Effects of intravenous administration of pirfenidone on horses with experimentally induced endotoxemia

Amy E. Poulin Braim Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Melinda H. MacDonald Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Michael L. Bruss Department of Anatomy, Physiology, and Cell Biology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Ken J. Grattendick Solanan Inc, 11034 Shady Trail, Ste 108, Dallas, TX 75229 and Marnac Inc, 9400 N Central Expressway, Ste 305, Dallas, TX 75231.

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Shri N. Giri Solanan Inc, 11034 Shady Trail, Ste 108, Dallas, TX 75229 and Marnac Inc, 9400 N Central Expressway, Ste 305, Dallas, TX 75231.

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Solomon B. Margolin Solanan Inc, 11034 Shady Trail, Ste 108, Dallas, TX 75229 and Marnac Inc, 9400 N Central Expressway, Ste 305, Dallas, TX 75231.

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Abstract

Objective—To characterize effects of IV administration of pirfenidone on clinical, biochemical, and hematologic variables and circulating tumor necrosis factor (TNF)-α concentrations in horses after infusion of a low dose of endotoxin.

Animals—18 healthy adult horses.

Procedures—Horses were randomly assigned to 3 groups (n = 6 horses/group) and administered an IV infusion of 30 ng of endotoxin/kg or saline (0.9% NaCl) solution during a 30-minute period. Lipopolysaccharide-pirfenidone horses received endotoxin followed by pirfenidone (loading dose of 11.6 mg/kg and then constant rate infusion [CRI] at 9.9 mg/kg/h for 3 hours). Lipopolysaccharide-saline horses received endotoxin followed by infusion (loading dose and CRI for 3 hours) of saline solution. Saline-pirfenidone horses received saline solution followed by pirfenidone (loading dose and then CRI for 3 hours). Physical examination variables were recorded and blood samples collected at predetermined intervals throughout the 24-hour study period. Blood samples were used for CBCs, biochemical analyses, and determinations of TNF-α concentrations.

Results—IV infusion of pirfenidone after administration of a low dose of endotoxin failed to attenuate the clinical, clinicopathologic, or cytokine alterations that developed secondary to endotoxin exposure. Intravenous infusion of pirfenidone after administration of saline solution induced mild transient clinical signs, but associated clinicopathologic changes were not detected.

Conclusions and Clinical Relevance—IV administration of pirfenidone was tolerated with only mild transient clinical adverse effects during infusion. However, administration of pirfenidone did not protect horses from the systemic effects of experimentally induced endotoxemia. Further studies of related, but more potent, drugs may be warranted.

Abstract

Objective—To characterize effects of IV administration of pirfenidone on clinical, biochemical, and hematologic variables and circulating tumor necrosis factor (TNF)-α concentrations in horses after infusion of a low dose of endotoxin.

Animals—18 healthy adult horses.

Procedures—Horses were randomly assigned to 3 groups (n = 6 horses/group) and administered an IV infusion of 30 ng of endotoxin/kg or saline (0.9% NaCl) solution during a 30-minute period. Lipopolysaccharide-pirfenidone horses received endotoxin followed by pirfenidone (loading dose of 11.6 mg/kg and then constant rate infusion [CRI] at 9.9 mg/kg/h for 3 hours). Lipopolysaccharide-saline horses received endotoxin followed by infusion (loading dose and CRI for 3 hours) of saline solution. Saline-pirfenidone horses received saline solution followed by pirfenidone (loading dose and then CRI for 3 hours). Physical examination variables were recorded and blood samples collected at predetermined intervals throughout the 24-hour study period. Blood samples were used for CBCs, biochemical analyses, and determinations of TNF-α concentrations.

Results—IV infusion of pirfenidone after administration of a low dose of endotoxin failed to attenuate the clinical, clinicopathologic, or cytokine alterations that developed secondary to endotoxin exposure. Intravenous infusion of pirfenidone after administration of saline solution induced mild transient clinical signs, but associated clinicopathologic changes were not detected.

Conclusions and Clinical Relevance—IV administration of pirfenidone was tolerated with only mild transient clinical adverse effects during infusion. However, administration of pirfenidone did not protect horses from the systemic effects of experimentally induced endotoxemia. Further studies of related, but more potent, drugs may be warranted.

Contributor Notes

The study was performed at the Veterinary Medical Teaching Hospital of the University of California, Davis, Calif; and at Marnac Inc, Dallas, Tex.

Supported by the Center for Equine Health with funds provided by the Oak Tree Racing Association, the State of California pari-mutuel fund, and contributions by private donors; and by Marnac Incorporated.

