Antitussive activity of alcoxyphenyl carbamic acid analogues.

In this study we report pharmacological evaluation of four newly synthetized analogues of alcoxyphenyl carbamic acid, structurally related to butamirate citrate that is frequently used as cough suppressing drug, and marked as ATK 231, ATK 241, ATK 251 and ATK 261. These agents with various modifications of the molecular structure have been tested for antitussive activity in cough induced by inhalation of aerosol of citric acid (0.3 M) over 3 minutes using conscious guinea pigs. Results revealed significant cough suppressing activity without significant influence on specific airways resistances in all tested substances. ATK 231 and ATK241 showed significantly higher total antitussive activities when compared to both codeine phosphate and butamirate citrate, while ATK 251 only comparing to butamirate citrate. We did not observe any notable adverse effects and these compounds could thus potentially represent promising new non-narcotic antitussives suitable for further studies.

QTc prolongation after ADHD medication.

OBJECTIVE: Multicenter studies have shown that cardiovascular risks of ADHD medication are extremely low. However, QTc length has been shown to be increased in smaller samples of patients or case reports after stimulant and atomoxetine medication. Based on recent studies of genetic polymorphisms associated with drug-induced QTc prolongation and polymorphisms linkage to regional populations, we hypothesized that the drug-induced QTc prolongation could be a factor of particular polymorphisms linked to specific regional populations undistinguished in multicenter studies. METHODS: We included 69 patients from a region of central Slovakia, 36 patients were taking atomoxetine and 33 patients methylphenidate. QTc, heart rate, potassium levels and BMI were examined before and after 8 weeks of treatment. Therapeutic effect was measured by ADHD-RS-IV. RESULTS: We found QTc prolongation after 8 weeks of treatment both with atomoxetine and methylphenidate that was neither followed by the significant changes in BMI and potassium levels nor the significant increase of heart rate. CONCLUSION: This is the first study revealing QTc prolongation in the group of ADHD children from the same region after 8-week treatment with atomoxetine and methylphenidate, indicating the potential discrete abnormalities in cardiac functioning associated with polymorphisms in genes of dopaminergic and noradrenergic system.

Anxiolytic effects of venlafaxine/olanzapine combination in treatment of anxious depression.

OBJECTIVE: Both venlafaxine and olanzapine have been previously found to have anxiolytic properties, however no study examined the effect of their combination on anxiety in anxious MDD. The aim of this study was to reveal if and when venlafaxine/olanzapine combination (VOC) can reduce the anxiety and depressive symptoms in patients with severe MDD at the level of patients with moderate-severe depression treated with venlafaxine monotherapy. METHODS: Fifty seven patients were included into the study. Symptoms of depression were objectively assessed by Montgomery-Asberg Depression Rating Scale and subjectively scored by BECK Depression scale, symptoms of anxiety were objectively assessed by Hamilton Anxiety scale and subjectively evluated by ZUNG Self-Rating Anxiety scale before treatment and after each following week untill the fourth week of treatment. RESULTS: VOC eliminated the pre-treatment score differences in all the scales within the first week of treatment. At the third week, VOC group had significantly lower level of anxiety symptoms and the effect maintained through the fourth week of medication. CONCLUSION: Our results indicate that VOC could replace another anxiolytic medication in managing the symptoms of anxiety in patients with severe anxious MDD already within the first week of treatment.

Chemical profile of a polysaccharide from Psidium guajava leaves and it's in vivo antitussive activity.

