thromboxane-a2 and Fever

Historically, anti-inflammatory drugs had their origins in the serendipitous discovery of certain plants and their extracts being applied for the relief of pain, fever and inflammation. When salicylates were discovered in the mid-19th century to be the active components of Willow Spp., this enabled these compounds to be synthesized and from this, acetyl-salicylic acid or Aspirin was developed. Likewise, the chemical advances of the 19th-20th centuries lead to development of the non-steroidal anti-inflammatory drugs (NSAIDs), most of which were initially organic acids, but later non-acidic compounds were discovered. There were two periods of NSAID drug discovery post-World War 2, the period up to the 1970's which was the pre-prostaglandin period and thereafter up to the latter part of the last century in which their effects on prostaglandin production formed part of the screening in the drug-discovery process. Those drugs developed up to the 1980-late 90's were largely discovered empirically following screening for anti-inflammatory, analgesic and antipyretic activities in laboratory animal models. Some were successfully developed that showed low incidence of gastro-intestinal (GI) side effects (the principal adverse reaction seen with NSAIDs) than seen with their predecessors (e.g. aspirin, indomethacin, phenylbutazone); the GI reactions being detected and screened out in animal assays. In the 1990's an important discovery was made from elegant molecular and cellular biological studies that there are two cyclo-oxygenase (COX) enzyme systems controlling the production of prostanoids [prostaglandins (PGs) and thromboxane (TxA2)]; COX-1 that produces PGs and TxA2 that regulate gastrointestinal, renal, vascular and other physiological functions, and COX-2 that regulates production of PGs involved in inflammation, pain and fever. The stage was set in the 1990's for the discovery and development of drugs to selectively control COX-2 and spare the COX-1 that is central to physiological processes whose inhibition was considered a major factor in development of adverse reactions, including those in the GI tract. At the turn of this century, there was enormous commercial development following the introduction of two new highly selective COX-2 inhibitors, known as coxibs (celecoxib and rofecoxib) which were claimed to have low GI side effects. While found to have fulfilled these aims in part, an alarming turn of events took place in the late 2004 period when rofecox

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Cardiovascular Diseases; Cyclooxygenase 1; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cytokines; Digestive System Diseases; Disease Models, Animal; Drug Delivery Systems; Drug Design; Fever; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Inflammation; Isoenzymes; Neoplasms; Neurodegenerative Diseases; Pain; Prostaglandins; Signal Transduction; Stroke; Thromboxane A2

The actions of prostanoids in various physiological and pathophysiological conditions have been being examined using mice lacking different prostanoid receptors. Prostaglandin (PG) I2 worked not only as a mediator of inflammation but also as an antithrombotic agent. PGF2alpha was found to be an essential inducer of labor. Several important actions of PGE2 are exerted via each of the four PGE2 receptor subtypes: EP1, EP2, EP3 and EP4. PGE2 participated in colon carcinogenesis via the EP1. PGE2 also participates in ovulation and fertilization and contributes to the control of blood pressure under high-salt intake via the EP2. PGE2 worked as a mediator of febrile responses to both endogenous and exogenous pyrogens and as a regulator of bicarbonate secretion induced by acid-stimulation in the duodenum via the EP3. It regulated the closure of ductus arteriosus and showed bone resorbing action via the EP4. PGD2 was found to be a mediator of allergic asthma. These studies have revealed important roles of prostanoids, some of which had not previously been known.

Topics: Animals; Asthma; Bicarbonates; Colonic Neoplasms; Dinoprost; Dinoprostone; Female; Fever; Hypertension; Inflammation; Labor, Obstetric; Mice; Mice, Knockout; Pregnancy; Prostaglandins; Receptors, Prostaglandin; Reproduction; Thrombosis; Thromboxane A2

Thrombotic thrombocytopenic purpura is an uncommon, life-threatening disorder that affects older children and adolescents as well as adults. A variety of theories have been proposed to explain its clinical and pathologic manifestations, but the pathophysiology remains poorly understood. It is not even clear whether this disease primarily affects the endothelial cell, the platelet, or both. Most patients have no discernable predisposition to this disease. Our failure to define the pathophysiology of thrombotic thrombocytopenic purpura adequately has hampered our ability to design rational and consistently successful therapy. The present knowledge of this pathophysiology is discussed in detail. The high mortality of this disease necessitates rapid diagnosis so that therapy can be instituted as quickly as possible. The clinical manifestations and diagnostic criteria of thrombotic thrombocytopenic purpura are therefore reviewed.

Topics: Anemia, Hemolytic; Blood Coagulation Factors; Blood Platelets; Child; Diagnosis, Differential; Endothelium; Epoprostenol; Factor VIII; Female; Fever; Fibrinolytic Agents; Hemolytic-Uremic Syndrome; Humans; Kidney Diseases; Male; Neurologic Manifestations; Platelet Activating Factor; Purpura; Purpura, Thrombotic Thrombocytopenic; Thromboxane A2

Topics: Animals; Anti-Inflammatory Agents; Arachidonic Acids; Fever; Humans; Inflammation; Prostaglandin Endoperoxides; Prostaglandins; Thromboxane A2

