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Published in: Inflammation Research 5/2011

01-05-2011 | Original Research Paper

Evaluation of antioxidative and anti-inflammatory potential of hesperidin and naringin on the rat air pouch model of inflammation

Authors: Mandipika Jain, Hamendra Singh Parmar

Published in: Inflammation Research | Issue 5/2011

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Abstract

Background

Anti-inflammatory and antioxidative potential of hesperidin and naringin was carried out considering the rat air pouch model of inflammation.

Methods

Reference dose of hesperidin (H) or naringin (N) or indomethacin (I) was administered to the rat air pouches. The pouches were induced by injecting sterile air into the intra-scapular region of the rats followed by carrageenan (AP + C) administration. Rats injected only with air (AP) served as controls.

Results

The AP + C group, showed an increase in the exudate lipid peroxidation (LPO), reduced glutathione (GSH), TNF-α, activity of catalase (CAT), total leukocytes and neutrophils along with tissue edema and infiltration of inflammatory cells. Increases in tissue nitrite, LPO, GSH, SOD (superoxide dismutase) and CAT were recorded. Increased CAT and SGPT with concomitant decrease in ALP were observed in serum. When treated with indomethacin (AP + C + I), all the alterations in the exudate, tissue and serum shifted towards normalcy, except LPO in exudate and nitrite in tissue, while, hesperidin (AP + C + H) or naringin (AP + C + N) treatment normalized all the alterations.