Decoction of Psidium guajava leaves has been used as medication for chronic coughs and breathlessness for ages. Despite demonstration of antitussive activity, the specific molecule responsible for this remains unidentified. Herein, we report chemical profile and antitussive activity of its water extract (WE) and a polysaccharide (F1) present therein. This polysaccharide (F1), purified from WE by precipitation with ethanol and then through Cu(II)acetate, contains Ara, Gal, Rha, Glc and GalA residues, and has a molecular mass of 156 kDa. It comprises of terminal-, (1,5)- and (1,3,5)-linked Araf; (1,3)-, (1,6)- and (1,3,6)-linked Galp alongside (1,2)- and (1,2,4)-linked Rhap residues. Oligosaccharides indicating polysaccharide structure have been generated by Smith degradation and characterized. The WE fraction suppressed citric acid induced cough efforts in guinea pigs in the dose of 50 mg kg-1. Assessment of antitussive activity of fractions prepared from WE namely F1 (polysaccharide) and F2 (ethanol soluble fraction) revealed that polysaccharide is the active component. Remarkably, tested samples do not alter the specific airway smooth muscle reactivity in animals significantly. The simple extraction method, prominent activity and favorable reactions profile suggest that this macromolecule could be an antitussive drug candidate.

In vivo cough suppressive activity of pectic polysaccharide with arabinogalactan type II side chains of Piper nigrum fruits and its synergistic effect with piperine.

Piper nigrum L. fruits are not only a prized spice, but also highly valued therapeutic agent that heals many ailments including asthma, cold and respiratory problems. Herein, we have investigated structural features and in vivo antitussive activity of three fractions isolated from Piper nigrum fruits. The water extract (PN-WE) upon fractionation with EtOH yielded two fractions: a soluble fraction (PN-eSf) and a precipitated (PN-ePf) one. The existence of a pectic polysaccharide with arabinogalactan type II side chains (147kDa) in PN-ePf and piperine in PN-eSf were revealed. Moreover, oligosaccharides providing fine structural details of side chains were generated from PN-ePf and then characterized. The parental water extract (PN-WE) that contained both pectic polysaccharide and piperine, after oral administration (50mgkg-1 body weight) to guinea pigs, showed antitussive activity comparable to codeine phosphate (10mgkg-1 body weight). The EtOH precipitated fraction (PN-ePf) containing pectic polysaccharide showed comparatively higher antitussive activity than EtOH soluble fraction (PN-eSf) that contained piperine, but their potencies are lower than the parental water extract. Significantly, the specific airway smooth muscle reactivity of all three fractions remained unchanged. Finally, pectic polysaccharide-piperine combination in parental extract synergistically enhances antitussive effect in guinea pigs.

Anxiety reduction on atomoxetine and methylphenidate medication in children with ADHD.

BACKGROUND: Atomoxetine and methylphenidate are widely used to treat attention-deficit-hyperactivity disorder (ADHD) with similar effectiveness after 8 weeks of treatment, when atomoxetine has reached its a full effect. Both drugs have also been shown to have an effect on comorbid anxiety. To the best of our knowledge, no study has compared their effect on the dynamics of anxiety symptom reduction. The aim of this study was to compare the medication effect on core and comorbid anxiety symptom dynamics in children with ADHD. METHODS: Sixty-nine patients participated in the study: 36 patients were taking atomoxetine and 33 patients, methylphenidate. Therapeutic effect on core symptoms of ADHD was measured on the ADHD-rating scale IV, and symptoms of anxiety were measured using the Conners Parent Rating Scale (CPRS). Symptoms were measured prior to and every 2 weeks during 8 weeks of treatment. RESULTS: There was a significant decrease in CPRS anxiety subscale score in both medication groups. Anxiety subscale score was significantly lower in the atomoxetine group in the fourth week, and lasted through to 8 weeks of medication. CONCLUSION: Both atomoxetine and methylphenidate reduced the symptoms of ADHD and anxiety. Atomoxetine was more effective in anxiety symptom reduction from the fourth week of treatment.

The Effect of Methylphenidate on Neurological Soft Signs in ADHD.

