Impact of Different Doses of Nicorandil-Induced Ulceration (Oral , Gastrointestinal Tract, and Anal) in Rats: Roles of Leptin and Prostaglandin E2

Many reports confirm ulcers as an adverse effect of drugs such as nicorandil and aspirin. The exact responsible mechanisms of ulceration have until now not proved. Mucosal ulcers associated with the onset of ulcer are manifested by an increase in proinflammatory cytokine, excessive prostaglandin, and up-regulation of Endothilin-1 level, which directly impacts the release of leptin. These, released locally within mucosal tissues, have played a role in controlling the extent of local inflammatory responses and processes of mucosal repair. This study was designed to find out the correlation of plasma leptin and prostaglandin levels as a possible mechanism of oral ulcer formation as an adverse effect of nicorandil. The effect of nicorandil for inducing ulceration was assessed. The plasma leptin and prostaglandin E2 for the tested groups in relation to the studied parameters (gender, and daily body weight change) were estimated in albino rats. Nicorandil causes mucous membrane damage, inflammation, and ulceration. A significant reduction of plasma leptin level, which was dose-dependent, and a non-significant reduction of serum prostaglandin E2 level. The mechanisms of ulcer induction as an adverse effect of nicorandil can be related to dose-dependant leptin and prostaglandin E2 levels, which affects on repair and healing process. Keywords: Nicorandil, Leptin, Prostaglandin E2, Ulcer

The Efficacy of Topically Applied Silymarin in the Treatment of Herpes Labialis Ulcers

Herpes labialis is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums, or the skin around the mouth. Although there is no successful treatment available, the local use of compounds with effective anti-inflammatory and cytoprotective effects may be of value in this respect. This project was designed to evaluate clinically the local use of silymarin, a group of flavonoids with powerful antioxidant, anti-inflammatory and cytoprotective activity, in the treatment of herpes simplex ulcer. Fifty three patients with herpes labialis ulcers (HLU) were enrolled in this randomized, single blinded, placebo controlled clinical study, and they were allocated into 4 groups, treated with 1%, 3% and 5% silymarin paste and placebo formula respectively. Patient's responses to treatment were followed by clinical evaluation of healing time, size of the ulcers and pain sensation, in addition to evaluating biochemical and immunological markers of the oxidative stress and inflammatory response. HLU patients showed dose dependent improvement in the healing time, pain score and size of ulcer as a result of treatment with various concentrations (1%, 3% and 5%) of silymarin paste, associated with improvement in the oxidative stress state and immunological parameters. In conclusion, silymarin can be used locally as paste formula for the treatment of HLU, an effect which may be attributed to its antioxidant, anti-inflammatory and cytoprotective properties. Keywords: Herpes labialis, ulcers, silymari