaicin consumption and stomach or gall bladder cancer, but contamination of capsaicin-containing foods with known carcinogens renders their interpretation problematic. The postulated ability of capsaicin metabolites to damage DNA and promote carcinogenesis remains unsupported. Anticancer activities of capsaicin have been widely reported, as it inhibits the activity of carcinogens and induces apoptosis in numerous cancer cell lines in vitro and explanted into rodents. Diverse mechanisms have been postulated for capsaicin's anticancer properties. One hypothesis is that inhibition of cytochrome P450 enzymes-particularly CYP2E1-retards carcinogen activation but is contradicted by the low potency of capsaicin for CYP inhibition. The potential for dietary capsaicin to act as a chemopreventative is now widely postulated.


Subject(s)
Anticarcinogenic Agents/pharmacology , Capsaicin/pharmacology , Capsaicin/toxicity , Carcinogens/toxicity , Animals , Humans , Neoplasms/chemically induced , Neoplasms/prevention & control
5.
Xenobiotica ; 40(12): 807-16, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20863199

ABSTRACT

Widespread exposure to capsaicin occurs through food and topical medicines. To investigate potential food-drug or drug-drug interactions, capsaicin was evaluated in vitro against seven human drug-metabolizing cytochrome P450 (CYP) enzymes. At concentrations occurring after ingestion of chili peppers or topical administration of a high-concentration patch, capsaicin did not cause direct inhibition of any CYP enzyme. Direct inhibition was only observed at much higher concentrations; the lowest IC(50) value was 2.0 µM. For CYP2E1, the IC(50) value was too high to calculate. With pre-incubation, inhibition decreased for CYP1A2, 2C9, 2C19 and 3A4/5, whereas inhibition of CYP2B6 increased and moderately increased for CYP2D6. Induction of CYP activity was evaluated in microsomes from hepatocyte primary cultures. Capsaicin did not induce CYP1A2, 2B6, 2C9, 2C19, 2E1 or 3A4/5. 10 µM capsaicin caused a statistically significant increase in CYP1A2 activity (8.6% of the positive control). Inhibition of drug metabolism by capsaicin should be minimal, as the ratio of [I]/K(i) for direct inhibition is < 0.1. Although pre-incubation did enhance the potency for CYP2B6 inhibition to 5.1 µM, given that exposure to capsaicin from either food or a topical medicine is very low (≤58 nM) and transient, effects on CYPs appear unlikely.


Subject(s)
Capsaicin/pharmacology , Cytochrome P-450 Enzyme Inhibitors , Cytochrome P-450 Enzyme System/biosynthesis , Cells, Cultured , Child , Enzyme Assays , Enzyme Induction/drug effects , Female , Hepatocytes/drug effects , Hepatocytes/enzymology , Humans , Male , Middle Aged
6.
J Pain ; 11(6): 579-87, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20400377

ABSTRACT

UNLABELLED: Desensitization of nociceptive sensory nerve endings is the basis for the therapeutic use of capsaicin in neuropathic pain syndromes. This study evaluated the pharmacodynamic effects of a single 60-minute application of NGX-4010, a high-concentration (8% w/w) capsaicin patch, on both thighs of healthy volunteers. Epidermal nerve fiber (ENF) density and quantitative sensory testing (QST) using thermal, tactile, and sharp mechanical-pain (pinprick) stimuli were evaluated 1, 12 and 24 weeks after capsaicin exposure. After 1 week, there was about an 80% reduction of ENF density compared to unexposed sites. In addition, there was about an 8% increase in tactile thresholds compared to baseline and the proportion of stimuli reported as sharp mechanical pain decreased by about 15 percentage points. Twelve weeks after exposure to capsaicin, ENF regeneration was evident, but not complete, and sharp mechanical-pain sensation and tactile thresholds did not differ from unexposed sites. Nearly full (93%) ENF recovery was observed at 24 weeks. No statistically significant changes in heat- or cold-detection thresholds were observed at any time point. NGX-4010 was generally well tolerated. Transient, mild warming or burning sensations at the site of application were common adverse effects. PERSPECTIVE: This article evaluates the effect of a single 60-minute NGX-4010 application on ENF density and QST in healthy volunteers followed for 24 weeks. The results help predict the long-term safety of NGX-4010 applications in patients.