Conclusion

It seems that both naringin and hesperidin are anti-inflammatory and antioxidative in nature, but hesperidin proved to be better than indomethacin and naringin because of more pronounced pharmacological actions without tissue toxicity.
Literature
1.
go back to reference Jeon SM, Bok SH, Jang MK, Lee MK, Nam KT, Park YB, Rhee SJ, Choi MS. Antioxidative activity of naringin and lovastin in high cholesterol-fed rabbits. Life Sci. 2001;69(24):2855–66.PubMedCrossRef Jeon SM, Bok SH, Jang MK, Lee MK, Nam KT, Park YB, Rhee SJ, Choi MS. Antioxidative activity of naringin and lovastin in high cholesterol-fed rabbits. Life Sci. 2001;69(24):2855–66.PubMedCrossRef
2.
go back to reference Jeon SM, Bok SH, Jang MK, Lee MK, Nam KT, Jeong TS, Park YB, Choi MS. Comparison of naringin and probucol in cholesterol-fed rabbits. Clin Chem Acta. 2002;317(1–2):181–90.CrossRef Jeon SM, Bok SH, Jang MK, Lee MK, Nam KT, Jeong TS, Park YB, Choi MS. Comparison of naringin and probucol in cholesterol-fed rabbits. Clin Chem Acta. 2002;317(1–2):181–90.CrossRef
3.
go back to reference Jeon SM, Park YB, Choi MS. Antihypercholesterolemic property of naringin alters plasma and tissue lipids, cholesterol-regulating enzymes, fecal sterol and tissue morphology in rabbits. Clin Nutr. 2004;23(5):1025–34.PubMedCrossRef Jeon SM, Park YB, Choi MS. Antihypercholesterolemic property of naringin alters plasma and tissue lipids, cholesterol-regulating enzymes, fecal sterol and tissue morphology in rabbits. Clin Nutr. 2004;23(5):1025–34.PubMedCrossRef
4.
go back to reference Chen MC, Ye YY, Ji G, Liu JW. Hesperidin upregulates heme oxyenase-1 to attenuate hydrogen peroxide-induced cell damage in hepatic L02 cells. J Agric Food Chem. 2010;58(6):3330–5.PubMedCrossRef Chen MC, Ye YY, Ji G, Liu JW. Hesperidin upregulates heme oxyenase-1 to attenuate hydrogen peroxide-induced cell damage in hepatic L02 cells. J Agric Food Chem. 2010;58(6):3330–5.PubMedCrossRef
5.
go back to reference Zielinska-Przyiemska M, Ignatowicz E. Citrus fruit flavanoids influence on neutrophil apoptosis and oxidative metabolism. Phytother Res. 2008;22(12):1557–62.CrossRef Zielinska-Przyiemska M, Ignatowicz E. Citrus fruit flavanoids influence on neutrophil apoptosis and oxidative metabolism. Phytother Res. 2008;22(12):1557–62.CrossRef
6.
go back to reference Yeh MH, Kao ST, Hung CM, Liu CJ, Lee KH, Yeh CC. Hesperidin inhibited acetaldehyde-induced matrix metalloproteinase-9 gene expression in human hepatocellular carcinoma cells. Toxicol Lett. 2009;184(3):204–10.PubMedCrossRef Yeh MH, Kao ST, Hung CM, Liu CJ, Lee KH, Yeh CC. Hesperidin inhibited acetaldehyde-induced matrix metalloproteinase-9 gene expression in human hepatocellular carcinoma cells. Toxicol Lett. 2009;184(3):204–10.PubMedCrossRef
7.
go back to reference Emim JA, Oliveria AB, Lapa AJ. Pharmacological evaluation of the ant-inflammatory activity of a citrus bioflavonoid, hesperidin and the isoflavonoids, duartin and claussequinone in rats and mice. J Pharm Pharmacol. 1994;46(2):118–22.PubMed Emim JA, Oliveria AB, Lapa AJ. Pharmacological evaluation of the ant-inflammatory activity of a citrus bioflavonoid, hesperidin and the isoflavonoids, duartin and claussequinone in rats and mice. J Pharm Pharmacol. 1994;46(2):118–22.PubMed
8.
go back to reference Guardia T, Rotelli AE, Juarez AO, LE Pelzer. Anti-inflammatory properties of plant flavonoids. Effect of rutin, quercetin and hesperidin on adjuvant arthritis in rat. Farmaco. 2001;56(9):683–7.PubMedCrossRef Guardia T, Rotelli AE, Juarez AO, LE Pelzer. Anti-inflammatory properties of plant flavonoids. Effect of rutin, quercetin and hesperidin on adjuvant arthritis in rat. Farmaco. 2001;56(9):683–7.PubMedCrossRef
9.
