Cinnamaldehyde/lactulose combination therapy alleviates thioacetamide-induced hepatic encephalopathy via targeting P2X7R-mediated NLRP3 inflammasome signaling

Life Sci. 2024 May 1:344:122559. doi: 10.1016/j.lfs.2024.122559. Epub 2024 Mar 11.

Abstract

Aims: Cinnamaldehyde (CA), the main active constituent of cinnamon oil, is reported to have neuroprotective effects. However, the potential benefits of CA for brain protection in hepatic encephalopathy (HE) are still not understood. Thus, the present study investigates the possible ameliorative effect of CA (70 mg/kg/day, I.P.) either alone or in combination with lactulose (Lac) (5.3 g/kg/day, oral) against thioacetamide (TAA)-induced hepatic encephalopathy in rats.

Materials and methods: For induction of HE, TAA (200 mg/kg) was intraperitoneally administered for 1 week at alternative days. CA, Lac and Lac+CA were administered for 14 days prior to and for further 7 days together with TAA injection.

Key findings: CA, Lac and Lac+CA combination effectively attenuated TAA-induced HE; as indicated by the improvement in behavioral tests, mitigation of pathological abnormalities in both liver and brain, the significant reduction in serum hyperammonemia and amelioration in liver function biomarkers; ALT and AST. This was accompanied with a substantial restoration of redox state in liver and brain; MDA and GSH levels. Moreover, CA, Lac and Lac+CA combination reduced neuroinflammation as demonstrated by the notable attenuation of P2X7R, NLRP3, caspase-1, IL-1β, GFAP and Iba1 brain levels, as well as the amelioration of brain edema as manifested by reduction in AQP4 levels in brain.

Significance: Our study has demonstrated that CA in combination with Lac possesses a superior neuroprotective effect over Lac alone against TAA-induced HE by attenuation of P2X7R/NLRP3 mediated neuroinflammation and relieving brain edema.

Keywords: Aquaporin 4; Cinnamaldehyde; Hepatic encephalopathy; Lactulose; NLRP3; P2X7R.

MeSH terms

  • Acrolein / analogs & derivatives*
  • Animals
  • Brain Edema* / pathology
  • Hepatic Encephalopathy* / chemically induced
  • Hepatic Encephalopathy* / drug therapy
  • Inflammasomes
  • Lactulose / adverse effects
  • Liver
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • Neuroinflammatory Diseases
  • Rats
  • Rats, Wistar
  • Thioacetamide / pharmacology

Substances

  • Lactulose
  • Inflammasomes
  • Thioacetamide
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • cinnamaldehyde
  • Acrolein