Subject(s)
Capsaicin/toxicity , Epidermis/drug effects , Epidermis/innervation , Sensory Receptor Cells/drug effects , Sensory System Agents/toxicity , Adolescent , Adult , Capsaicin/administration & dosage , Cold Temperature , Female , Health Status , Hot Temperature , Humans , Male , Nerve Regeneration , Pain Threshold/drug effects , Peripheral Nerves/drug effects , Peripheral Nerves/pathology , Peripheral Nerves/physiopathology , Physical Stimulation , Sensory Receptor Cells/pathology , Sensory Receptor Cells/physiology , Sensory System Agents/administration & dosage , Sensory Thresholds/drug effects , Time Factors , Young Adult
7.
Ther Drug Monit ; 31(4): 502-10, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19494795

ABSTRACT

Capsaicin, a pungent compound in chili peppers, is a highly selective agonist for the transient receptor potential vanilloid 1 receptor expressed in nociceptive sensory nerves. A high-concentration (640 microg/cm2) capsaicin patch, designated NGX-4010, is in clinical evaluation for the management of peripheral neuropathic pain. To determine systemic capsaicin exposure after single 60- or 90-minute NGX-4010 applications, plasma samples were collected from 173 patients with postherpetic neuralgia (PHN), painful human immunodeficiency virus-associated neuropathy (HIV-AN), and painful diabetic neuropathy (PDN). The percentages of patients with quantifiable levels of capsaicin at any time point were 31% for PHN (30 of 96), 7% for HIV-AN (3 of 44), and 3% for PDN (1 of 33). The maximum plasma concentration observed in any patient was 17.8 ng/mL. Due to the limited number of quantifiable levels, a population analysis was performed to characterize the pharmacokinetics (PK) of capsaicin. Plasma concentrations were fitted adequately using a 1-compartment model with first-order absorption and linear elimination. Capsaicin levels declined very rapidly, with a mean population elimination half-life of 1.64 hours. Mean area under the curve and C max values after a 60-minute application were 7.42 ng x h/mL and 1.86 ng/mL, respectively. Only a few correlations between calculated PK parameters and patient characteristics were observed. Duration and area of application of the patch were detected as significant covariates explaining the PK of capsaicin. Ninety-minute applications of NGX-4010 resulted in capsaicin area under the curve and Cmax values approximately 1.78- and 2.15-fold higher than those observed in patients treated for 60 minutes. Treatment on the feet (patients with HIV-AN and PDN) produced far lower systemic exposure than treatment on the trunk (patients with PHN). Finally, larger treatment areas were associated with statistically higher Vc/F values. The low systemic exposure and very rapid elimination half-life of capsaicin after NGX-4010 administration are unlikely to result in systemic effects and support the overall safety profile of this investigational cutaneous patch.


Subject(s)
Capsaicin/pharmacokinetics , Pain/metabolism , Peripheral Nervous System Diseases/metabolism , Administration, Cutaneous , Administration, Topical , Capsaicin/administration & dosage , Capsaicin/pharmacology , Capsicum , Dosage Forms , Dose-Response Relationship, Drug , Female , HIV Infections , HIV-1 , Half-Life , Humans , Kinetics , Male , Pain Measurement , Treatment Outcome
8.
Drug Metab Dispos ; 36(4): 670-5, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18180272

ABSTRACT

On the basis of the ability of capsaicin to activate the transient receptor potential vanilloid 1 receptor (TRPV1) expressed in nociceptive sensory neurons, topical and injectable high-concentration formulations are being developed as potential treatments for various pain syndromes. As much of the published literature on capsaicin is based on pepper extracts, which are typically a mixture of capsaicin and other capsaicinoids (including norhydrocapsaicin, dihydrocapsaicin, homocapsaicin and homodihydrocapsaicin), the purpose of this investigation was to study the in vitro metabolism of pure capsaicin. The metabolism of capsaicin was similar in human, rat, and dog microsomes and S9 fractions. In these assays, three major metabolites were detected and identified as 16-hydroxycapsaicin, 17-hydroxycapsaicin, and 16,17-dehydrocapsaicin. In addition to these three metabolites, rat microsomes and S9 fractions also produced vanillylamine and vanillin. Biotransformation of capsaicin was slow in human skin in vitro, with the majority of the applied capsaicin remaining unchanged and a small fraction being metabolized to vanillylamine and vanillic acid. These data suggest that the metabolism of capsaicin by cytochrome P450 enzymes in skin is minimal, relative to hepatic metabolism.