go back to reference Ribeiro IA, João R, Bruno S, Mota-Filipe H, Ribeiro HM. Effect of naringin enzymatic hydrolysis towards naringenin on the anti-inflammatory activity of both compounds. J Mol catal B Enzym. 2008;52(53):13–8.CrossRef Ribeiro IA, João R, Bruno S, Mota-Filipe H, Ribeiro HM. Effect of naringin enzymatic hydrolysis towards naringenin on the anti-inflammatory activity of both compounds. J Mol catal B Enzym. 2008;52(53):13–8.CrossRef
10.
go back to reference Benavente-Garcia O, Castillo J. Update on uses and properties of citrus flavonoids: new finding in anticancer, cardiovascular and anti-inflammatory activity. J Agric Food Chem. 2008;56(15):6185–205.PubMedCrossRef Benavente-Garcia O, Castillo J. Update on uses and properties of citrus flavonoids: new finding in anticancer, cardiovascular and anti-inflammatory activity. J Agric Food Chem. 2008;56(15):6185–205.PubMedCrossRef
11.
go back to reference Liu L, Shan S, Zhang K, Ning ZQ, Lu XP, Cheng Y. Naringenin and hesperitin, two flavonoids derived from Citrus aurrantium up-regulate transcription of adiponectin. Phytother Res. 2008;22(10):1400–3.PubMedCrossRef Liu L, Shan S, Zhang K, Ning ZQ, Lu XP, Cheng Y. Naringenin and hesperitin, two flavonoids derived from Citrus aurrantium up-regulate transcription of adiponectin. Phytother Res. 2008;22(10):1400–3.PubMedCrossRef
12.
go back to reference Leontowicz H, Gorinstein S, Lojek A, Leontowicz M, Ciz M, Soliva-Fortuny R, Park YS, Jung ST, Trakhtenberg S, Martin-Belloso O. Comparative content of some bioactive compounds in apples, peaches and pears and their influence on lipids and antioxidant capacity in rats. J Nutr Biochem. 2002;13(10):603–10. Leontowicz H, Gorinstein S, Lojek A, Leontowicz M, Ciz M, Soliva-Fortuny R, Park YS, Jung ST, Trakhtenberg S, Martin-Belloso O. Comparative content of some bioactive compounds in apples, peaches and pears and their influence on lipids and antioxidant capacity in rats. J Nutr Biochem. 2002;13(10):603–10.
13.
go back to reference Parmar HS, Kar A. Comparative analysis of free radical scavenging potential of several fruit peel extracts by in vitro method. Drug Discov Ther. 2009;3(2):49–55. Parmar HS, Kar A. Comparative analysis of free radical scavenging potential of several fruit peel extracts by in vitro method. Drug Discov Ther. 2009;3(2):49–55.
14.
go back to reference Morikawa K, Nonaka M, Narahara M, Torii I, Kawaguchi K, Yoshikawa T, Kumazawa Y, Morikawa S. Inhibitory effect of quercetin on carrageenan-induced inflammation in rats. Life sci. 2003;74(6):709–21.PubMedCrossRef Morikawa K, Nonaka M, Narahara M, Torii I, Kawaguchi K, Yoshikawa T, Kumazawa Y, Morikawa S. Inhibitory effect of quercetin on carrageenan-induced inflammation in rats. Life sci. 2003;74(6):709–21.PubMedCrossRef
15.
go back to reference Sedgwick AD, Lees P. Studies of eicosanoid production in the air pouch model of synovial inflammation. Agents Actions. 1986;18(3–4):429–38.PubMedCrossRef Sedgwick AD, Lees P. Studies of eicosanoid production in the air pouch model of synovial inflammation. Agents Actions. 1986;18(3–4):429–38.PubMedCrossRef
16.
go back to reference Masferrer JL, Zweifel BS, Manning PT, Hauser SD, Leahy KM, Smith WG, Isakson PC, Seibert K. Selective inhibition of inducible cyclooxygenase 2 in vivo is antiinflammatory and nonulcerogenic. Proc Natl Acad Sci. 1994;91(8):3228–32.PubMedCrossRef Masferrer JL, Zweifel BS, Manning PT, Hauser SD, Leahy KM, Smith WG, Isakson PC, Seibert K. Selective inhibition of inducible cyclooxygenase 2 in vivo is antiinflammatory and nonulcerogenic. Proc Natl Acad Sci. 1994;91(8):3228–32.PubMedCrossRef
17.
