In malaria, PCT levels are elevated in both severe and uncomplicated Plasmodium falciparum malaria, but how useful is this inflammatory test in VL [ 4]?
Maybe in this disease we have not evaluated an inflammatory test like C-reactive protein or procalcitonin to be convicted if higher than the normal value, but we think we need to start a study about markers of sepsis in this systemic parasitic disease, because our opinion is that VL is a SIRS plus parasitic systemic infection - which does mean sepsis.
Nevertheless, the anti-inflammatory activity was tested in carrageenan induced paw edema and histamine induced inflammatory tests.
Biological: severe pancytopenia (WBC = 700/mmc, Hb = 8.2 g/dl, platelets = 34.000/mmc), coagulation disorders, nitrogen retention syndrome, hypoalbuminemia, hepatic cytolysis syndrome, procalcitonin and inflammatory tests intensely positive.
The 414 patients with LDIE were analyzed for the following factors: primary indication for TLE, duration of symptoms until diagnosis, most frequent clinical symptoms (fever, shivers, pulmonary infections), antibiotic therapy, transthoracic echocardiography (TTE) showing the most frequent location of vegetations, and microbiological and inflammatory tests.
Assessment criteria included the evaluation of: age at onset (years), diagnosis delay (months), disease duration (years), disease activity (evaluated by physical examination, biological inflammatory tests; and disease activity score (DAS 28)), pain intensity (measured with a visual analogue scale (VAS)); and radiographic damage (evaluated by the Sharp's method as modified by van der Heijde).
On the anti-inflammatory test, compound 4a inhibited the edema up to 87%, while 4d & 10b achieved significant inflammation inhibition at a lower effective dose 50 (ED50) than ibuprofen´s.
Consistently, 12a was the most active with all the other anti-inflammatory test descriptors and its activity in diminishing the PGE2 with the other analogs confirmed the elaboration of new class of selective COX-2 inhibitors beyond the diarylsulfonamides as a previously common class of selective COX-2 inhibitors.
Finally in vitro anti-inflammatory test by protein-denaturation method was followed.
In in-vitro anti-inflammatory test, the extract significantly inhibited protein denaturation of 77.15, 64.43, 53.04, 36.78 and 23.70% for doses of 500, 400, 300, 200 and 100 μg/mL respectively.
In the present study for in vitro anti-inflammatory test, the ethanol extract, of C.zedoaria showed mean inhibition of protein denaturation of 77.15, 64.43, 53.04, 36.78 and 23.70% for doses of 500, 400, 300, 200 and 100 μg/mL respectively, whereas, for ASA it was found to be 88.06, 80.25, 77.18, 69.58 and 50.56% for same doses respectively (Table 9 & Figure 12).
