Clavulanic acid improves ethanol withdrawal symptoms in rats

Document Type : Original Article

Authors

1 Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran

2 Department of Internal Medicine, Sabzevar University of Medical Sciences, Mashhad, I.R. Iran

3 Cellular and Molecular Research Center, Department of Physiology and Pharmacology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran

4 Department of physiology and pharmacology, Mashhad University of Medical Sciences, Mashhad, I.R. Iran

5 Department of Pharmacodynamics and Toxicology, Pharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, I.R. Iran

Abstract

Objective(s): Ethanol withdrawal following chronic use, is an important challenge clinically. In this study, the effect of clavulanic acid was evaluated on the symptoms of ethanol withdrawal in rats.
Materials and Methods: Alcohol dependence was induced by the gavage of ethanol (10% v/v, 2 g/kg), twice daily for 10 days. Clavulanic acid (10, 20, 40, and 80 mg/kg) was administered concurrently with ethanol (sub-acute study), or a single dose after ethanol withdrawal (acute study). Six hours after the last dose of ethanol, anxiety was assessed by the elevated plus-maze (EPM). Seizure-like behavior was evaluated by a sub-convulsive dose of pentylenetetrazol (PTZ, 25 mg/kg/IP). Locomotor activity and motor coordination were measured by the open field and rotarod tests, respectively. Lipid peroxidation marker and antioxidant content were assessed through measuring malondialdehyde (MDA) and glutathione (GSH), respectively.
Results: The number of entries and time spent on the open arms of EPM decreased during the withdrawal state. Motor coordination and locomotor activity were significantly decreased. In the sub-acute study, clavulanic acid 80 mg/kg increased time spent and the number of entries to the open arms of EPM, in withdrawn animals. Both motor incoordination and locomotor activity reduction were normalized by clavulanic acid (10, 20, 40 and 80 mg/kg). Withdrawal-induced PTZ kindling seizure was also suppressed by all of the doses. MDA increased, while GSH decreased after withdrawal. Clavulanic acid attenuated such changes.
Conclusion: Clavulanic acid could prevent the development of alcohol withdrawal-induced anxiety and seizure. Alcohol withdrawal causes oxidative stress which can be prevented by clavulanic acid.