The authors thank Dr. Phil Kass for assistance with statistical analysis and Mai Mok, Jackie Hill, Jennifer Jeske, and Nicole Fawns for assistance with data acquisition.

Address correspondence to Dr. MacDonald.
  • 1.

    Werners AH, Bull S, Fink-Gremmels J. Endotoxaemia: a review with implications for the horse. Equine Vet J 2005;37:371383.

  • 2.

    Sykes BW, Furr MO. Equine endotoxaemia—a state-of-the-art review of therapy. Aust Vet J 2005;83:4550.

  • 3.

    Moore JN, Barton MH. Treatment of endotoxemia. Vet Clin North Am Equine Pract 2003;19:681695.

  • 4.

    Morris DD. Endotoxemia in horses. A review of cellular and humoral mediators involved in its pathogenesis. J Vet Intern Med 1991;5:167181.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Morris DD, Crowe N, Moore JN. Correlation of clinical and laboratory data with serum tumor necrosis factor activity in horses with experimentally induced endotoxemia. Am J Vet Res 1990;51:19351940.

    • Search Google Scholar
    • Export Citation
  • 6.

    Lorente JA, Marshall JC. Neutralization of tumor necrosis factor in preclinical models of sepsis. Shock 2005;24(suppl 1):107119.

  • 7.

    Barton MH, Collatos C. Tumor necrosis factor and interleukin-6 activity and endotoxin concentration in peritoneal fluid and blood of horses with acute abdominal disease. J Vet Intern Med 1999;13:457464.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Morris DD, Moore JN. Tumor necrosis factor activity in serum from neonatal foals with presumed septicemia. J Am Vet Med Assoc 1991;199:15841589.

    • Search Google Scholar
    • Export Citation
  • 9.

    Morris DD, Moore JN, Crowe N. Serum tumor necrosis factor activity in horses with colic attributable to gastrointestinal tract disease. Am J Vet Res 1991;52:15651569.

    • Search Google Scholar
    • Export Citation
  • 10.

    MacKay RJ, Merritt AM, Zertuche JM, et al. Tumor necrosis factor activity in the circulation of horses given endotoxin. Am J Vet Res 1991;52:533538.

    • Search Google Scholar
    • Export Citation
  • 11.

    Kelmer G, Doherty TJ, Elliott S, et al. Evaluation of dimethyl sulphoxide effects on initial response to endotoxin in the horse. Equine Vet J 2008;40:358363.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Moore JN, Norton N, Barton MH, et al. Rapid infusion of a phospholipid emulsion attenuates the effects of endotoxaemia in horses. Equine Vet J 2007;39:243248.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Morresey PR, MacKay RJ. Endotoxin-neutralizing activity of polymyxin B in blood after IV administration in horses. Am J Vet Res 2006;67:642647.

  • 14.

    Barton MH, Parviainen A, Norton N. Polymyxin B protects horses against induced endotoxaemia in vivo. Equine Vet J 2004;36:397401.

  • 15.

    Tetens J, Moore RM, Hosgood GL, et al. Effects of infusion of adenosine triphosphate-magnesium chloride on cardiopulmonary and clinicopathologic variables, cytokine activity, and endothelin concentration in horses administered a low dose of endotoxin. Am J Vet Res 2004;65:225237.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Longworth KE, Smith BL, Staub NC, et al. Use of detergent to prevent initial responses to endotoxin in horses. Am J Vet Res 1996;57:10631066.

    • Search Google Scholar
    • Export Citation
  • 17.

    Figueiredo MD, Moore JN, Vandenplas ML, et al. Effects of the second-generation synthetic lipid A analogue E5564 on responses to endotoxin in equine whole blood and monocytes [Erratum published in Am J Vet Res 2008;69:1021]. Am J Vet Res 2008;69:796803.

    • Search Google Scholar
    • Export Citation
  • 18.

    Sun WC, Moore JN, Hurley DJ, et al. Adenosine A2A receptor agonists inhibit lipopolysaccharide-induced production of tumor necrosis factor-alpha by equine monocytes. Vet Immunol Immunopathol 2008;121:91100.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Barton MH, Bruce EH, Moore JN, et al. Effect of tumor necrosis factor antibody given to horses during early experimentally induced endotoxemia. Am J Vet Res 1998;59:792797.

    • Search Google Scholar
    • Export Citation
  • 20.

    Cargile JL, MacKay RJ, Dankert JR, et al. Effect of treatment with a monoclonal antibody against equine tumor necrosis factor (TNF) on clinical, hematologic, and circulating TNF responses of miniature horses given endotoxin. Am J Vet Res 1995;56:14511459.

