Assessment of Anti-Inflammatory Drugs in the Rat Using Subcutaneous Implants of Polyurethane Foam Impregnated with Dead Tubercle Bacilli
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Ann. rheum. Dis. (1975), 34, 326 Ann Rheum Dis: first published as 10.1136/ard.34.4.326 on 1 August 1975. Downloaded from Assessment of anti-inflammatory drugs in the rat using subcutaneous implants of polyurethane foam impregnated with dead tubercle bacilli A. K. CLARKE, B. VERNON-ROBERTS, AND H. L. F. CURREY From the Bone andJoint Research Unit, The London Hospital Medical College, Turner Street, London, El 2AD Clarke, A. K., Vernon-Roberts, B., and Currey, H. L. F. (1975). Annals ofthe Rheumatic Diseases, 34, 326-331. Assessment of anti-inflammatory drugs in the rat using subcuta- neous implants of polyurethane foam impregnated with dead tubercle bacilli. The fluid and cellular phases of inflammatory response have been measured using a technique employ- ing subcutaneous implantation of polyurethane foam cubes impregnated with heat-killed Mycobacterium tuberculosis. Phenylbutazone, azathioprine, aspirin, cyclophosphamide, and prednisolone suppressed fluid response, whereas sodium aurothiomalate, hydroxy- chloroquine, and D-penicillamine had no effect. All the drugs used suppressed the infiltration of inflammatory cells into the cubes. copyright. Laboratory tests of the anti-inflammatory action of in these models has been largely centred upon the drugs are based upon the suppression of some feature later, fibrotic, stages of the inflammatory reaction of the inflammatory response such as the migration (Bole and Heath, 1967; Kaltiala and Heikkinen, of leucocytes, changes in blood flow, and vascular 1971). This report describes the effects of a variety of permeability, or the formation of granulation tissue anti-inflammatory agents, commonly used in the http://ard.bmj.com/ and oedema. The weight ofgranulation tissue formed treatment of rheumatic diseases, on the cellular and and the effects of drugs in suppressing it are the basis fluid phases of the inflammatory response to polyure- of the granuloma pouch test (Selye, 1953) and thane cubes impregnated with heat-killed Myco- techniques employing the implantation of cotton bacterium tuberculosis. pellets (Meier, Schuler, and Desaulles, 1950), poly- vinyl sponges (Boucek and Noble, 1955), and other Materials and methods irritant materials. These techniques, and those which on September 24, 2021 by guest. Protected rely on the measurement of oedematous tissue swell- ANIMALS Female Wistar or Sprague-Dawley rats weighing 150 to ing after the injection ofirritants such as carrageenan, 250 g were used. Unless otherwise specified, each test dextran, ovalbumin, formalin, etc., fail to separate group contained 8 animals. the relative contributions of fluid and cellular exuda- tion to the inflammatory reaction. PREPARATION OF CUBES We have attempted to obtain this important infor- Polyurethane foam (Dunlopillo grade D12, Dunlop) was mation by implanting subcutaneously in the rat poly- cut into cubes measuring slightly less than 1 cm3 and urethane foam cubes impregnated with an irritant. weighing 17 mg. Some ofthe cubes were then impregnated Such implants can be recovered after various intervals with heat-killed M. tuberculosis (TBC) (Tuberculin and processed in different ways for separate Section, Ministry of Agriculture, Fisheries and Food) by analysis immersingandcompressing them in anaqueous suspension of the fluid exudate and the infiltrating cells. In pre- of TBC (0 5 mg/ml) followed by drying overnight at 37°C vious studies in which pieces of foam have been (to constant weight). Each cube then contained approxi- implanted subcutaneously in experimental animals it mately 0-33 mg dry TBC, and microscopical examination has beenthe irritant nature ofthefoam itselfwhichhas of suitably stained sections showed this to be distributed provoked an inflammatory response and the interest evenly through the cube. Before implantation cubes were Accepted for publication October 24, 1974. Correspondence to: Professor H. L. F. Currey. Ann Rheum Dis: first published as 10.1136/ard.34.4.326 on 1 August 1975. Downloaded from Assessment ofanti-inflammatory drugs 327 sterilized in ethylene oxide. Control (nonimpregnated) cubes were processed similarly except that the TBC were omitted. IMPLANTATION OF CUBES Under ether anaesthesia and using a sterile technique, E cubes were implanted (one into each flank) through a a,0-7-/ dorsal midline incision. Each animal received an intra- peritoneal injection of 20 mg chloramphenicol to prevent -n 0*5// bacterial infection. O 0'4// 03 ASSESSMENT OF INFLAMMATORY FLUID EXUDATE 0*l- */Controls When cubes were removed, care was taken not to squeeze 02/ out any of the contained fluid. Cubes were then dried at 1 37°C overnight (to constant weight). The difference between the initial and final dry weight of each cube was 0~~~~~~~~l2 3 4 5 6 7 12/18 9 10 11 12 13 14 recorded as the 