[Comparison of the effects of NG-monomethyl-L-arginine and indomethacin on tuberculous arthritis: an experimental study in rats].
OBJECTIVE
We evaluated therapeutic effects of NG-monomethyl-L-arginine (NMMA), a nitric-oxide synthase inhibitor, and indomethacin in a rat model of tuberculous arthritis.


METHODS
Eighty male Wistar albino rats were randomly divided into five equal groups. In the first group (controls) normal saline solution was injected into the right knee joints of the rats. In the remaining groups, tuberculous arthritis was induced in the right knee joints of the rats via injection of 0.1 ml of a solution prepared from Mycobacterium tuberculosis strains. No treatment was given to the second group. The third and forth groups were assigned to receive oral indomethacin and intraperitoneal NMMA, respectively, while the fifth group received a combination thereof. The occurrence of arthritis was evaluated in four rats in each group on the 3rd, 7th, 14th, and 21st days after induction of arthritis. The rats were then subjected to scintigraphic imaging with Tc99 and focal activity involvement was analysed. The ratio of joint to soft tissue was calculated quantitatively. Following sacrifice with ether anesthesia, nitrate/nitrite levels were measured via Griess reaction in the bone tissue adjoining the knee. The knee joints were histopathologically examined.


RESULTS
The severity of arthritis in the NMMA group decreased by one point on the 14th day. On Day 21, arthritis score was zero in rats receiving a combination of indomethacin and NMMA. Scintigraphic examination revealed increased uptake activity on the 3rd and 7th days, whereas no uptake activity was seen on the 21st day in the group receiving both indomethacin and NMMA. Histopathologically, chronic inflammatory infiltration disappeared on Day 21 in rats receiving either NMMA alone or in combination with indomethacin. During the experiment, four rats in the second group and two rats in the third group died from sepsis. Nitrate measurements of the fifth group on Day 21 showed approximate values to those of the control group (p>0.05).


CONCLUSIONS
The combined use of indomethacin and NMMA seems to be more efficacious in reducing negative effects of tuberculous arthritis on the joint.
Kabak
Sevki
S
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Erciyes University, 38039 Kayseri, Turkey. ksevki@e-kolay.net
Halici
Mehmet
M
Yakan
Birkan
B
Kutlubay
Recep
R
Kula
Mustafa
M
D000284:Administration, Oral; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D016918:Arthritis, Reactive / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D004195:Disease Models, Animal; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D007213:Indomethacin / Q000008:administration & dosage / Q000627:therapeutic use*; D007274:Injections, Intraperitoneal; D007719:Knee Joint; D008297:Male; D019331:NG-Nitroarginine Methyl Ester / Q000008:administration & dosage / Q000627:therapeutic use*; D011877:Radionuclide Imaging; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D014394:Tuberculosis, Osteoarticular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004791:Enzyme Inhibitors; D019331:NG-Nitroarginine Methyl Ester; D007213:Indomethacin