Subject(s)
Capsaicin/metabolism , Microsomes, Liver/metabolism , Skin/metabolism , Animals , Capsaicin/chemistry , Capsaicin/pharmacokinetics , Dogs , Female , Humans , Male , Metabolic Networks and Pathways/drug effects , Metabolic Networks and Pathways/physiology , Microsomes, Liver/drug effects , Rats , Skin/drug effects , Species Specificity
9.
Int J Toxicol ; 26(2): 123-33, 2007.
Article in English | MEDLINE | ID: mdl-17454252

ABSTRACT

The objective of this study was to assess the oncogenic potential of trans-capsaicin when administered weekly via topical application to the dorsal skin of Tg.AC mice for 26 weeks. Male and female Tg.AC mice (25 mice/sex/group) received dose formulations containing trans-capsaicin dissolved in diethylene glycol monoethyl ether (DGME). The positive control was tetradecanoylphorbol-13-acetate (TPA) dissolved in DGME. Appropriate controls, including a topical lidocaine local anesthetic pretreatment (4%w/w), were maintained. All groups were dosed once weekly, except for the TPA group, which was dosed twice per week. Analysis of the macroscopic observations after the final sacrifice revealed no noteworthy treatment-related findings, with the exception of dermal masses that were randomly dispersed throughout all treatment groups for both males and females. The frequency of dermal masses in the capsaicin-treated groups (at a dose level of up to 102 mg/kg and an application rate of 25.6 mg/cm2/kg/week) was not elevated in comparison to either concurrent vehicle or untreated controls. In contrast, a notable increase in the frequency of dermal masses was observed in the TPA-treated mice compared to both the concurrent vehicle and untreated controls. Dermal application of capsaicin resulted in no increased incidence of preneoplastic or neoplastic skin lesions. In contrast, over half the male and female mice exposed to TPA had multiple skin papillomas; the majority of the TPA-treated animals either died early or was humanely euthanized due to tumor load. Spontaneously occurring neoplasms were not appreciably increased in capsaicin-treated animals. Capsaicin-related non-neoplastic microscopic findings were seen sporadically in both genders and included acanthosis, hyperkeratosis/parakeratosis (primarily females), epidermal crusts, subepidermal fibrosis, epidermal ulcerations/erosions, and chronic-active inflammation. There was no evidence of a dose response in either the incidence or severity of these findings. The lidocaine- (at a dose level of 162 mg/kg and at an application rate of 40.5 mg/cm2/kg/week) and DGME-treated (at a dose level of 4.0 g/kg and at an application rate of 1 g/cm2/kg/week) control groups also did not display any evidence of increase in dermal masses. Based on these results, trans-capsaicin, lidocaine, and DGME should be considered nononcogenic in the Tg.AC mouse dermal model.


Subject(s)
Capsaicin/toxicity , Carcinogens/toxicity , Skin Diseases/chemically induced , Administration, Cutaneous , Animals , Capsaicin/administration & dosage , Capsaicin/classification , Carcinogenicity Tests , Carcinogens/administration & dosage , Carcinogens/classification , Dose-Response Relationship, Drug , Ethylene Glycols/administration & dosage , Ethylene Glycols/classification , Ethylene Glycols/toxicity , Female , Heterozygote , Lidocaine/administration & dosage , Lidocaine/classification , Lidocaine/toxicity , Male , Mice , Mice, Transgenic , Skin/drug effects , Skin/pathology , Skin Diseases/pathology , Stereoisomerism
10.
Int J Toxicol ; 25(3): 205-17, 2006.
Article in English | MEDLINE | ID: mdl-16717036