go back to reference Kumar P, Kumar A. Protective effect of hesperidin and naringin against 3-nitropropionic acid induced Huntington’s like symptoms in rats: possible role of nitric oxide. Behav Brain Res. 2006;206(1):38–46.CrossRef Kumar P, Kumar A. Protective effect of hesperidin and naringin against 3-nitropropionic acid induced Huntington’s like symptoms in rats: possible role of nitric oxide. Behav Brain Res. 2006;206(1):38–46.CrossRef
18.
go back to reference Kanno S, Shouji A, Tomizawa A, Hiura T, osanai Y, Ujibe M, Obara Y, Nakahata N, Ishikawa M. Inhibitory effect of naringin on lipopolysaccharide (LPS)-induced endotoxin shock in mice and nitric oxide production in RAW 264.7 macrophages. Life Sci. 2006;78(7):673–81.PubMedCrossRef Kanno S, Shouji A, Tomizawa A, Hiura T, osanai Y, Ujibe M, Obara Y, Nakahata N, Ishikawa M. Inhibitory effect of naringin on lipopolysaccharide (LPS)-induced endotoxin shock in mice and nitric oxide production in RAW 264.7 macrophages. Life Sci. 2006;78(7):673–81.PubMedCrossRef
19.
go back to reference Bauerova K, Nosalova V, Mihalova D, Bauero JN. Contribution to safe anti-inflammatory therapy with indomethacin. Cent Eur J Public Health. 2004;12:S8–10. Bauerova K, Nosalova V, Mihalova D, Bauero JN. Contribution to safe anti-inflammatory therapy with indomethacin. Cent Eur J Public Health. 2004;12:S8–10.
20.
go back to reference Letelier ME, Molina-Berrios A, Cortes-Tronsco J, Jara-sandoval J, Holst M, Palma K, Montoya M, Miranda D, Gonzalez-Lira V. DPPH and oxygen free radicals as pro-oxidant of biomolecules. Toxicol In Vitro. 2008;22(2):279–86.PubMedCrossRef Letelier ME, Molina-Berrios A, Cortes-Tronsco J, Jara-sandoval J, Holst M, Palma K, Montoya M, Miranda D, Gonzalez-Lira V. DPPH and oxygen free radicals as pro-oxidant of biomolecules. Toxicol In Vitro. 2008;22(2):279–86.PubMedCrossRef
21.
go back to reference Bradford MM. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem. 1976;7(72):248–54.CrossRef Bradford MM. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem. 1976;7(72):248–54.CrossRef
22.
go back to reference Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reactions. Anal Biochem. 1979;95(2):451–8.CrossRef Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reactions. Anal Biochem. 1979;95(2):451–8.CrossRef
23.
go back to reference Marklund S, Marklund G. Involvement of the superoxide anion radical in the autoxidation of pyrogallol and a convenient assay for superoxide dismutase. Eur J Biochem. 1974;47(3):469–74.PubMedCrossRef Marklund S, Marklund G. Involvement of the superoxide anion radical in the autoxidation of pyrogallol and a convenient assay for superoxide dismutase. Eur J Biochem. 1974;47(3):469–74.PubMedCrossRef
24.
go back to reference Aebi HU. Catalase: methods in enzymatic analysis. New York: Academic Press; 1983. vol. 3, p. 276–86. Aebi HU. Catalase: methods in enzymatic analysis. New York: Academic Press; 1983. vol. 3, p. 276–86.
26.
go back to reference Reitman S, Frankel S. A colorimetric method for the determination of serum glutamic oxaloacetic and glutamic pyruvic transaminase. Am J Clin Pathol. 1957;28(1):56–63.PubMed Reitman S, Frankel S. A colorimetric method for the determination of serum glutamic oxaloacetic and glutamic pyruvic transaminase. Am J Clin Pathol. 1957;28(1):56–63.PubMed
27.
go back to reference Bessey OA, Lowry OH, Brock MJ. A method for the rapid determination of alkaline phosphatase with five cubic millimetres of serum. J Biol Chem. 1946;164:321–9.PubMed Bessey OA, Lowry OH, Brock MJ. A method for the rapid determination of alkaline phosphatase with five cubic millimetres of serum. J Biol Chem. 1946;164:321–9.PubMed
28.