OBJECTIVE: Neurological soft signs are very common in children with the attention deficit hyperactivity disorder (ADHD), and the first line medication of this disorder is methylphenidate. The aim of the study was to assess the effect of methylphenidate on the neurological soft signs in children and adolescents suffering from ADHD depending on the dose of methylphenidate. METHODS: Thirty five patients with ADHD were investigated by the ADHD RS-IV parent version questionnaire and the Revised Neurological Examination for Subtle Signs before treatment adjustment and after four weeks of methylphenidate medication. The changes in hyperactivity symptomatology, neurological soft signs during therapy and the influence of the methylphenidate dose were statistically analyzed. RESULTS: A significant decrease in hyperactivity symptomatology was found after one month of methylphenidate medication (p=0.0001) and significant decrease in neurological soft signs was demonstrated in 21 from a total of 26 items (p<0.05). Correlation analysis showed no relationship between the dose of methylphenidate and the improvement of neurological soft signs. Similarly, the improvement of ADHD symptomatology had not correlation with the improvement of neurological soft signs. CONCLUSION: The study demonstrated the positive effect of methylphenidate on neurological soft signs in which improvement occurred independently of the dose, indicating that their progress may be due to methylphenidate treatment of any dose. The unrelated effect of methylphenidate on the attention deficit hyperactivity disorder and neurological soft signs suggest that methylphenidate might be useful in the therapy of clumsy child syndrome and in ADHD treatment of non-responders.

Extracted polysaccharide from Nyctanthes arbor-tristis leaves: chemical and antitussive properties.

The prevalence of cough is reflected in antitussives being one of the most widely used therapies in the world; however no new class of drugs has been introduced into the market for many years. Water decoction of the leaves of Nyctanthes arbor-tristis L. is used in Indian Ayurvedic system to alleviate a wide range of diseases including cough. Herein, we have isolated a carbohydrate polymer (CP) containing fraction from its leaves by aqueous extraction method. CP is a branched polysaccharide containing, amongst others, 1,3-/1,3,6-linked galactopyranosyl, 1,5-/1,3,5-linked arabinofuranosyl and 1,2-/1,2,4-linked rhamnopyranosyl residues. Oral administration of CP fraction in doses of 25 and 50 mg kg(-1) body weight significantly inhibited the number of citric acid-induced cough efforts in guinea pigs in a dose dependent manner. Remarkably, CP did not altered specific airway resistance of animals significantly. Consequently, aqueous extraction method provided a molecular entity, which exhibited the cough suppressive activity: this could symbolize an attractive approach in phytotherapeutic treatment.

Antitussive activity of Withania somnifera and opioid receptors.

Arabinogalactan is a polysaccharide isolated from the roots of the medicinal plant Withania somnifera L. It contains 65% arabinose and 18% galactose. The aim of the present study was to evaluate the antitussive activity of arabinogalactan in conscious, healthy adult guinea pigs and the role of the opioid pathway in the antitussive action. A polysaccharide extract was given orally in a dose of 50 mg/kg. Cough was induced by an aerosol of citric acid in a concentration 0.3 mol/L, generated by a jet nebulizer into a plethysmographic chamber. The intensity of cough response was defined as the number of cough efforts counted during a 3-min exposure to the aerosol. The major finding was that arabinogalactan clearly suppressed the cough reflex; the suppression was comparable with that of codeine that was taken as a reference drug. The involvement of the opioid system was tested with the use of a blood-brain barrier penetrable, naloxone hydrochloride, and non-penetrable, naloxone methiodide, to distinguish between the central and peripheral mu-opioid receptor pathways. Both opioid antagonists acted to reverse the arabinogalactan-induced cough suppression; the reversion was total over time with the latter antagonist. We failed to confirm the presence of a bronchodilating effect of the polysaccharide, which could be involved in its antitussive action. We conclude that the polysaccharide arabinogalactan from Withania somnifera has a distinct antitussive activity consisting of cough suppression and that this action involves the mu-opioid receptor pathways.

In vivo antitussive activity of a pectic arabinogalactan isolated from Solanum virginianum L. in Guinea pigs.