ABSTRACT

Human environmental and dietary exposure to trans-capsaicin--the pungent ingredient in chili peppers--is ubiquitous. Moreover, based on the highly selective agonism of trans-capsaicin for TRPV1 receptors, drug products containing high concentrations of trans-capsaicin are under development as analgesics. For instance, a high-concentration (8% w/w) pure trans-capsaicin dermal patch (designated NGX-4010) is in advanced clinical evaluation for the management of neuropathic pain of peripheral origin. Our objective was to investigate effects of trans-capsaicin on embryo/fetal development, consequent to maternal exposure, from implantation to closure of the hard palate. trans-Capsaicin was delivered systemically by means of either a patch [NGX-4010 (25, 37.5, or 50 cm(2))] to pregnant Sprague-Dawley rats on days of presumed gestation (DGs) 7 through 17, or via a 10% w/v capsaicin liquid formulation (CLF), at dosages of 3, 6.5 or 13 mul/cm(2) applied to a 200-cm(2) area on the back on DGs 7 though 19 to timed-mated New Zealand white rabbits. In rats, the maternal no-observable-effect level (NOEL) was less than 25 cm(2) but no cesarean-sectioning or litter parameters were affected by application of NGX-4010 at patch sizes as high as 50 cm(2). The only test article-related observations were delays in skeletal ossification, evident as significant reductions in the average number of metatarsals and ossified hindlimb and forelimb phalanges that occurred in the 50 cm(2) NGX-4010 dose group. Although the values for ossified metatarsals were outside the historical control range, ossified hindlimb and forelimb phalanges were within historical control ranges. No other gross external, soft tissue, or skeletal fetal alterations (malformations or variations) were caused by application of the NGX-4010. In rabbits, the maternal NOEL was less than 3 mul/cm(2) CLF (or 0.3 mg/cm(2)trans-capsaicin) per 200 cm(2), but no cesarean-sectioning or litter parameters were affected. No fetal alterations (malformations or variations) were caused by dosages of CLF as high as 13 mul/cm(2) (or 1.3 mg/cm(2)trans-capsaicin). Taken together, these data suggest that tran s-capsaicin should not be considered a developmental toxicant.


Subject(s)
Capsaicin/toxicity , Administration, Cutaneous , Animals , Capsaicin/blood , Capsaicin/pharmacokinetics , Delayed-Action Preparations , Embryonic Development/drug effects , Female , Fetal Development/drug effects , Male , No-Observed-Adverse-Effect Level , Osteogenesis/drug effects , Pregnancy , Rabbits , Rats , Rats, Inbred Strains , Skin/drug effects , Skin/pathology
11.
Br J Pharmacol ; 147(3): 335-45, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16331286

ABSTRACT

Prostacyclin (PGI2) possesses various physiological functions, including modulation of nociception, inflammation and cardiovascular activity. Elucidation of these functions has been hampered by the absence of selective IP receptor antagonists. Two structurally distinct series of IP receptor antagonists have been developed: 4,5-dihydro-1H-imidazol-2-yl)-[4-(4-isopropoxy-benzyl)-phenyl]-amine (RO1138452) and R-3-(4-fluoro-phenyl)-2-[5-(4-fluoro-phenyl)-benzofuran-2-ylmethoxycarbonylamino]-propionic acid (RO3244794).RO1138452 and RO3244794 display high affinity for IP receptors. In human platelets, the receptor affinities (pKi) were 9.3 +/- 0.1 and 7.7 +/- 0.03, respectively; in a recombinant IP receptor system, pKi values were 8.7 +/- 0.06 and 6.9 +/- 0.1, respectively. Functional antagonism of RO1138452 and RO3244794 was studied by measuring inhibition of carbaprostacyclin-induced cAMP accumulation in CHO-K1 cells stably expressing the human IP receptor. The antagonist affinities (pKi) of RO1138452 and RO3244794 were 9.0 +/- 0.06 and 8.5 +/- 0.11, respectively. Selectivity profiles for RO1138452 and RO3244794 were determined via a panel of receptor binding and enzyme assays. RO1138452 displayed affinity at I2 (8.3) and PAF (7.9) receptors, while RO3244794 was highly selective for the IP receptor: pKi values for EP1 (< 5), EP3 (5.38), EP4 (5.74) and TP (5.09). RO1138452 (1-10 mg kg(-1), i.v.) and RO3244794 (1-30 mg kg(-1), i.v.) significantly reduced acetic acid-induced abdominal constrictions. RO1138452 (3-100 mg kg(-1), p.o.) and RO3244794 (0.3-30 mg kg(-1), p.o.) significantly reduced carrageenan-induced mechanical hyperalgesia and edema formation. RO3244794 (1 and 10 mg kg(-1), p.o.) also significantly reduced chronic joint discomfort induced by monoiodoacetate. These data suggest that RO1138452 and RO3244794 are potent and selective antagonists for both human and rat IP receptors and that they possess analgesic and anti-inflammatory potential.