go back to reference Bansal AK, Trivedi R, Soni GL, Bhatnagar D. Hepatic and renal oxidative stress in acute toxicity of N-nitrosodiethylamine in rats. Ind J Exp Biol. 2009;38(9):916–20. Bansal AK, Trivedi R, Soni GL, Bhatnagar D. Hepatic and renal oxidative stress in acute toxicity of N-nitrosodiethylamine in rats. Ind J Exp Biol. 2009;38(9):916–20.
29.
go back to reference Tanas S, Odabasoglu F, Halici Z, Cakir A, Aygun H, Aslan A, Suleyman H. Evaluation of anti-inflammatory and antioxidant activities of Peltigera rufescens lichen species in acute and chronic inflammation models. J Nat Med. 2010;64(1):42–9.PubMedCrossRef Tanas S, Odabasoglu F, Halici Z, Cakir A, Aygun H, Aslan A, Suleyman H. Evaluation of anti-inflammatory and antioxidant activities of Peltigera rufescens lichen species in acute and chronic inflammation models. J Nat Med. 2010;64(1):42–9.PubMedCrossRef
30.
go back to reference Ceriello A, Kumar S, Piconi L, Esposito K, Giugliano D. Simultaneous control of hyperglycemia and oxidative stress normalizes endothelial function in type 1 diabetes. Diabetes Care. 2007;30(3):649–54.PubMedCrossRef Ceriello A, Kumar S, Piconi L, Esposito K, Giugliano D. Simultaneous control of hyperglycemia and oxidative stress normalizes endothelial function in type 1 diabetes. Diabetes Care. 2007;30(3):649–54.PubMedCrossRef
31.
go back to reference Griffiths RJ. Prostaglandins and inflammation. In: Gallin JI, Snyderman R, editors: Inflammation: basic principles and clinical correlates. Philadelphia: Lippincott; 1999. p. 349–60. Griffiths RJ. Prostaglandins and inflammation. In: Gallin JI, Snyderman R, editors: Inflammation: basic principles and clinical correlates. Philadelphia: Lippincott; 1999. p. 349–60.
32.
go back to reference Bastard JP, Maachi M, Lagathu C, Kim MJ, Caron M, Vidal H, Capeau J, Feve B. Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw. 2006;17(1):4–12.PubMed Bastard JP, Maachi M, Lagathu C, Kim MJ, Caron M, Vidal H, Capeau J, Feve B. Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw. 2006;17(1):4–12.PubMed
33.
go back to reference Ceriello A. Oxidative stress and diabetes-associated complications. Endocr Pract. 2006;12(S1):60–2.PubMed Ceriello A. Oxidative stress and diabetes-associated complications. Endocr Pract. 2006;12(S1):60–2.PubMed
34.
go back to reference Baiyr Y, Odabasoglu F, Cakir A, Aslan A, Suleman H, Halici M, Kazaz C. The inhibition of gastric mucosal lesion, oxidative stress and neutrophil-infiltration in rats by the lichen constituent diffractaic acid. Phytomedicine. 2006;13(8):584–90.CrossRef Baiyr Y, Odabasoglu F, Cakir A, Aslan A, Suleman H, Halici M, Kazaz C. The inhibition of gastric mucosal lesion, oxidative stress and neutrophil-infiltration in rats by the lichen constituent diffractaic acid. Phytomedicine. 2006;13(8):584–90.CrossRef
35.
go back to reference Laurila JP, Laatikainen LE, Castellone MD, Laukkanen MO. SOD3 Reduces Inflammatory cell migration by regulating adhesion molecule and cytokine expression. PLoS One. 2009;4(6):e5786.PubMedCrossRef Laurila JP, Laatikainen LE, Castellone MD, Laukkanen MO. SOD3 Reduces Inflammatory cell migration by regulating adhesion molecule and cytokine expression. PLoS One. 2009;4(6):e5786.PubMedCrossRef
36.
go back to reference Kanno S, Shouji A, Tomizawam A, Hiura T, Osanai Y, Ujibe M, Obara Y, Nakahata N, Ishikaw M. Inhibitory effect of naringin on lipopolysaccharide (LPS)-induced endotoxin shock in mice and nitric oxide production in RAW 264.7 macrophages. Life Sci. 2006;78(7):673–81.PubMedCrossRef Kanno S, Shouji A, Tomizawam A, Hiura T, Osanai Y, Ujibe M, Obara Y, Nakahata N, Ishikaw M. Inhibitory effect of naringin on lipopolysaccharide (LPS)-induced endotoxin shock in mice and nitric oxide production in RAW 264.7 macrophages. Life Sci. 2006;78(7):673–81.PubMedCrossRef
37.