ETHNOPHARMACOLOGICAL RELEVANCE: Solanum virginianum L. is used for the management of fever, bronchial asthma and cough for thousands of years. While the link to a particular indication has been established in human, the active principle of the formulation remains unknown. Herein, we have investigated a polysaccharide isolated from its leaves. MATERIALS AND METHODS: Utilizing traditional aqueous extraction protocol and using chemical, chromatographic, spectroscopic and biological methods we have analysed an antitussive pectic arabinogalactan isolated from its leaves. RESULTS: The water extracted polymer (WEP) is a highly branched arabinogalactan containing, inter alia, (1,3)-, (1,6)- and (1,3,6)-linked ß-Galp residues, terminal-, (1,5)- and (1,3,5)-linked units of α-Araf together with (1,2)- and (1,2,4)-linked Rhap. In vivo investigation on the citric-acid induced cough efforts in guinea pigs shows that the antitussive activity of the orally administered pectic arabinogalactan is greater than codeine phosphate. Remarkably, this macromolecule neither altered specific airway smooth muscle reactivity significantly nor it induced considerable change on levels of NO in expiratory flow in guinea pigs. CONCLUSIONS: Thus, traditional aqueous extraction method provides a molecular entity, which induces antitussive activity without addiction: this could represent an attractive approach in phytotherapeutic management.

Antitussive arabinogalactan of Andrographis paniculata demonstrates synergistic effect with andrographolide.

Traditional Indian medicines have been used in humans for thousands of years. While the link to a particular indication has been established in man, the active principle of the formulations often remains unknown. In this study, we aim to investigate the structural features and antitussive activity of fractions from Andrographis paniculata leaves. In vivo investigations of water extract (WE), and both ethanol-soluble (WES) and precipitated (WEP) fractions from WE on the citric-acid induced cough efforts and airways smooth muscle reactivity in guinea pigs were performed. Chemical, chromatographic and spectroscopic analysis revealed the existence of a highly branched pectic arabinogalactan (109kDa) in WEP and andrographolide in WES. WEP showed significant antitussive activity while the potencies of WE and WES are even higher. Neither WE nor WES significantly alter specific airway smooth muscle reactivity. Remarkably, the antitussive activity of arabinogalactan could be increased by synergistic action with andrographolide. Finally, traditional aqueous extraction method provides an arabinogalactan from A. paniculata, which stimulate biological response but without addiction.

Antitussive Activity of the Water-Extracted Carbohydrate Polymer from Terminalia chebula on Citric Acid-Induced Cough.

Terminalia chebula, a medicinal plant, is widely used in the management of various diseases. As the water extract of its dried ripe fruit is a frequently used preparation, we decided to look for bioactive polysaccharide in this extract. We demonstrate that the obtained polysaccharide fraction, CP, contained a highly branched arabinogalactan protein having a (1 → 3)-, (1 → 6)- and (1 → 3, 6)-linked ß -D-Galp together with (1 → 5)- and (1 → 3)-linked α -L-Araf and nonreducing end units of α -L-Araf. This polymer possesses strong antitussive property. Our results showed that the number of citric acid-induced cough efforts decreased significantly after the oral application of polysaccharide fraction in a dose of 50 mg kg(-1) body weight. Its antitussive efficacy was higher than cough suppressive effect of standard drug codeine. Therefore, traditional aqueous extraction method provides a major polysaccharide, which induces a pharmacological effect: this could represent an attractive approach in phytotherapeutic managements.

Herbal polysaccharides and cough reflex.

In the last decades plant substances have become a leading form of treatment of many respiratory symptoms, including cough. It has been shown that compounds purified form polysaccharides from Adhatoda vasica, Withania somnifera, and Glycyrrhiza glabra have various biological activities, such as antioxidant, anti-inflammatory, immunomodulating, antispasmodic action, or antiallergic properties, and they often act as cough suppressants. This work demonstrates new natural substitutes for synthetic antitussives whose application is associated with numerous adverse effects. We investigated pharmacodynamic characteristics of arabinogalacatan samples extracted from A. vasica, W. somnifera, and G. glabra. These extracts showed the ability to reduce citric acid-induced cough in awake guinea pigs after oral administration in a dose of 50mg/kg. The strongest antitussive effect (81%) was found after application of the extract from G. glabra. There was a 67% cough suppression with A. vasica and 61% with W. somnifera, which was comparable with the antitussive activity of codeine (62%).