    • Search Google Scholar
    • Export Citation
  • 21.

    Cargile JL, MacKay RJ, Dankert JR, et al. Effects of tumor necrosis factor blockade on interleukin 6, lactate, thromboxane, and prostacyclin responses in miniature horses given endotoxin. Am J Vet Res 1995;56:14451450.

    • Search Google Scholar
    • Export Citation
  • 22.

    Bruss ML, Stanley SD, Margolin SB, et al. Pharmacokinetics and metabolism of intravenous pirfenidone in sheep. Biopharm Drug Dispos 2008;29:119126.

  • 23.

    Balamugesh T, Behera D. Idiopathic pulmonary fibrosis. J Assoc Physicians India 2007;55:363370.

  • 24.

    Cho ME, Smith DC, Branton MH, et al. Pirfenidone slows renal function decline in patients with focal segmental glomerulosclerosis. Clin J Am Soc Nephrol 2007;2:906913.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Burton JM, O'Connor P. Novel oral agents for multiple sclerosis. Curr Neurol Neurosci Rep 2007;7:223230.

  • 26.

    Babovic-Vuksanovic D, Ballman K, Michels V, et al. Phase II trial of pirfenidone in adults with neurofibromatosis type 1. Neurology 2006;67:18601862.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Antoniu SA. Pirfenidone for the treatment of idiopathic pulmonary fibrosis. Expert Opin Investig Drugs 2006;15:823828.

  • 28.

    Antoniu SA. Pirfenidone for the treatment of idiopathic pulmonary fibrosis: therapeutic potential prompts further investigation. Expert Opin Investig Drugs 2005;14:14431447.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Wang F, Wen T, Chen XY, et al. Protective effects of pirfenidone on D-galactosamine and lipopolysaccharide-induced acute hepatotoxicity in rats. Inflamm Res 2008;57:183188.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Dosanjh A. Pirfenidone: a novel potential therapeutic agent in the management of chronic allograft rejection. Transplant Proc 2007;39:21532156.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Pesce E, Struma E, Giri SN, et al. Antirheumatic effect of pirfenidone in a double blind clinical pilot trial in humans. Res Commun Mol Pathol Pharmacol 2004;115–116:3948.

    • Search Google Scholar
    • Export Citation
  • 32.

    Di Sario A, Bendia E, Svegliati Baroni G, et al. Effect of pirfenidone on rat hepatic stellate cell proliferation and collagen production. J Hepatol 2002;37:584591.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Hale ML, Margolin SB, Krakauer T, et al. Pirfenidone blocks the in vitro and in vivo effects of staphylococcal enterotoxin B. Infect Immun 2002;70:29892994.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Kaibori M, Yanagida H, Yokoigawa N, et al. Effects of pirfenidone on endotoxin-induced liver injury after partial hepatectomy in rats. Transplant Proc 2004;36:19751976.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Kaibori M, Yanagida H, Uchida Y, et al. Pirfenidone protects endotoxin-induced liver injury after hepatic ischemia in rats. Transplant Proc 2004;36:19731974.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Tsuchiya H, Kaibori M, Yanagida H, et al. Pirfenidone prevents endotoxin-induced liver injury after partial hepatectomy in rats. J Hepatol 2004;40:94101.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Spond J, Case N, Chapman RW, et al. Inhibition of experimental acute pulmonary inflammation by pirfenidone. Pulm Pharmacol Ther 2003;16:207214.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Giri SN, Wang Q, Xie Y, et al. Pharmacokinetics and metabolism of a novel antifibrotic drug pirfenidone, in mice following intravenous administration. Biopharm Drug Dispos 2002;23:203211.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Oku H, Nakazato H, Horikawa T, et al. Pirfenidone suppresses tumor necrosis factor-alpha, enhances interleukin-10 and protects mice from endotoxic shock. Eur J Pharmacol 2002;446:167176.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Corbel M, Lanchou J, Germain N, et al. Modulation of airway remodeling-associated mediators by the antifibrotic compound, pirfenidone, and the matrix metalloproteinase inhibitor, batimastat, during acute lung injury in mice. Eur J Pharmacol 2001;426:113121.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    Cain WC, Stuart RW, Lefkowitz DL, et al. Inhibition of tumor necrosis factor and subsequent endotoxin shock by pirfenidone. Int J Immunopharmacol 1998;20:685695.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    Grattendick KJ, Nakashima JM, Feng L, et al. Effects of three anti-TNF-αlpha drugs: etanercept, infliximab and pirfenidone on release of TNF-αlpha in medium and TNF-αlpha associated with the cell in vitro. Int Immunopharmacol 2008;8:679687.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43.

