Abstract

Background: Prostaglandin E₂ (PGE₂) plays key physiological roles within the body’s organs and the systemic environment. Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the biosynthesis of PGE₂, which can lead to global PGE₂ deficiency, resulting in serious side effects in the gastrointestinal, renal and other systems. In contrast, various pyridine derivatives have been found to increase endogenous PGE₂ levels within multiple organs and the systemic environment. We hypothesised that the use of pyridine derivatives (nicotinic acid, nicotine, niceritrol, nicotinyl alcohol, pyridinol carbamate, pyridoxine hydrochloride and pyridostigmine bromide) can recover PGE₂ levels during NSAID treatment. Methods: Reassessment of experimental data on PGE₂ levels in NSAIDs and pyridine derivatives treatment, and in controls from previously published, independent studies. Results: Overall, in all our investigations P values for unpaired or pair-wise comparisons were not statistically significant. Conclusions: We demonstrated that using pyridine derivatives along with NSAIDs, such as nonselective cyclooxygenase (COX) and selective COX-2 inhibitors, does not reduce endogenous PGE₂ expression to below basal levels. This finding is based on both in vitro studies using animal and human tissues and in vivo studies performed with healthy volunteers. Using pyridine derivatives to correct a PGE₂ deficiency during NSAID treatment is a novel method that we propose can offer a valuable, cost-effective therapeutic approach to preventing and treating the side effects of NSAIDs.

Keywords: Anti-inflammatory agents, drug development, drug interactions, drug side effects, non-steroidal anti-inflammatory drugs, prostaglandin E2, pyridine derivatives.

Graphical Abstract