Felix Hoffman synthesized acetylsalicylic acid in 1897, which was the first nonsteroidal anti-inflammatory drug (NSAID) (
31). Nowadays, NSAIDs are among the most commonly used drugs worldwide and their analgesic, anti-inflammatory and anti-pyretic therapeutic properties are thoroughly accepted. More than 30 million people use NSAIDs every day, and they account for 60% of the US over-the-counter analgesic market (
32). AEE is being developed for anti-inflammatory, analgesic, antipyretic, anti-atherosclerosis and anti-thrombosis pharmaceutical. Metabolites of AEE
in-vivo and
in-vitro have been confirmed by HPLC-MS/MS (
26). Five metabolites of AEE were detected in the experimental condition, including salicylic acid, salicylic acid glucuronide, salicylic acid glycine, eugenol glucuronide and eugenol sulfate. Previous studies showed that the effect of AEE is similar to aspirin and eugenol but last for long time, which indicated that AEE could be a promising NSAID candidate (
21). Due to the significant efficacy against inflammation, the action mechanism of AEE is necessary to be understood. In this study, STITCH database and ELISA method were used to measure the concentration changes of five proteins which are related to inflammation and thrombosis processes.
The primary anti-inflammatory effects of NSAIDs is competitive inhibition of cyclooxygenases (COX) 1 and 2 which catalyze the rate-limiting conversion of arachidonic acid to the pro- and anti-inflammatory prostaglandins and thromboxanes. COX-1 and COX-2 convert arachidonic acid to prostaglandin H2 (PGH2), a committed step in prostanoid synthesis. COX-2 is responsible for production of inflammatory prostaglandins, which could be induced by inflammatory stimuli (
33). COX-1 plays a major role in the generation of prostaglandins in gastric epithelial cells, such as prostaglandin E2 (PGE2), which plays an important role in cytoprotection (
34). CRP displays several functions associated with host defense and be treated as a maker of inflammation (
35). FII converts fibrinogen to fibrin and activates factors V, VII, VIII, XIII and functions in blood homeostasis, inflammation and wound healing (
36). ALOX5 catalyzes the first step in leukotriene biosynthesis, and thereby plays a role in inflammatory processes.
After strictly biological and toxicological research and test, pure CMC had been approved as food additive by (WHO) and (FAO). CMC has found wide applications in the pharmaceutical industry as a reliable carrier of drug (
37,
38). In this study, the effect of CMC-Na was eliminated by administrating CMC-Na to control group. Therefore, it manifests that the effect of AEE is not related to CMC-Na. Tween-80 is widely used as emulsifier in food industry and drug production. In general, the body has a great tolerance to Tween-80 (
39) but the biological potency of Tween-80 on target protein in this experiment is not investigated.
Compared with AEE groups, the ALOX5 values of integration of aspirin and eugenol group did not show statistical differences. This indicated that AEE may have similar effect to integration of aspirin and eugenol at molar ratio 1:1. The COX-1 and COX-2 values in AEE groups decreased with the increase of AEE dose. This change trend may result from the dose changes of salicylic acid and eugenol from enzymolysis of AEE which is crucial for inhibition of COX-1 and COX-2 (
26). The COX-1 and COX-2 values in eugenol group were significantly lower than the values in CMC-Na group, which indicated that eugenol had influence in COX-1 and COX-2 and also showed positive impact on inflammation. However, the effect of aspirin on COX-1 and COX-2 was stronger than eugenol.
The CRP concentration of rats in low-, medium- and high-dose groups did not have great differences. However, its concentration was decreased compared to CMC-Na, eugenol, and aspirin groups. The reduction of CRP in AEE groups may be caused by synergistic effect of aspirin and eugenol. In addition, CRP concentration in the high-dose AEE group was higher than low- and medium-group, which may be caused by the side effects of salicylic acid from hydrolysis of AEE (
26). The concentration change of FII in AEE groups appeared dose-dependent relationship and showed significant differences in comparison with CMC-Na and eugenol groups. The results in CMC-Na and eugenol groups were very close, which may indicate that eugenol have little or no effect on FII. There were statistical differences among aspirin, medium-dose AEE and integration of aspirin and eugenol three groups (same molar quantity). The differences in three groups may be from eugenol which increased the effect of aspirin on FII.
Like many other drugs, NSAIDs are associated with a broad spectrum of side effects, including gastrointestinal and cardiovascular events, renal toxicity, increased blood pressure, and deterioration of congestive heart failure. The side effects of AEE were not evaluated in this experiment. More studies are necessary to investigate on drug action of AEE such as side effects, aspirin-eugenol interactions, and clinical use.
From the results of the experiment, the concentrations of all key endogenic bioactive enzymes were reduced in AEE groups, which indicated that AEE had positive effects on anti-inflammation and anti-thrombosis. From the view of chemical-protein interactions, the results showed that AEE had stronger effects than aspirin and eugenol. Meanwhile, the effect difference between medium-dose and high-dose AEE groups was not significant. Therefore, it may be suggested that the clinical use dose of AEE is 100 mg/kg. In the present study, it is possible to conclude that AEE is a good candidate for the development of new anti-inflammatory NSAIDs. At the same time, these findings lay the groundwork for further pharmacological and clinical studies.
The study provides the first evidence that AEE is an effective COX inhibitor. AEE can significantly reduce the concentrations of CRP, ALOX5, COX-1, COX-2, and FII, which show better effects than that of aspirin and eugenol. Therefore, AEE could be a potential candidate for the treatment of inflammation as a new NSAID. Further studies of its clinical use and drug effects are necessary.