Comparison of the Effects of Contractubex Gel and Benzothiazole After Topical Application in an Experimental Model of Epidural Fibrosis in Rats.

BACKGROUND: Postoperative epidural adhesion is a frequent cause of failed back surgery syndrome, manifesting with back and leg pain or neurologic deficits. Development of preventive measures for epidural adhesion after laminectomy is critical to improve outcomes of lumbar surgery. We hypothesized that positive effects of topical application of Contractubex (CTX) gel and benzothiazole (BT) individually and in combination could aid in preventing epidural fibrosis in a rat laminectomy model. METHODS: Rats were randomly assigned to 2 control and 5 experimental groups (n = 8 for each group). The control(-) group received no surgery, whereas the control(+) group underwent laminectomy without any drug administration. In experimental groups, study agents applied to dura mater after laminectomy were 100mgCTX, 2.5%BT, 5%BT; 100mgCTXplus2.5%BT, and 100mgCTXplus5%BT. Laminectomy was performed at the L3 level for all rats. The extent of epidural fibrosis was assessed 4 weeks later macroscopically and histopathologically. Hepatic and renal toxicity of study drugs was assessed histopathologically. RESULTS: Topical CTX and BT individually and in combination reduced epidural fibrosis after laminectomy in rats. Although a meaningful decrease of epidural fibrosis with individual application of CTX and BT (2.5% or 5%) was obtained (P < 0.05), the effect of their combination was more pronounced without meaningful hepatic and renal toxicity (P < 0.05). CONCLUSIONS: Combined use of topical CTX and BT could be a potential therapy for epidural fibrosis. Further research with this agents for the prevention of epidural fibrosis is warranted.

Final report of the safety assessment of allantoin and its related complexes.

Allantoin is a heterocyclic organic compound. Allantoin ascorbate, allantoin biotin, allantoin galacturonic acid, allantoin glycyrrhetinic acid, allantoin panthenol, and allantoin polygalacturonic acid are complexes of allantoin. All of the ingredients in this review act as skin-conditioning agents. Allantoin was reported to be used in 1376 cosmetic products at concentrations up to 2%. There are data gaps regarding use and concentration of the remaining allantoin complexes. Ascorbic acid, biotin, glycyrrhetinic acid, and panthenol have been determined by the CIR Expert Panel to be safe. Galacturonic acid and polygalacturonic acid have not been reviewed by the CIR Expert Panel, and substantial data on these chemicals were not available. The safety test data in this safety assessment and in previous safety assessments were considered sufficient to support the safety of allantoin and the allantoin complexes in product categories and at concentrations reviewed in this safety assessment.

Induction of tumours in rats by feeding nitrosatable amines together with sodium nitrite.

Feed containing 0.2% allantoin or diphenhydramine (as the hydrochloride) or 0.1% chlorpheniramine (as the maleate), with or without 0.2% sodium nitrite, was given ad lib. to groups of 20 or 24 male and 20 or 24 female F344 rats for 106 wk. Groups of 24 male and 24 female F344 rats were given drinking-water that contained N,N-dimethyldodecylamine-N-oxide at a concentration of 0.1%, with or without 0.2% sodium nitrite, for 93 wk. Control rats were given untreated feed or drinking-water and nitrite-treated controls were given sodium nitrite at a concentration of 0.2% in feed or drinking-water. At the end of the treatment period the rats were given untreated feed and water and observed until death. There was little or no life-shortening effect in any treatment group. None of the four amines administered alone induced an increase in the incidence of any tumour in comparison with the untreated control groups. In the male rats given diphenhydramine, chlorpheniramine or N,N-dimethyldodecylamine-N-oxide concurrently with nitrite there was a significant increase in the incidence of liver neoplasms (hepatocellular carcinomas and neoplastic nodules). In the groups given untreated feed or drinking-water there were, respectively, five and three male rats that had liver tumours. In contrast the number of male rats with liver tumours was ten in the group given dimethyldodecylamine-N-oxide plus nitrite, 11 in that given diphenhydramine plus nitrite and 14 (eight with carcinomas) in the group given chlorpheniramine plus nitrite. These results suggest that the ingestion of dimethyldodecylamine-N-oxide, diphenhydramine hydrochloride or chlorpheniramine under conditions when they could be nitrosated with nitrite in the stomach might present an increased carcinogenic risk.