Bunczak-Reeh M A, Hargreaves K M
Division of Endodontics, University of Minnesota, Minneapolis, USA.
J Endod. 1998 Dec;24(12):822-5. doi: 10.1016/S0099-2399(98)80010-1.
Although numerous studies have evaluated the effects of drugs on inflammation, comparatively few studies have evaluated the effects of inflammation on drugs. In this study, we have evaluated whether pulpal inflammation alters the delivery of flurbiprofen or Evan's blue, two agents that bind with high affinity to plasma proteins. The results indicate that pulpal inflammation alters the delivery of these agents to inflamed molars, that activation of capsaicin-sensitive nerves increases pulpal content of protein-bound agents, and that reduced pH increases free drug concentrations of flurbiprofen. Thus, alterations in both plasma extravasation and tissue pH seem to be relevant factors regulating the delivery and bioavailability of this nonsteroidal anti-inflammatory drug to dental pulp. Because many drugs used in endodontics (e.g. nonsteroidal anti-inflammatory drugs, clindamycin, bupivacaine, etc.) are heavily bound to plasma proteins, it is likely that the status of pulpal inflammation is a contributing factor in modifying the pharmacological efficacy of these agents.
尽管众多研究评估了药物对炎症的影响，但相对较少的研究评估了炎症对药物的影响。在本研究中，我们评估了牙髓炎症是否会改变氟比洛芬或伊文思蓝的递送情况，这两种药物与血浆蛋白具有高亲和力。结果表明，牙髓炎症会改变这些药物向发炎磨牙的递送，辣椒素敏感神经的激活会增加蛋白结合药物的牙髓含量，而pH值降低会增加氟比洛芬的游离药物浓度。因此，血浆外渗和组织pH值的改变似乎都是调节这种非甾体抗炎药向牙髓递送和生物利用度的相关因素。由于许多用于牙髓病学的药物（如非甾体抗炎药、克林霉素、布比卡因等）与血浆蛋白紧密结合，牙髓炎症状态很可能是改变这些药物药理疗效的一个因素。
