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CHAPTER 26. ANTI-INFLAMMATORY DRUGS

Inflammation is a universal response of the body to the influence of various exogenic and endogenous damaging factors, for example bacterial, viral, parasitic infections as well as allergens, physical and chemical stimuli. They cause both local and systemic (generalized) reactions. Inflammatory reactions occur in many pathological conditions of infectious and non-infectious aetiology; they may be very severe, leading to organs and tissue function disturbances. Therefore, it is obvious that, besides etiotropic therapy (if it is available), proper management of the inflammatory process is of great practical importance. Nowadays anti-inflammatory agents are the integral components of pharmacotherapy of quite a few diseases and pathological conditions.

Inflammation is a complex process regulated by a number of endogenous substances. Endogenous substances are produced by various cells participating in inflammation (mast cells, polymorphonuclear leukocytes, monocytes/macrophages, endothelial cells, platelets). They secrete such biologically active substances as prostanoids, leukotrienes, NO, platelet activating factor (PAF1), histamine, some interleukins, etc.2 Therefore, there are many ways to regulate inflammation pharmacologically. Usually they are aimed at the suppression of the production and release of the substances stimulating the inflammatory process.

From the point of view of developing anti-inflammatory drugs, agents that influence the formation of biologically active substances from membrane phospholipids of the cells participating in the inflammatory process deserve special

1 Biologically active lipid. It is formed under the influence of phospholipase A2 from phospholipids in many cells participating in the inflammatory process (in platelets, neutrophils, monocytes, mast cells, eosinophils, in the kidneys and endothelium). It is related to inflammation mediators. It also participates in the development of allergic reactions. It has a vasodilating effect, increases vascular permeability, causes leukocyte chemotaxis, activates leukocytes, enhances platelet aggregation and causes smooth muscle contraction.

2 Such substances are called inflammatory mediators.

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