Introduction: Rheumatoid Arthritis (RA) is an incurable chronic inflammatory disorder. Indomethacin is used for symptomatic management of RA; its long term use is associated with potentially life-threatening deleterious side effects. Vinpocetine is an alkaloid extracted from the periwinkle plant used for treating cerebrovascular disorders with no significant side effects. Recent evidences demonstrate its anti-inflammatory properties.Objective: To evaluate the anti-inflammatory, analgesic and neuroprotective activities of vinpocetine against RA as well as the associated neurological disorders and to investigate its influence on the anti-inflammatory activity of indomethacin in rats. Methods:Complete Freund's adjuvant induced arthritic rats were treated for 3 weeks with indomethacin (1, 2 mg/ kg P.O.) and/or vinpocetine (20 mg/kg P.O.). Body weight, ankle diameter, arthritic score, serum tumor necrosis factor alpha (TNF-α) and interleukin one beta (IL-1β), tissue expression of nuclear factor kappa B (NF-κB) were determined and gait score were assessed. Brain monoamines levels and behavior in the swimming test were also measured. In addition, histopathological examinations of hind paw and brain tissues as well as X-ray examinations of the paw were performed.Results: Combination therapy of vinpocetine with indomethacin significantly improved analgesic and inflammatory parameters as compared to indomethacin alone. Vinpocetine alone decreased the inflammatory markers in the same extent as indomethacin. In some parameters, vinpocetine has equal effect as the combination therapy. It also decreased swimming time while increased direction score together with increased brain norepinepherine and serotonin as well as serum total anti-oxidant capacity (TAC) level. Histopathological and X-ray examinations supported these results.Conclusion: Vinpocetine has potent anti-arthritic, anti-inflammatory and anti-nociceptive effects. It also potentiates the anti-inflammatory action of indomethacin. It also improves RA associated depression. Thus, it can be used either alone or in combination with indomethacin to avoid or to decrease the serious side effects of indomethacin and to improve RA associated depression. Citation: Ali AA, El-Zaitony AS, Al-Haleem ENA (2016) Evaluation of Therapeutic Efficacy of Vinpocetine in Adjuvant Induced Arthritis Model in Rats. J Pain Manage Med 2: 115.

Methotrexate (MTX) is commonly used in the treatment of many different types of cancer and inflammatory diseases. Its cytotoxic nature also lends a substantial risk of life-threatening side effects. L-arginine is beneficial in the treatment of hepatic injury, hepatic cirrhosis and fatty liver degeneration. The present work aims to study the effect of L-arginine on hepatotoxicity of methotrexate in albino rats. Five groups of albino rats were used. Group I: control. Group II: rats were administered (MTX) in a daily oral dose of 0.45 mg/kg, for 28 days. Group III: rats were administered L-arginine in a daily oral dose of 300 mg/kg, for 28 days. Group IV: rats were received L-arginine 2 hrs before (MTX). Group V: rats were received L-arginine 2 hrs after (MTX). The results revealed different histopathological changes in liver of MTX-treated rats such as focal areas of necrosis and increased numbers of activated Kupffer cells, an apparent increase in the amount of collagen fibers and strong immunoreactive expression of α-SMA. Biochemical results revealed a significant increase in the serum levels of ALT, AST, bilirubin and decreasing the level of antioxidant enzymes. L-agrinine minimized the hepatotoxicity of MTX by decreasing the level of ALT, AST and bilirubin, MDA and increasing the antioxidant enzymes. It is concluded that L-arginine protects liver from hepatotoxicity of methotrexate and this due to its antioxidant activity.