Subject(s)
Benzofurans/pharmacology , Benzyl Compounds/pharmacology , Imidazoles/pharmacology , Propionates/pharmacology , Receptors, Epoprostenol/antagonists & inhibitors , Animals , CHO Cells , Cricetinae , Cyclic AMP/metabolism , Dinoprostone/pharmacology , Dose-Response Relationship, Drug , Epoprostenol/pharmacology , Humans , Hyperalgesia/drug therapy , Male , Rats , Rats, Sprague-Dawley
12.
Regul Toxicol Pharmacol ; 43(1): 66-75, 2005 Oct.
Article in English | MEDLINE | ID: mdl-16051405

ABSTRACT

Previous toxicology and pharmacology studies have reported variable acute cardiac effects of capsaicin, primarily involving hypotension and bradycardia. However, these studies have suffered from two important limitations. First, the capsaicin tested has been derived from pepper plant extracts, which is likely to display varying degrees of purity and possibly diverse impurity profiles. Second, post-dosing follow-up was generally limited to three or fewer days. Therefore, the objective of the studies reported here was to test the cardiac and other target organ toxicity potential of pure, synthetic trans-capsaicin (the only naturally occurring stereoisomer of capsaicin) when delivered via intravenous administration to dogs either acutely or for 14 days. Taken together, results from these two studies indicate that pure trans--capsaicin--even when delivered directly into the systemic circulation at high dose levels--is rapidly eliminated, induces transient tachycardia and hypertension, does not alter the duration of cardiac action potentials, and causes only very minimal organ toxicities. The different toxicity profiles of pure trans-capsaicin reported here and chili pepper extracts previously reported suggest that the purity and source of capsaicin should be an important consideration for toxicological evaluations.


Subject(s)
Capsaicin/toxicity , Cardiovascular System/drug effects , Respiratory System/drug effects , Animals , Blood Cell Count , Capsaicin/blood , Capsaicin/pharmacokinetics , Dogs , Dose-Response Relationship, Drug , Enzymes/blood , Female , Hypertension/chemically induced , Injections, Intravenous , Male , Sex Factors , Stereoisomerism , Tachycardia/chemically induced , Time Factors
13.
Expert Opin Investig Drugs ; 13(11): 1445-56, 2004 Nov.
Article in English | MEDLINE | ID: mdl-15500392

ABSTRACT

Capsaicin and other naturally occurring pungent molecules have been used for centuries as topical analgesics and rubefactants to treat a variety of chronically painful conditions. Recently, instillations of high-concentration capsaicin and resiniferatoxin solutions have been found to be useful for the management of persistent bladder pain or overactive bladder. However, only within the last 7 years has it been appreciated that the selective action of these compounds on a subset of sensory nerve fibres is mediated by agonist activity at a ligand-gated ion channel called the transient receptor potential vanilloid receptor 1 (TRPV1). Accordingly, this discovery has fueled intensive research and drug development efforts, mainly in a search for novel analgesic or anti-inflammatory therapies. Two different, but non-mutually exclusive, strategies are being pursued: optimisation of TRPV1 agonist-based therapies, which can functionally inactivate nociceptive nerve fibres, and identification of receptor antagonists, which would prevent nociceptive fibres from being activated by ongoing inflammatory stimuli. Available information on TRPV1 agonists in development and their biological rationale will be summarised in this review.


Subject(s)
Capsaicin/pharmacology , Capsaicin/therapeutic use , Pain/drug therapy , Receptors, Drug/agonists , Receptors, Drug/metabolism , Capsaicin/administration & dosage , Capsaicin/analogs & derivatives , Humans , Urinary Bladder/drug effects , Urinary Bladder/physiopathology
14.
Pain ; 111(3): 360-367, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15363880

ABSTRACT

Capsaicin-containing plant extracts have been used as topical treatments for a variety of pain syndromes for many centuries. Current products containing capsaicin in low concentrations (usually 0.025-0.075% w/w) have shown efficacy against a variety of pain conditions in clinical studies. However, in order to produce significant analgesic effects, these formulations require frequent re-dosing, often as much as three to five times daily for several weeks. Previous functional and immunohistochemical studies following prolonged exposures to low-concentration capsaicin cream suggested that the duration and onset of analgesic efficacy correlate with a reduction of cutaneous nociceptive sensory nerve fiber responsiveness and immunostaining. The purpose of the present study was to determine whether a single topical application of a high-concentration capsaicin-containing (8%w/w) patch for 120 min or less would induce similar effects on cutaneous nociceptive nerve fibers. Seven days following patch application, changes in heat and cold perception thresholds were determined by quantitative sensory testing and punch biopsies were collected to assess epidermal nerve fiber (ENF) immunostaining density at the application site using PGP 9.5 as a marker. The results show a significant reduction of heat, but not cold, sensitivity and reduction of ENF immunostaining with high-capsaicin concentration patch applications for 60 or 120 min, compared to placebo patch applications. Application sites exposed to low-capsaicin concentration (0.04%w/w) patches for 120 min or high-concentration patches for 30 min were not significantly different from placebo with respect to either thermal threshold detection or ENF immunostaining. The ability of a single 60 min high-concentration patch application to mimic effects produced by prolonged exposure to low-concentration capsaicin creams suggests a new approach to the management of chronic pain syndromes.