    Arumugam TV, Shiels IA, Margolin SB, et al. Pirfenidone attenuates ischaemia-reperfusion injury in the rat small intestine. Clin Exp Pharmacol Physiol 2002;29:9961000.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44.

    Nakazato H, Oku H, Yamane S, et al. A novel anti-fibrotic agent pirfenidone suppresses tumor necrosis factor-alpha at the translational level. Eur J Pharmacol 2002;446:177185.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45.

    Mitani Y, Sato K, Muramoto Y, et al. Superoxide scavenging activity of pirfenidone-iron complex. Biochem Biophys Res Commun 2008;372:1923.

  • 46.

    Benton HP, Esquivel AV, Rice AD, et al. Modulation of articular chondrocyte activity by pirfenidone. Res Commun Mol Pathol Pharmacol 2003;113–114:275288.

    • Search Google Scholar
    • Export Citation
  • 47.

    Nakanishi H, Kaibori M, Teshima S, et al. Pirfenidone inhibits the induction of iNOS stimulated by interleukin-1beta at a step of NF-kappaB DNA binding in hepatocytes. J Hepatol 2004;41:730736.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 48.

    Giri SN, Leonard S, Shi X, et al. Effects of pirfenidone on the generation of reactive oxygen species in vitro. J Environ Pathol Toxicol Oncol 1999;18:169177.

    • Search Google Scholar
    • Export Citation
  • 49.

    Misra HP, Rabideau C. Pirfenidone inhibits NADPH-dependent microsomal lipid peroxidation and scavenges hydroxyl radicals. Mol Cell Biochem 2000;204:119126.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 50.

    Braim AE, MacDonald MH, Bruss ML, et al. Pharmacokinetics and clinical effects of pirfenidone administered intravenously in horses. Am J Vet Res 2008;69:952960.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 51.

    Giri SN, Margolin SB. Effects of topical application of pirfenidone ointment on thermoplasty-induced acute lameness in a double-blind and acute and chronic lameness of musculoskeletal origin in an open multi-centered field trial in horses. Res Commun Mol Pathol Pharmacol 2005;117–118:4763.

    • Search Google Scholar
    • Export Citation
  • 52.

    Thomas JS. Overview of plasma proteins. In: Feldman BF, Zinkle JG, Jain NC, eds. Schalm's veterinary hematology. 5th ed. Philadelphia: Lippincott, William & Wilkins, 2000;891898.

    • Search Google Scholar
    • Export Citation
  • 53.

    Morgan CD, Mills KC, Lefkowitz DL, et al. An improved colorimetric assay for tumor necrosis factor using WEHI 164 cells cultured on novel microtiter plates. J Immunol Methods 1991;145:259262.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 54.

    Bruss ML, Margolin SB, Giri SN. Pharmacokinetics of orally administered pirfenidone in male and female beagles. J Vet Pharmacol Ther 2004;27:361367.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 55.

    Mansoor JK, Decile KC, Giri SN, et al. Influence of pirfenidone on airway hyperresponsiveness and inflammation in a Brown-Norway rat model of asthma. Pulm Pharmacol Ther 2007;20:660668.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 56.

    Iyer SN, Wild JS, Schiedt MJ, et al. Dietary intake of pirfenidone ameliorates bleomycin-induced lung fibrosis in hamsters. J Lab Clin Med 1995;125:779785.

    • Search Google Scholar
    • Export Citation
  • 57.

    Azuma A, Nukiwa T, Tsuboi T, et al. Double-blind, placebo-controlled trial of pirfenidone in patients with idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2005;171:10401047.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 58.

    Kaneko M, Inoue H, Nakazawa R, et al. Pirfenidone induces intercellular adhesion molecule-1 (ICAM-1) down-regulation on cultured human synovial fibroblasts. Clin Exp Immunol 1998;113:7276.

    • Search Google Scholar
    • Export Citation
  • 59.

    Opal SM, Yu RI. Antiendotoxin strategies for the prevention and treatment of septic shock. New approaches and future directions. Drugs 1998;55:497508.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 60.

    Ammar YA, Ismail MM, El-Sehrawi HM, et al. Novel pirfenidone analogues: synthesis of pyridin-2-ones for the treatment of pulmonary fibrosis. Arch Pharm Chem (Kbh) 2006;339:429436.

    • Crossref
    • Search Google Scholar
    • Export Citation

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