go back to reference Vanamala J, Leonardi T, Patil BS, Taddeo SS, Murphy ME, Pike LM, Chapkin RS, Lupton JR, Turner ND. Suppression of colon carcinogenesis by bioactive compounds in grapefruit. Cacinogenesis. 2006;27(6):1257–65.CrossRef Vanamala J, Leonardi T, Patil BS, Taddeo SS, Murphy ME, Pike LM, Chapkin RS, Lupton JR, Turner ND. Suppression of colon carcinogenesis by bioactive compounds in grapefruit. Cacinogenesis. 2006;27(6):1257–65.CrossRef
38.
go back to reference Kirkova M, Kassabova T, Russanov E. In vivo effects of indomethacin-I activity of anti-oxidant enzymes and lipid peroxidation. Gen Pharmacol. 1992;23(3):503–7.PubMed Kirkova M, Kassabova T, Russanov E. In vivo effects of indomethacin-I activity of anti-oxidant enzymes and lipid peroxidation. Gen Pharmacol. 1992;23(3):503–7.PubMed
39.
go back to reference Deepa PR, Varlakshmi P. Protective effects of certoparin sodium, a low molecular weight heparin derivative, in experimental atherosclerosis. Clin Chim Acta. 2004;339(1–2):105–15.PubMedCrossRef Deepa PR, Varlakshmi P. Protective effects of certoparin sodium, a low molecular weight heparin derivative, in experimental atherosclerosis. Clin Chim Acta. 2004;339(1–2):105–15.PubMedCrossRef
40.
go back to reference Gallo RL, Dorscnner RA, Takashima S, Klagsburn M, Eriksson E, Bernfield M. Endothelial cell surface alkaline phosphatase activity is induced by IL-6 released during wound repair. J Invest Dermatol. 1997;109(4):597–603.PubMedCrossRef Gallo RL, Dorscnner RA, Takashima S, Klagsburn M, Eriksson E, Bernfield M. Endothelial cell surface alkaline phosphatase activity is induced by IL-6 released during wound repair. J Invest Dermatol. 1997;109(4):597–603.PubMedCrossRef
41.
go back to reference Ahmadi A, Hosseinimehr SJ, Naghshvar F, Hajir E, Ghahremani M. Chemoprotective effects of hesperidin against genotoxicity induced by cyclophosphamide in mice bone marrow cells. Arch Pharm Res. 2008;31(6):794–7.PubMedCrossRef Ahmadi A, Hosseinimehr SJ, Naghshvar F, Hajir E, Ghahremani M. Chemoprotective effects of hesperidin against genotoxicity induced by cyclophosphamide in mice bone marrow cells. Arch Pharm Res. 2008;31(6):794–7.PubMedCrossRef
42.
go back to reference Kazlowaska K, Hsu T, Hou CC, Yang WC, Tsai GJ. Anti-inflammatory properties of phenolic compounds and crude extract from Porphyra dentata. J Ethnopharmacol. 2010;128(1):123–30.CrossRef Kazlowaska K, Hsu T, Hou CC, Yang WC, Tsai GJ. Anti-inflammatory properties of phenolic compounds and crude extract from Porphyra dentata. J Ethnopharmacol. 2010;128(1):123–30.CrossRef
43.
go back to reference Kaur G, Tirkey N, Chopra K. Beneficial effect of hesperidin on lipopolysaccharide-induced hepatotoxicity. Toxicology. 2006;226(2–3):152–60.PubMedCrossRef Kaur G, Tirkey N, Chopra K. Beneficial effect of hesperidin on lipopolysaccharide-induced hepatotoxicity. Toxicology. 2006;226(2–3):152–60.PubMedCrossRef
44.
go back to reference Aggarwal A, Gaur V, Kumar A. Nitric oxide mechanism in the protective effect of naringin against post-stroke depression (PSD) in mice. Life Sci. 2010;86(25–26):928–35.PubMedCrossRef Aggarwal A, Gaur V, Kumar A. Nitric oxide mechanism in the protective effect of naringin against post-stroke depression (PSD) in mice. Life Sci. 2010;86(25–26):928–35.PubMedCrossRef
Metadata
Title
Evaluation of antioxidative and anti-inflammatory potential of hesperidin and naringin on the rat air pouch model of inflammation
Authors
Mandipika Jain
Hamendra Singh Parmar
Publication date
01-05-2011
Publisher
SP Birkhäuser Verlag Basel
Published in
Inflammation Research / Issue 5/2011
Print ISSN: 1023-3830
Electronic ISSN: 1420-908X
DOI
https://doi.org/10.1007/s00011-010-0295-0

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