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EXPRESS SUMMARY ARTICLE The Full-length version of this article is also available, published online November 14, 2000 as doi:10.1096/fj.00-0130fje. |
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B and AP-1 activation by R- and S-flurbiprofen1 ,2
Zentrum der Pharmakologie, Johann Wolfgang Goethe-Universität, Frankfurt, 60590 Frankfurt am Main, Germany; and
* Institut für Experimentelle Pharmakologie and Toxikologie, Universität Erlangen, Fahrstr.19, 91054 Erlangen, Germany
3Correspondence: Center of Pharmacology, Johann Wolfgang Goethe-University of Frankfurt, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany. E-mail. geisslinger{at}em.uni-frankfurt.de
SPECIFIC AIMS
Flurbiprofenbelongs to the 2-aryl-propionic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs consist of two optical isomers. R-flurbiprofen is considered to be the inactive isomer because it does not inhibit cyclooxygenase (COX) activity. However, previous studies have revealed that it has antinociceptive and anti-tumor effects. Since R-flurbiprofen is not epimerized to the S-enantiomer in rats and humans, these effects are not mediated through the COX-inhibiting S-isomer. The aim of the present study was to evaluate the potential mechanisms that might explain the observed effects of R-flurbiprofen and to find out whether R-flurbiprofen was also able to reduce inflammation.
PRINCIPAL FINDINGS
1. In the zymosan-induced paw inflammation model in rats,
R-flurbiprofen reduced inflammation as effectively as dexamethasone and
was even more effective than the cyclooxygenase inhibiting
S-isomer
Since the anti-inflammatory efficacy of NSAIDs is considered
to be closely related to the COX inhibitory properties, a lack of
anti-inflammatory efficacy for R-flurbiprofen was hypothesized. To
address this hypothesis, we assessed its effects in the zymosan-induced
hind paw inflammation model in rats. R- and S-flurbiprofen (1, 3, and 9
mg/kg) and dexamethasone (0.5 mg/kg, positive control) were injected
intraperitoneally (i.p.) 15 min before the intraplantar injection of
0.625 mg zymosan. The paw volume as indicator of the inflammatory
response was measured using a plethysmometer. The time course is shown
in Fig. 1
. Surprisingly, R-flurbiprofen reduced the paw edema at least as
effectively as S-flurbiprofen. At 3 and 9 mg/kg, effects of
R-flurbiprofen were indistinguishable from those of 0.5 mg/kg
dexamethasone. For statistical comparisons, the area under the paw
volume increase vs. time curves were calculated. R-flurbiprofen
significantly (
< 0.05) reduced the paw edema at 1, 3, and 9 mg/kg.
Effects of S-flurbiprofen were statistically significant only between 4
and 8 h.
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To evaluate the concentration range and to check the rate of epimerization, plasma concentrations of R- and S-flurbiprofen were determined after i.p. administration of 9 mg/kg R-flurbiprofen. Maximum plasma concentrations of R-and S-flurbiprofen were 520.9 ± 126.9 µmol/l and 3.89 ± 0.64 µmol/l, respectively. Based on AUC calculations, 1.61 ± 0.21% of R-flurbiprofen was found to be epimerized to S-flurbiprofen.
2. R- and S-flurbiprofen inhibited the zymosan-induced COX-2 mRNA
and protein expression in the inflamed paw and spinal cord, which was
associated with a significant reduction of prostaglandin release
To evaluate the underlying mechanisms, we first assessed the
effects of R- and S-flurbiprofen on prostaglandin E2
(PGE2) release in the inflamed paw and spinal cord. As
expected because of its COX inhibitory properties, S-flurbiprofen
significantly reduced PGE2 release at both sites.
Unexpectedly, R-flurbiprofen was almost as effective as S-flurbiprofen.
Since R-flurbiprofen does not inhibit COX enzymatically, we
hypothesized that it might affect its expression. To address this
hypothesis COX-2 mRNA and protein expression was assessed by means of
quantitative reverse transcription-polymerase chain reaction and
Western blot analysis, respectively.
In the noninflamed paw, only minimal COX-2 mRNA was measurable. After zymosan injection, however, it was increased about 15-fold. This increase was significantly reduced by 9 mg/kg R- and S-flurbiprofen. In the spinal cord both COX isoforms were expressed in control rats i.e. constitutively. After zymosan injection into the paw, COX-2 mRNA in the spinal cord increased about sevenfold and this increase was dose dependently reduced by R- and S-flurbiprofen and by dexamethasone.
COX-2 protein expression was similarly affected. Lumbar spinal cord was excised 6 h after zymosan injection and protein extracts of lumbar spinal cord homogenates were subjected to Western blot analysis. An obvious reduction of zymosan-induced COX-2 protein expression was observed with 9 mg/kg R- and S-flurbiprofen and 0.5 mg/kg dexamethasone.
3. R- and S-flurbiprofen inhibited lipopolysaccharide (LPS)
-induced activation of the transcription factor NF-
B in RAW 264.7
macrophages by blocking its nuclear translocation. R-flurbiprofen also
inhibited activator protein 1 (AP-1)
The transcription of the COX-2 gene is regulated among others by
the transcription factor NF-
B. Therefore, we were interested in
whether the observed inhibition of COX-2 expression might be mediated
through inhibition of NF-
B activation. RAW 264.7 mouse macrophages
were used to study NF-
B activation in vitro. DNA
binding activity was assessed by electrophoretic mobility shift assays.