Effects of selective inhibition of PDE4 and PDE7 on airway reactivity and cough in healthy and ovalbumin-sensitized guinea pigs.

Phosphodiesterases (PDEs) are enzymes responsible for degradation of cAMP and cGMP in cells. Thus, PDE inhibitors may have significant clinical benefit in respiratory diseases associated with inflammation. The aim of the present study was to evaluate the effects of selective PDE4 (rolipram, ROL) and PDE7 inhibitors (BRL50481, BRL) on citric acid-induced cough, in vivo and in vitro airway smooth muscle reactivity in both healthy and ovalbumin sensitized guinea pigs. The drugs tested were administered intraperitoneally to male guinea pigs once daily for 7 days - ROL 1 mg/kg, BRL 1 mg/kg, and ROL+BRL 0.5 mg/kg. Double chamber whole body plethysmography was used for the evaluation of citric acid (0.6 M)-induced cough and specific airway resistance. An organ bath method was used for the measurement of tracheal and lung tissue strip contractions evoked by cumulative doses (10(-8)-10(-3) mol/L) of acetylcholine (ACH) and histamine (HIS). In healthy guinea pigs, the only significant relaxation was observed after ROL in ACH-induced contractions in vitro and the effect on cough was negligible. In ovalbumin-sensitized animals, more pronounced in vitro relaxing effects of BRL in HIS-induced contractions and of combination (ROL+BRL) in ACH-induced contractions were observed, with similar results in vivo, and no significant change in the number of cough efforts was observed in any of the groups tested. The results suggest that PDE4 and PDE7 inhibitors have stronger anti-inflammatory effects compared with direct effects on smooth muscle and cough, with a potential benefit of their concomitant administration.

Antitussive activity of an extracellular Rhodella grisea proteoglycan on the mechanically induced cough reflex.

A mucilagineous extracellular proteoglycan (EPG) composed of xylose and its 3-O-and 4-O-methyl-derivates (55%), glucuronic acids (17%), rhamnose (14%), galactose (8%), glucose (4%) and minor amounts of other sugars (∼2%) has been isolated from culture medium of Rhodella grisea. A white fluffy algal biopolymer of molecular mass over 8.1×105 contained protein (13%), methoxyl (6%), acetyl and succinyl groups. EPG was tested in vivo on mechanically induced cough in non-anaesthetized cats as a test system. The biopolymer showed a cough suppressing effect on laryngopharyngeal type of cough while the cough from tracheobronchial mucous area was slightly or not affected. Further, the intensity of maximal cough efforts from laryngopharyngeal and tracheobronchial parts in expirium and inspirium were influenced slightly only indicating that the expectoration effect was not suppressed by biopolymer application.

Pharmacologic modulation of experimentally induced allergic asthma.

Allergic asthma is the most frequent disease of the respiratory tract. The aim of the current experimental and clinical studies was to find new sources of drugs able to control asthmatic inflammation and airway hyperresponsiveness. Our experimental studies were focused on efficiency evaluation of substances able to influence activities of ion channels, phosphodiesterase (PDE) isoforms, substances from the group of polyphenols and NO metabolism modulators during experimentally induced allergic asthma.

Suppressive effect of pectic polysaccharides from Cucurbita pepo L. var. Styriaca on citric acid-induced cough reflex in guinea pigs.