'dry weight gain'. Preliminary studies in Days after implontation which rats were implanted with a TBC-impregnated cube FIG. 2 Comparison ofdepth ofcellular invasion into cubes in one flank and a nonimpregnated cube on the opposite impregnated with tubercle bacilli and into nonimpregnated side established that there was a reproducible and pro- cubes examined at various intervals after implantation gressive daily increase in the dry weight gain ofthe irritant implant, while the dry weight gain ofthe nonirritant cubes and impregnated cubes on day +5. Preliminary studies had remained relatively constant for the first 6 days (Fig. 1). also established that this method of assessing the cellular This consideration led to the choice of 5 days for the infiltration correlated well with results obtained by actually duration of the experiments described below. Further counting the numbers ofcells in chosen fields. preliminary studies employing trypsinization and separate analysis of the cellular and fluid contents had established ADMINISTRATION OF DRUGS that on day +5 cells accounted for only about 12-5 % ofthe Sodium aurothiomalate (Myocrisin, May and Baker) was dry weight gain in the impregnated cube, and for about given by intramuscular injection on alternate days. 2-5 % in the nonirritant implants. Prednisolone suspended in arachis oil was given by copyright. intraperitoneal injection. The remaining drugs were ASSESSMENT OF INFLAMMATORY CELLULAR administered as a single daily dose via oral tube. The EXUDATE following preparations were employed. On the fifth day after implantation, cubes complete with Drug Preparation Vehicle overlying skin and underlying body wall were removed, Hydroxychloroquine Plaquenil, Winthrop Distilled water fixed in formol-saline, and embedded in wax. 5 ,um sections D-Peniclll_mine Distamine, Dista Deionized water Phenylbutazone Butazolidin, Geigy 025 Y/, carboxymethyl- were cut through the central part of each cube and were cellulose Azathioprine Imuran, Wellcome 0-251% carboxymethyl- stained with and A http://ard.bmj.com/ haematoxylin eosin. calibrated eye- cellulose piece was used to measure the depth of cellular invasion Aspirin Aspirin, B.P. Distilled water from the cube at on Cyclophosphamide Endoxana, Ward edge ofthe three points the superficial Blenkinsop Distilled water surface, three points on the deep surface, and two points Nil (controls) Nil 0-25V% carboxymethyl- on each of two remaining surfaces. The mean of these ten cellulose measurements gave the 'depth of cell invasion' for each cube. Preliminary experiments, similar to those described Results above, had indicated the progressive changes in this measurement after implantation (Fig. 2) and had shown EFFECT OF VARIOUS DRUGS ON DRY WEIGHT that there was a marked difference between the control GAIN OF CUBES IMPREGNATED WITH M. TUBER- on September 24, 2021 by guest. Protected CULOSIS (TABLES I AND II; FIG. 3) 110I 901 100- L -2..UflJ rui '-4 , AZR - ASP 3 90- a E~ 80 PRE .E- 70 cr c 60' ' 6o -6 50' a ' 40Q 3; 50 a' 40 > 30' 0 O 20' . TBC 30. 10' *-* Controls 5 10 o00 I0 I io 6 7 14 Daily dose in mg/kg (log scale) Days after implantation FIG. 3 Graphillustratingrelativesuppression ofdry weight FIG. 1 Dry weight gain (mean ±2 SE) ofpolyurethane gain of tubercle-impregnated cubes by increasing doses of foam cubes impregnated with tubercle bacilli compared with prednisolone (PRED), cyclophosphamide (CY), azathio- dry weightgain ofnonimpregnatedcubes prine (AZ), phenylbutazone (PBZ), and aspirin (ASP) Ann Rheum Dis: first published as 10.1136/ard.34.4.326 on 1 August 1975. Downloaded from 328 Annals ofthe Rheumatic Diseases Table I Effect ofvarious anti-inflammatory agents on dry weight gain ofpolyurethane cubes impregnated with heat-killed M. tuberculosis Drug Route of Frequency of Daily dose (mg/kg) Dry weight gain ofcubes administration administration (mg + SE) (day 0 = day ofcube implantation) Sodium aurothiomalate Intramuscular Alternate days 12-5 84-7+3-2 -10 to +4 25 85-6±2-6 50 848 ±2-7 100 85-3 3-3 Hydroxychloroquine Oral Daily 6-25 87-0 3-7 -10 to +4 12-5 86-9 + 2-5 25 80-1 ± 1*8 50 86-5 + 2-6 D-Penicillamine Oral Daily 25 78-5+2-0 -10 to +4 50 79-3 + 2-2 100 69-7 + 3-5* 200 75-6 + 3-6 Phenylbutazone Oral Daily 37-5 69-3 ± 1-9: 0 to +4 75 64-9 + 1-91: 150 63 5 ± 191: 300 60-8±3-01 Azathioprine Oral Daily 25 80-5+2-0 0 to +4 50 75-4 3-9 100 60-0 3-61 copyright. 200 54-96-1: Aspirin Oral Daily 100 78-9 + 2-0 0 to +4 200 70-3 + 2-0t 400 63-9 + 2-21: 800 53-6 ± 091: Cyclophosphamide Oral Daily 6-25 77-2 + 2-1 0 to +4 12-5 63-1 + 2-0t 25 540± 1-31: http://ard.bmj.com/ 50 49-0 ± 2-4: Prednisolone Intra- Daily 6-25 66-1 + 1-6t peritoneal 0 to +4 12-5 52-4 ± 2-3: 25 39-0 ± 1-3: 50 41-4 + 2-5$ Controls - 82-1 +2-7 on September 24, 2021 by guest. Protected *P = < 0-05; tP - < 0-01; $P = < 0-001. Groups of rats (8 in each group) were given one of the established that neither azathioprine nor phenyl- drugs in the range of doses shown in Table I.