Combination of Vinpocetine and Dexamethasone Alleviates Cognitive Impairment in Nasopharyngeal Carcinoma Patients following Radiation Injury.
Adult
Anti-Inflammatory Agents
/ pharmacology
Antioxidants
/ metabolism
Cognition
/ drug effects
Cognitive Dysfunction
/ drug therapy
Cytokines
/ blood
Dexamethasone
/ pharmacology
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Inflammation
/ blood
Male
Mental Status and Dementia Tests
Middle Aged
Nasopharyngeal Carcinoma
/ radiotherapy
Nasopharyngeal Neoplasms
/ radiotherapy
Oxidants
/ metabolism
Oxidative Stress
/ drug effects
Radiation Injuries
/ complications
Random Allocation
Toll-Like Receptors
/ blood
Vinca Alkaloids
/ pharmacology
Cognitive impairment
Inflammation
Oxidative stress
Radiation-induced
Vinpocetine
Journal
Pharmacology
ISSN: 1423-0313
Titre abrégé: Pharmacology
Pays: Switzerland
ID NLM: 0152016
Informations de publication
Date de publication:
2021
2021
Historique:
received:
26
11
2019
accepted:
24
02
2020
pubmed:
16
4
2020
medline:
23
3
2021
entrez:
16
4
2020
Statut:
ppublish
Résumé
Nasopharyngeal carcinoma (NPC) originates in the nasopharyngeal epithelium. The most common treatments for NPC rT1-4 are radiotherapy and surgery. The pathogenesis of radiation-induced cognitive impairment is complex and includes oxidative stress, mitochondrial dysfunction, neuro-inflammation, and even apoptosis and cell death. Principally, toll-like receptors (TLRs) could regulate the inflammatory/anti-inflammatory balance in patients with radiation-induced brain injury. Vinpocetine has an anti-inflammatory effect as shown in both animal and in vitro studies. Also, dexamethasone is a widely used anti-inflammatory drug. Thus, it is important to test whether addition of vinpocetine could improve the anti-inflammatory properties of dexamethasone for the treatment of NPC patients with radiation-induced brain injuries. A total of 60 NPC patients with radiation-related brain injury were recruited for this study. All subjects were randomly and blindly assigned to the following groups: the dexamethasone group (D group, n = 30) and the vinpocetine and dexamethasone group (VD group, n = 30). Both medicine treatments were uninterrupted for 14 days of administration. Combined administration of vinpocetine and dexamethasone lowered the expression levels of serum inflammatory cytokines, including TLR2, TLR4, interleukin (IL)-20, IL-8, tumor necrosis factor-α, interferon-γ, monocyte chemoattractant protein 2, and interferon-induced protein 20, when compared to dexamethasone monotherapy. Notably, combination therapy increased antioxidants (superoxide dismutase, glutathione, glutathione peroxidase, and glutathione reductase) and decreased oxidants (thiobarbituric acid reactive substances). Furthermore, combination therapy significantly increased the Mini Mental State Examination score, when compared to dexamethasone monotherapy. Administration of a combination of vinpocetine and dexamethasone may enhance the anti-inflammatory and anti-oxidative effects when compared to dexamethasone monotherapy, which leads to alleviated cognitive impairment in NPC patients with radiation injury.
Sections du résumé
BACKGROUND
BACKGROUND
Nasopharyngeal carcinoma (NPC) originates in the nasopharyngeal epithelium. The most common treatments for NPC rT1-4 are radiotherapy and surgery. The pathogenesis of radiation-induced cognitive impairment is complex and includes oxidative stress, mitochondrial dysfunction, neuro-inflammation, and even apoptosis and cell death. Principally, toll-like receptors (TLRs) could regulate the inflammatory/anti-inflammatory balance in patients with radiation-induced brain injury. Vinpocetine has an anti-inflammatory effect as shown in both animal and in vitro studies. Also, dexamethasone is a widely used anti-inflammatory drug. Thus, it is important to test whether addition of vinpocetine could improve the anti-inflammatory properties of dexamethasone for the treatment of NPC patients with radiation-induced brain injuries.
METHODS
METHODS
A total of 60 NPC patients with radiation-related brain injury were recruited for this study. All subjects were randomly and blindly assigned to the following groups: the dexamethasone group (D group, n = 30) and the vinpocetine and dexamethasone group (VD group, n = 30). Both medicine treatments were uninterrupted for 14 days of administration.
RESULTS
RESULTS
Combined administration of vinpocetine and dexamethasone lowered the expression levels of serum inflammatory cytokines, including TLR2, TLR4, interleukin (IL)-20, IL-8, tumor necrosis factor-α, interferon-γ, monocyte chemoattractant protein 2, and interferon-induced protein 20, when compared to dexamethasone monotherapy. Notably, combination therapy increased antioxidants (superoxide dismutase, glutathione, glutathione peroxidase, and glutathione reductase) and decreased oxidants (thiobarbituric acid reactive substances). Furthermore, combination therapy significantly increased the Mini Mental State Examination score, when compared to dexamethasone monotherapy.
CONCLUSION
CONCLUSIONS
Administration of a combination of vinpocetine and dexamethasone may enhance the anti-inflammatory and anti-oxidative effects when compared to dexamethasone monotherapy, which leads to alleviated cognitive impairment in NPC patients with radiation injury.
Identifiants
pubmed: 32294652
pii: 000506777
doi: 10.1159/000506777
doi:
Substances chimiques
Anti-Inflammatory Agents
0
Antioxidants
0
Cytokines
0
Oxidants
0
Toll-Like Receptors
0
Vinca Alkaloids
0
vinpocetine
543512OBTC
Dexamethasone
7S5I7G3JQL
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
37-44Informations de copyright
© 2020 S. Karger AG, Basel.