Several water-soluble pectic polysaccharides were isolated from the pumpkin fruit biomass and characterized by composition, structural features and molecular properties. The pectic polysaccharides were tested for antitussive activity by studying the effects of citric acid-induced cough reflex in guinea pigs and reactivity of the airway smooth muscle in vivo conditions in comparison to the narcotic drug codeine. Oral administration of all pectic polysaccharides from pumpkin inhibited the number of coughs induced by citric acid in guinea pigs, but to various extents. The results indicated that the antitussive activity of the pectic polysaccharides is affected by their molecular and structural properties, whereby a synergistic action between the polysaccharide and non-carbohydrate components on the biological response has been suggested as well. The cough depressive efficacy of most of the tested polysaccharides was comparable and even higher than that of codeine. Moreover, the application of these polysaccharides provoked any side effects what is their advantage towards the conventional opioid-derived antitussive agents.

Predictive significance of TCI-R for antidepressant treatment.

BACKGROUND: The aim of this study was to investigate the significance of the Temperament and Character Inventory-Revised (TCI-R) dimensions of personality for prediction of treatment outcome in depressed outpatients during 6 months of antidepressant treatment. MATERIAL/METHODS: Thirty outpatients were treated for mild or moderate depressive episode, current mild or moderate episode of recurrent depressive disorder or mixed anxiety and depressive disorder (ICD-10). The intensity of depression was assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) at the beginning of treatment and then after the 1st, 3rd and 6th months of treatment. The personality dimensions were assessed by the TCI-R at the same time points as the MADRS. Differences in TCI-R dimensions between treatment responders (> or =50% decrease in MADRS score after 6 months of treatment) and nonresponders (<50% decrease in MADRS score) were compared by repeated measures analysis of variance (ANOVA). Predictive value for the treatment outcome was assessed by Spearman's correlation coefficient. RESULTS: The predictive significance for treatment outcome (Spearman's correlation coefficient) was identified for reward dependence (RD) (R=-0.44) and harm avoidance (HA) (R=0.46) dimensions. Treatment responders and nonresponders significantly differed (ANOVA) in HA (p<0.05), showing a decrease in total mean HA score only in responders during treatment. CONCLUSIONS: Our findings showed predictive significance of the TCI-R dimensions HA and RD for long-term antidepressant treatment outcome.

The pharmacological activity of wheat bran polysaccharides.

(Glucurono)arabinoxylans were extracted from the wheat bran with acetate buffer in the first step (WBH1) and with dilute alkali in the second step (WBH2). In both samples xylose and arabinose dominated, accompanied with smaller amounts of galactose, glucose, mannose and uronic acids mainly in WBH1. WBH1 was free of protein and with low content of phenolic compounds. Fraction WBH2 contained relatively low levels of proteins and about 4.5% of the total phenolic. When tested for antitussive activity, the (glucurono)arabinoxylans exhibited comparable cough-suppressing effect with centrally acting codeine. The observed effects of bronchoconstriction are limiting practical application of WBH2.

Personality changes during antidepressant treatment.

OBJECTIVES: We have investigated the changes of Temperament and Character Inventory (TCI) dimensions of personality in outpatients during 6 months of antidepressant treatment. SUBJECTS AND METHODS: 30 outpatients were treated for mild or moderate depressive episode, current mild or moderate episode of reccurent depressive disorder or mixed anxiety and depressive disorder (ICD-10). The intensity of depression was assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) at the beginning of treatment and then after the 1st, 3rd and 6th month of treatment. The TCI dimensions were assessed by the Temperament and Character Inventory-Revised (TCI-R) at the same time periods as the MADRS. The mean scores of the TCI-R dimensions and MADRS were processed by Wilcoxon pair test. RESULTS: We have observed a significant decrease in harm avoidance (HA) score after 6 months of treatment (p<0.05), between the 1st and 6th month (p<0.05), between the 3rd and 6th month, (p=0.033), significant increase in persistance (P) between the 1st and 6th month (p<0.05) and a significant decrease in self-transcendence (ST) score after 3 months (p<0.05) and after 6 months (p<0.05). In the MADRS total score we have observed a significant decrease after the 1st (p<0.001), 3rd (p<0.001) and also 6th month (p<0.001). CONCLUSIONS: Our findings showed changes of personality dimensions HA, P and ST in outpatients during antidepressant treatment.