Hyperthermia is one of the main disturbances of homeostasis occurring during sepsis or hypermetabolic states such as cancer. Platelets are important mediators of the inflammation that accompanies these processes, but very little is known about the changes in platelet function that occur at different temperatures.. To explore the effect of higher temperatures on platelet physiology.. Platelet responses including adhesion, spreading (fluorescence microscopy), α(IIb)β(3) activation (flow cytometry), aggregation (turbidimetry), ATP release (luminescence), thromboxane A(2) generation, alpha-granule protein secretion (ELISA) and protein phosphorylation from different signaling pathways (immunoblotting) were studied.. Preincubation of platelets at temperatures higher than 37 °C (38.5-42 °C) inhibited thrombin-induced hemostasis, including platelet adhesion, aggregation, ATP release and thromboxane A(2) generation. The expression of P-selectin and CD63, as well as vascular endothelial growth factor (VEGF) release, was completely inhibited by hyperthermia, whereas von Willebrand factor (VWF) and endostatin levels remained substantially increased at high temperatures. This suggested that release of proteins from platelet granules is modulated not only by classical platelet agonists but also by microenvironmental factors. The observed gradation of response involved not only antiangiogenesis regulators, but also other cargo proteins. Some signaling pathways were more stable than others. While ERK1/2 and AKT phosphorylation were resistant to changes in temperature, Src, Syk, p38 phosphorylation and IkappaB degradation were decreased in a temperature-dependent fashion.. Higher temperatures, such as those observed with fever or tissue invasion, inhibit the hemostatic functions of platelets and selectively regulate the release of alpha-granule proteins.

Topics: Adenosine Triphosphate; Blood Platelets; Blotting, Western; Enzyme-Linked Immunosorbent Assay; Fever; Flow Cytometry; Hemostasis; Hot Temperature; Humans; Microscopy, Fluorescence; Nephelometry and Turbidimetry; Phosphorylation; Platelet Activation; Platelet Adhesiveness; Platelet Aggregation; Platelet Glycoprotein GPIIb-IIIa Complex; Protein Kinases; Secretory Vesicles; Signal Transduction; Thrombin; Thromboxane A2; Time Factors

It has been proposed that ciliary neurotrophic factor (CNTF) belongs to the group of cytokines causing fever in response to infectious and inflammatory noxae. The present investigation was undertaken in the conscious cat to verify whether CNTF (human type, hCNTF) is pyrogenic when given either intravenously (i.v.) or intracerebroventricularly (i.c.v.) and correlate at the same time body temperature with cerebrospinal fluid (CSF) levels of prostaglandin (PG) E2 (i.e., the putative fever mediator in brain) and thromboxane (TX) B2 (the stable TXA2 byproduct) in untreated vs. treated animals. hCNTF (10 microg/kg i.v.; 1 microg i.c.v.) caused fever by both routes and the increase in body temperature was associated with an upward change in CSF PGE2. Conversely, CSF TXB2 showed no elevation. Similarly unaffected was CSF TXB2 by human interleukin 6 (hIL-6, 1 microg i.c.v.), a cytokine with known pyrogenic and PGE2-promoting actions sharing the signal-transducing mechanism with hCNTF. We conclude that CNTF lends itself to a role in the pathogenesis of fever. The modest PGE2 elevation relatively to other cytokines, specifically hIL-1, is ascribed to the fact that CNTF activates the inducible isoform of arachidonate cyclooxygenase, which is constitutively expressed in brain, without concomitantly promoting the formation of new enzyme.

Topics: Animals; Body Temperature; Body Temperature Regulation; Cats; Cerebral Ventricles; Ciliary Neurotrophic Factor; Dinoprostone; Female; Fever; Humans; Injections, Intravenous; Injections, Intraventricular; Interleukin-1; Male; Nerve Growth Factors; Nerve Tissue Proteins; Recombinant Proteins; Skin Temperature; Thromboxane A2; Thromboxane B2; Time Factors

Conscious cats were used to study the effects of endotoxin and interleukin 1 (IL 1) on levels of prostaglandin (PG) E2 and thromboxane (TX) B2 (the stable TXA2 byproduct) in cerebrospinal fluid (CSF) from the third ventricle. Pyrogens were given intravenously or intraventricularly and prostanoids were measured by radioimmunoassay. PGE2 was normally less abundant than TXB2 (mean, 37 vs. 528 pg/ml), and its level increased severalfold during the sustained fever following intravenous endotoxin (bolus) or IL 1 (bolus plus infusion). PGE2 elevation preceded the fever and was maintained thereafter. Likewise, intraventricular pyrogens promoted PGE2 formation, and their effect was also manifest during the latent period of the fever. The PGE2 metabolite, 13,14-dihydro-15-keto-PGE2, was not measurable in CSF from either afebrile or febrile animals. Basal content of PGE2, on the other hand, was higher in animals pretreated with probenecid (30 mg/kg ip or iv; 50 or 100 micrograms ivt), confirming the importance of transport processes in removing prostanoids from brain. Unlike PGE2, TXB2 levels did not change during the fever to intravenous endotoxin. TXB2 rose instead in response to intraventricular endotoxin, although the elevation did not extend beyond fever uprise. Furthermore, a TXA2 analog (ONO-11113;2 or 4 micrograms ivt) had inconsistent effects on body temperature, while a TXA2 antagonist (ONO-11120;2 micrograms ivt) did not interfere with endotoxin fever. These findings strongly support a causative role for PGE2 in the onset and progression of pyrogen fever. No evidence of a similar role was obtained for TXA2.

Topics: Animals; Brain; Cats; Dinoprostone; Endotoxins; Escherichia coli; Female; Fever; Injections, Intraventricular; Interleukin-1; Male; Prostaglandins E; Pyrogens; Thromboxane A2; Thromboxane B2

Topics: Animals; Brain; Cats; Dinoprostone; Endotoxins; Fever; Interleukin-1; Prostaglandins E; Pyrogens; Thromboxane A2

Topics: Animals; Dinoprostone; Fever; Humans; Prostaglandins E; Pyrogens; Thromboxane A2