Keywords


1. Angell M, JP. K. Alcohol and other drugs-toward a more rational and consistent policy. N Engl J Med. 1994; 331:537-539.
2. Amato L, Minozzi S, Davoli M. Efficacy and safety of pharmacological interventions for the treatment of the alcohol withdrawal syndrome. Cochrane Database Syst Rev. 2011:Cd008537.
3. Calcaterra NE, Barrow JC. Classics in chemical neuroscience: diazepam (valium). ACS Chem Neurosci. 2014; 5:253-260.
4. Parthasarathy R, Kattimani S, Sridhar MG. Oxidative stress during alcohol withdrawal and its relationship with withdrawal severity. Indian J Psychol Med. 2015; 37:175-180.
5. Tsai G, Coyle JT. The role of glutamatergic neurotransmission in the pathophysiology of alcoholism. Annu Rev Med. 1998; 49:173-184.
6. Dahchour A, De Witte P, Bolo N, Nedelec JF, Muzet M, Durbin P, et al. Central effects of acamprosate: part 1. Acamprosate blocks the glutamate increase in the nucleus accumbens microdialysate in ethanol withdrawn rats. Psychiatry Res. 1998; 82:107-114.
7. Tsai GE, Ragan P, Chang R, Chen S, Linnoila VM, Coyle JT. Increased glutamatergic neurotransmission and oxidative stress after alcohol withdrawal. Am J Psychiatry. 1998; 155:726-732.
8. Chen J, Shang X, Hu F, Lao X, Gao X, Zheng H, et al. beta-Lactamase inhibitors: an update. Mini Rev Med Chem. 2013; 13:1846-1861.
9. Nakagawa H, Yamada M, Tokiyoshi K, Miyawaki Y, Kanayama T. Penetration of potassium clavulanate/ticarcillin sodium into cerebrospinal fluid in neurosurgical patients. Jpn J Antibiot. 1994; 47:93-101.
10. Rawls, SM, Karaca F, Madhani I, Bhojani V, Martinez RL, Abou-Gharbia M, et al. Beta-lactamase inhibitors display anti-seizure properties in an invertebrate assay.  Neuroscience 2010;169:1800-1804.
11. Kim DJ, King JA, Zuccarelli L, Ferris CF, Koppel GA, Snowdon CT, et al. Clavulanic acid: a competitive inhibitor of beta-lactamases with novel anxiolytic-like activity and minimal side effects. Pharmacol Biochem Behav. 2009; 93:112-120.
12. Sanna F, Melis MR, Angioni L, Argiolas A. Clavulanic acid induces penile erection and yawning in male rats: comparison with apomorphine. Pharmacol Biochem Behav. 2013; 103:750-755.
13. Huh Y, Ju MS, Park H, Han S, Bang Y-M, Ferris CF, et al. Clavulanic acid protects neurons in pharmacological models of neurodegenerative diseases. Drug Develop Res. 2010; 71:351–357.
14. Schroeder JA, Tolman NG, McKenna FF, Watkins KL, Passeri SM, Hsu AH, et al. Clavulanic acid reduces rewarding, hyperthermic and locomotor-sensitizing effects of morphine in rats: a new indication for an old drug? Drug Alcohol Depend. 2014; 142:41-45.
15. Davidson M, Chen, WB and Wilce, PA Behavioral analysis of PTZ-kindled rats after acute and chronic ethanol treatments. Pharmacol Biochem Behav. 1999; 64: 7-13.
16. Scott-Stevens P, Atack JR, Sohal B, Worboys P. Rodent pharmacokinetics and receptor occupancy of the GABAA receptor subtype selective benzodiazepine site ligand L-838417. Biopharm Drug Dispos. 2005; 26:13-20.
17. Jung ME, Metzger DB. Alcohol withdrawal and brain injuries: beyond classical mechanisms. Molecules 2010; 15:4984-5011.
18. National, Research, Council. Guide for the care and use of laboratory animals. Washington: National Academy Press; 1996.
19. Shoja M, Mehri S, Amin B, Askari VR, Hosseinzadeh H. The prophylactic and therapeutic effects of saffron extract and crocin on ethanol withdrawal syndrome in mice. J Pharmacopuncture 2018; 21:277-283.
20. Ruby B, Benson MK, Kumar EP, Sudha S, Wilking JE. Evaluation of Ashwagandha in alcohol withdrawal syndrome. Asian Pacific J Trop Dis. 2012; 2:S856-S860.
21. Denenberg VH. Open-field behavior in the rat: what does it mean? Ann N Y Acad Sci. 1969;159:852-859.
22. Walf AA, Frye CA. The use of the elevated plus maze as an assay of anxiety-related behavior in rodents. Nat Protocols. 2007; 2:322-328.
23. Hamm RJ, Pike BR, O’Dell DM, Lyeth BG, Jenkins LW. The rotarod test: an evaluation of its effectiveness in assessing motor deficits following traumatic brain injury. J Neurotrauma. 1994; 11:187-196.
24. Becker A, Grecksch G, Brosz M. Antiepileptic drugs--their effects on kindled seizures and kindling-induced learning impairments. Pharmacol Biochem Behav. 1995; 52:453-459.
25. Mihara M, Uchiyama M. Determination of malonaldehyde precursor in tissues by thiobarbituric acid test. Anal Biochem. 1978; 86:271-278.
26. Moron MS, Depierre JW, Mannervik B. Levels of glutathione, glutathione reductase and glutathione S-transferase activities in rat lung and liver. Biochim Biophys Acta. 1979; 582:67-78.
27. Gasior M, Socala K, Nieoczym D, Wlaz P. Clavulanic acid does not affect convulsions in acute seizure tests in mice. J Neural Transm. 2012; 119:1-6.
28. Gonzaga NA, Mecawi AS, Antunes-Rodrigues J, De Martinis BS, Padovan CM, Tirapelli CR. Ethanol withdrawal increases oxidative stress and reduces nitric oxide bioavailability in the vasculature of rats. Alcohol 2014; 49:47-56.
29. Grant KA, Valverius P, Hudspith M, Tabakoff B. Ethanol withdrawal seizures and the NMDA receptor complex. Eur J Pharmacol.1990; 176:289-296.
30. Rao PS, Bell RL, Engleman EA, Sari Y. Targeting glutamate uptake to treat alcohol use disorders. Front Neurosci. 2015; 9:144.
31. Abulseoud OA, Camsari UM, Ruby CL, Kasasbeh A, Choi S, Choi DS. Attenuation of ethanol withdrawal by ceftriaxone-induced upregulation of glutamate transporter EAAT2. Neuropsychopharmacology 2014; 39:1674-1684.
32. Kim J, John J, Langford D, Walker E, Ward S, Rawls SM. Clavulanic acid enhances glutamate transporter subtype I (GLT-1) expression and decreases reinforcing efficacy of cocaine in mice. Amino Acids 2016; 48:689-696.
33. Kost GC, Selvaraj S, Lee YB, Kim DJ, Ahn CH, Singh BB. Clavulanic acid inhibits MPP(+)-induced ROS generation and subsequent loss of dopaminergic cells. Brain Res. 2012; 1469:129-135.
34. Bagdy G, Kecskemeti V, Riba P, Jakus R. Serotonin and epilepsy. J Neurochem 2007; 100:857-873.
35. Lal H, Prather PL, Rezazadeh SM. Potential role of 5HT1C and/or 5HT2 receptors in the mianserin-induced prevention of anxiogenic behaviors occurring during ethanol withdrawal. Alcohol Clin Exp Res. 1993; 17:411-417.
36. Connor H. Serotonin syndrome after single doses of co-amoxiclav during treatment with venlafaxine. J R Soc Med. 2003; 96:233-234.
37. Rosland JH, Hunskaar S, Hole K. Diazepam attenuates morphine antinociception test-dependently in mice. Pharmacol Toxicol. 1990; 66:382-386.
38. Batlle JF, Arranz EE, de Castro Carpeño J, Sáez EC, Auñón PZ, Sánchez AR, et al. Oral chemotherapy: potential benefits and limitations. Revista Oncología. 2004; 6:335-340.