Subject(s)
Capsaicin/administration & dosage , Epidermis/drug effects , Hot Temperature/adverse effects , Nerve Fibers/drug effects , Pain Measurement/drug effects , Adolescent , Adult , Aged , Dose-Response Relationship, Drug , Epidermis/physiology , Female , Humans , Immunohistochemistry , Male , Middle Aged , Nerve Fibers/physiology , Pain Measurement/methods
16.
Mutat Res ; 557(1): 85-97, 2004 Jan 10.
Article in English | MEDLINE | ID: mdl-14706521

ABSTRACT

Both positive and negative effects have been found in classical genetic toxicology assays with capsaicin. However, the capsaicin tested in most studies has been derived from pepper plant extracts, which is likely to display varying degrees of purity and possibly diverse impurity profiles. Therefore, the objective of the series of studies reported here was to test the genotoxic potential of pure, synthetic trans-capsaicin (the only naturally occurring geometric isomer of capsaicin), using four genotoxicity assays widely used to evaluate drug substances. These included the Ames, mouse lymphoma cell mutation, mouse in vivo bone marrow micronucleus and chromosomal aberration in human peripheral blood lymphocytes (HPBL) assays. In the Ames assay, pure trans-capsaicin was not mutagenic to Salmonella typhimurium or Escherichia coli when dissolved in dimethylsulfoxide and tested at concentrations extending into the toxic range. trans-Capsaicin was weakly mutagenic in mouse lymphoma L5178Y cells, in the presence of S9 mix, when dissolved in dimethylsulfoxide and tested at concentrations extending into the toxic range. Limited evidence for very weak activity was also obtained in the absence of S9 mix. trans-Capsaicin did not induce micronuclei in bone marrow cells when tested to the maximum tolerated dose of 800 mg/kg per day in male and 200 mg/kg per day in female CD-1 mice using a 0 h plus 24 h oral dosing and 48 h sampling regimen. Finally, trans-capsaicin did not induce structural or numerical chromosomal aberrations when evaluated for its ability to induce clastogenicity in blood lymphocytes. Taken together, these data suggest that the genotoxic potential of pure trans-capsaicin is very low, especially as the clinical significance of weak mutagenicity in the mouse lymphoma assay for catechol-moiety containing compounds is unclear. Moreover, the different genotoxicity profiles of pure trans-capsaicin and purified chili pepper extracts suggest that the purity and source of capsaicin should always be an important consideration for toxicological evaluations.


Subject(s)
Capsaicin/toxicity , Mutagens/toxicity , Animals , Capsaicin/pharmacokinetics , Chromosome Aberrations , Female , Lymphoma/genetics , Male , Mice , Micronucleus Tests , Mutagenicity Tests , Mutation , Salmonella typhimurium/drug effects , Salmonella typhimurium/genetics , Stereoisomerism
17.
J Org Chem ; 68(23): 9100-4, 2003 Nov 14.
Article in English | MEDLINE | ID: mdl-14604387

ABSTRACT

Molecules were prepared with substituted nitrobenzyl groups covalently bonded to N-(4-hydroxy-3-methoxybenzyl)acetamide (2) by ether or carbonate linkages. These compounds decomposed under irradiation at 363 nm. Those with carbonate linkages decomposed at slower rates than those with ether linkages. Molecules with dimethoxy-substituted benzyl groups decomposed more slowly than monomethoxy-substituted benzyl groups due to the electronic characteristics of the benzylic carbon.


Subject(s)
Capsaicin/chemistry , Models, Chemical , Capsaicin/chemical synthesis , Magnetic Resonance Spectroscopy , Photochemistry
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