Cells were stimulated with 10 µg/ml LPS for 1 h in the absence
or presence of R- and S-flurbiprofen (Fig. 2)
. Nuclear extracts were incubated with end 32 P-labeled
NF-
B consensus oligonucleotide. NF-
B DNA binding was minimal in
control cells but strongly increased after LPS stimulation. This
increase of DNA binding activity was dose dependently reduced by
R-flurbiprofen and less so by S-flurbiprofen (Fig. 2)
.
Immunocytochemistry using an antibody directed against the p65 subunit
of NF-
B revealed that R-flurbiprofen inhibited the nuclear
translocation of NF-
B. S-flurbiprofen had similar effects but was
less potent.
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In addition to NF-
B, the transcription factor AP-1 is substantially
involved in the regulation of the inflammatory response. Therefore, we
assessed whether flurbiprofen also affected AP-1 activation. Specific
AP-1 binding activity was markedly increased in LPS-stimulated cells as
compared to unstimulated control cells. R-flurbiprofen (101000 µM)
inhibited AP-1 DNA binding in a dose-dependent manner. At 1000 µM, it
was completely suppressed. With S-flurbiprofen, a reduction was
observed only at 1000 µM.
4. Inhibition of NF-
B activation by R- and S-flurbiprofen
was independent of I-
B phosphorylation and degradation
In unstimulated cells, NF-
B is inactive because it is retained
in the cytoplasm by its inhibitor I-
B. Upon stimulation, I-
B is
phosphorylated by I-
B kinases and subsequently degraded. This
releases NF-
B, which is then translocated to the nucleus. To
evaluate the stage at which R-flurbiprofen blocked NF-
B activation
we assessed whether I-
B breakdown could take place in its presence.
Cytosolic extracts were subjected to Western blot analysis using an
antibody directed against I-
B. The I-
B signal was rapidly reduced
after LPS stimulation (maximum at 30 min). Its degradation was affected
by neither R- nor S-flurbiprofen.
CONCLUSIONS AND SIGNIFICANCE
It has been shown before that the R-enantiomer of
flurbiprofen is a potent antinociceptive drug although it does not
inhibit cyclooxygenase activity at therapeutically relevant
concentrations. The present study demonstrates that R-flurbiprofen also
reduces inflammation nearly as effectively as dexamethasone in
zymosan-induced paw inflammation in rats. Different criteria suggest
that the observed anti-inflammatory effects are mediated at least in
part by inhibition of NF-
B and AP-1 activation: R-flurbiprofen
inhibited 1) NF-
B and AP-1 DNA binding activity,
2) LPS-induced nuclear translocation of NF-
B, and
3) NF-
B-dependent gene transcription. The inhibitory
effects on NF-
B appear to be independent of I-
B
degradation.
Concerning NF-
B and AP-1 activity and paw inflammation,
S-flurbiprofen was less effective. In vitro, NF-
B and
AP-1 inhibition occurred at concentrations of 100 to 1000 µM. Similar
concentrations were found in plasma of rats treated with 9 mg/kg
R-flurbiprofen. Thus, it may be assumed that the mechanisms observed
in vitro are relevant for the in vivo effects of
the drugs.
Recently, high NF-
B and AP-1 DNA binding activity have been
found in the synovium of patients with rheumatoid arthritis and
osteoarthritis. In collagen-induced arthritis in mice, NF-
B and AP-1
activation preceded both clinical arthritis and gene transcription of
collagenases (metalloproteinases), which play an important role in the
degradation of cartilage and bone. These findings suggest that
activation of NF-
B and AP-1 may be involved in the pathogenesis of
rheumatoid arthritis and explain the beneficial effects of
glucocorticoids, which inhibit activation of NF-
B. Since
R-flurbiprofen reduced inflammation nearly as effectively as
dexamethasone in the present study and appears to act through a similar
mechanism, it might likewise be able to reduce the clinical symptoms
and joint destruction in rheumatoid arthritis.
In addition to the previously reported antinociceptive and the here
demonstrated anti-inflammatory activity, R-flurbiprofen has been shown
to inhibit tumor formation and growth in multiple intestinal neoplasia
mice, with up to 90% inhibition of the total tumor number at a dose of
20 mg/(kg · day). The mechanism of this anticarcinogenic effect is
not known. However, considering the anti-apoptotic role of NF-
B in
several human cancer cells, it may be assumed that NF-
B inhibition
might be the mechanism underlying this chemopreventive efficacy.
Since it has been first recognized that glucocorticoids and
acetylsalicylic acid inhibit the transactivation of the transcription
factor NK-
B, much attention has been focused on NF-
B as a
potential target in the treatment of inflammatory diseases. Treatment
with glucocorticoids and acetylsalicylic acid, however, is limited by
their potential toxicities. That R-flurbiprofen inhibits NF-
B and
AP-1 at much lower concentrations than acetylsalicylic acid and exerts
anti-inflammatory effects similar to those of dexamethasone suggests
that R-flurbiprofen might be a useful new drug in the treatment of
RA.
FOOTNOTES
1 To read the full text of this article, go to http://www.fasebj.org/cgi/doi/10.1096/fj.00-0130fje To cite this article, use (November 14, 2000) FASEB J. 10.1096/fj.00-0130fje ![]()
2 This work was supported by Deutsche Forschungs-gesellschaft (SFB 553 C6). ![]()
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