Evaluating the Anti-inflammatory Efficacy of Steroids, COX-2 Selective, and Nonselective NSAIDs in Contusion Spinal Cord Injury: An Experimental Analysis

Context: The inclusion of an anti-inflammatory agent shall be inevitable in a combinatorial approach toward treating spinal cord injury (SCI). However, the best among the commonly used anti-inflammatory agents, namely, steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and cyclooxygenases-2 (C...

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Main Authors: Sreelakshmi Kokkatt Balachandran, Krithika Iyer, Sowbarnika Arul Senthil, Akshaya Priya Ramalingam, Sankar Venkatachalam
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-06-01
Series:Journal of Pharmacy and Bioallied Sciences
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Online Access:https://journals.lww.com/10.4103/jpbs.jpbs_604_25
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author Sreelakshmi Kokkatt Balachandran
Krithika Iyer
Sowbarnika Arul Senthil
Akshaya Priya Ramalingam
Sankar Venkatachalam
author_facet Sreelakshmi Kokkatt Balachandran
Krithika Iyer
Sowbarnika Arul Senthil
Akshaya Priya Ramalingam
Sankar Venkatachalam
author_sort Sreelakshmi Kokkatt Balachandran
collection DOAJ
description Context: The inclusion of an anti-inflammatory agent shall be inevitable in a combinatorial approach toward treating spinal cord injury (SCI). However, the best among the commonly used anti-inflammatory agents, namely, steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and cyclooxygenases-2 (COX-2) selective NSAIDs is not known due to the lack of comparative studies. Aim: It was intended to compare the efficacy of three classes of anti-inflammatory drugs in SCI by estimating the relevant cytokines. Materials and methods: Sprague Dawley rats subjected to contusion SCI were treated with methylprednisolone (steroid), or diclofenac (general COX-inhibitor), or meloxicam (selective COX-2 inhibitor). After three days of postlesion, the efficacy of the drugs was assessed by quantifying the levels of tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1) β, IL-6, IL-10, transforming growth factor-beta (TGF-β), and COX-2 through Western blotting. Statistical analysis used: The data were analyzed using one-way analysis of variance to determine statistical significance, and post-hoc analysis was performed using Tukey’s test. Results: Pro-inflammatory cytokines (TNF-α, IL-6, and IL-1) upregulated by SCI were reduced only by meloxicam treatment. Upregulation of anti-inflammatory cytokines (IL-10, TGF-β) observed in injury was unaffected by methylprednisolone and diclofenac but was downregulated in the meloxicam group although statistically not significant. Conclusion: By reducing the levels of pro-inflammatory cytokines and a mild increase in the levels of TGF-β, meloxicam outperforms the other two drugs tested. Reduced anti-inflammatory IL-10 levels in the meloxicam treatment were the only concern. Spinal inflammation may be more resilient and further studies are required to formulate a consistent anti-inflammatory therapy to treat contusion SCI.
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spelling doaj-art-c804507f48f74347bd262bdb1a533ca22025-08-20T03:15:20ZengWolters Kluwer Medknow PublicationsJournal of Pharmacy and Bioallied Sciences0976-48790975-74062025-06-0117Suppl 2S1877S188110.4103/jpbs.jpbs_604_25Evaluating the Anti-inflammatory Efficacy of Steroids, COX-2 Selective, and Nonselective NSAIDs in Contusion Spinal Cord Injury: An Experimental AnalysisSreelakshmi Kokkatt BalachandranKrithika IyerSowbarnika Arul SenthilAkshaya Priya RamalingamSankar VenkatachalamContext: The inclusion of an anti-inflammatory agent shall be inevitable in a combinatorial approach toward treating spinal cord injury (SCI). However, the best among the commonly used anti-inflammatory agents, namely, steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and cyclooxygenases-2 (COX-2) selective NSAIDs is not known due to the lack of comparative studies. Aim: It was intended to compare the efficacy of three classes of anti-inflammatory drugs in SCI by estimating the relevant cytokines. Materials and methods: Sprague Dawley rats subjected to contusion SCI were treated with methylprednisolone (steroid), or diclofenac (general COX-inhibitor), or meloxicam (selective COX-2 inhibitor). After three days of postlesion, the efficacy of the drugs was assessed by quantifying the levels of tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1) β, IL-6, IL-10, transforming growth factor-beta (TGF-β), and COX-2 through Western blotting. Statistical analysis used: The data were analyzed using one-way analysis of variance to determine statistical significance, and post-hoc analysis was performed using Tukey’s test. Results: Pro-inflammatory cytokines (TNF-α, IL-6, and IL-1) upregulated by SCI were reduced only by meloxicam treatment. Upregulation of anti-inflammatory cytokines (IL-10, TGF-β) observed in injury was unaffected by methylprednisolone and diclofenac but was downregulated in the meloxicam group although statistically not significant. Conclusion: By reducing the levels of pro-inflammatory cytokines and a mild increase in the levels of TGF-β, meloxicam outperforms the other two drugs tested. Reduced anti-inflammatory IL-10 levels in the meloxicam treatment were the only concern. Spinal inflammation may be more resilient and further studies are required to formulate a consistent anti-inflammatory therapy to treat contusion SCI.https://journals.lww.com/10.4103/jpbs.jpbs_604_25anti-inflammatory drugscontusion modelcytokinesneuroinflammationspinal cord injury
spellingShingle Sreelakshmi Kokkatt Balachandran
Krithika Iyer
Sowbarnika Arul Senthil
Akshaya Priya Ramalingam
Sankar Venkatachalam
Evaluating the Anti-inflammatory Efficacy of Steroids, COX-2 Selective, and Nonselective NSAIDs in Contusion Spinal Cord Injury: An Experimental Analysis
Journal of Pharmacy and Bioallied Sciences
anti-inflammatory drugs
contusion model
cytokines
neuroinflammation
spinal cord injury
title Evaluating the Anti-inflammatory Efficacy of Steroids, COX-2 Selective, and Nonselective NSAIDs in Contusion Spinal Cord Injury: An Experimental Analysis
title_full Evaluating the Anti-inflammatory Efficacy of Steroids, COX-2 Selective, and Nonselective NSAIDs in Contusion Spinal Cord Injury: An Experimental Analysis
title_fullStr Evaluating the Anti-inflammatory Efficacy of Steroids, COX-2 Selective, and Nonselective NSAIDs in Contusion Spinal Cord Injury: An Experimental Analysis
title_full_unstemmed Evaluating the Anti-inflammatory Efficacy of Steroids, COX-2 Selective, and Nonselective NSAIDs in Contusion Spinal Cord Injury: An Experimental Analysis
title_short Evaluating the Anti-inflammatory Efficacy of Steroids, COX-2 Selective, and Nonselective NSAIDs in Contusion Spinal Cord Injury: An Experimental Analysis
title_sort evaluating the anti inflammatory efficacy of steroids cox 2 selective and nonselective nsaids in contusion spinal cord injury an experimental analysis
topic anti-inflammatory drugs
contusion model
cytokines
neuroinflammation
spinal cord injury
url https://journals.lww.com/10.4103/jpbs.jpbs_604_25
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