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Thrombosis Research 127 (2011) 111–118

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Thrombosis Research
j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / t h r o m r e s

Regular Article

Anti-platelet effects of Curcuma oil in experimental models of myocardial


ischemia-reperfusion and thrombosis
Prem Prakash a, Ankita Misra a, William R. Surin a, Manish Jain a, Rabi S. Bhatta b, Raghvendra Pal c,
Kanwal Raj d, Manoj K. Barthwal a, Madhu Dikshit a,⁎
a
Department of Pharmacology, Central Drug Research Institute (CSIR), 1. M.G. Marg, Lucknow - (U.P) – 226001 India
b
Department of Pharmacokinetics and Metabolism, Central Drug Research Institute (CSIR), 1. M.G. Marg, Lucknow - (U.P) – 226001 India
c
Department of Pharmaceutics, Central Drug Research Institute (CSIR), 1. M.G. Marg, Lucknow - (U.P) – 226001 India
d
Department of Medicinal and Process Chemistry, Central Drug Research Institute (CSIR), 1. M.G. Marg, Lucknow - (U.P) – 226001 India

a r t i c l e i n f o a b s t r a c t

Article history: Extensive research on the mechanism of action and medicinal importance of curcumin obtained from
Received 28 May 2010 turmeric (Curcuma longa) has unfolded its potential therapeutic value against many chronic ailments.
Received in revised form 25 October 2010 Curcuma oil (C.oil), the highly lipophilic component from Curcuma longa has been documented for its
Accepted 8 November 2010
neuroprotective efficacy against rat cerebral ischemia-reperfusion injury; however its effect on myocardial
Available online 8 December 2010
reperfusion injury remains unexplored. In the present study, effect of C.oil (500 mg/kg, po) was evaluated
against myocardial ischemia-reperfusion induced injury in the rat model. C.oil failed to confer protection
Keywords:
C.oil/herbal medicament
against cardiac injury, however significant reversal of ADP induced platelet aggregation (p b 0.05) was evident
Myocardial ischemia-reperfusion in the same animals. Moreover, collagen and thrombin induced platelet aggregation (p b 0.001) as well as
Platelet activation tyrosine phosphorylation of various proteins in activated platelets was also suppressed. C.oil also offered
Platelet tyrosine phosphorylation significant protection against collagen-epinephrine induced thromboembolism in mice as well as augmented
Thrombosis total time to occlusion against FeCl3 induced arterial thrombosis in rats. C.oil however had no effect on
coagulation parameters (TT, PT and aPTT) and exerted a mild effect on the bleeding time. Bioavailability of
C.oil, as assessed by monitoring ar-turmerone, α,β-turmerone and curlone, was 13%, 11% and 7% respectively,
indicating high systemic exposure. Moreover, longer mean residence time (MRT) of ar-turmerone (13.2 h),
α,β-turmerone (11.6 h) and Curlone (14.0 h) and plasma elimination half lives in the range of 5.5 to 7.2 h
correlated with single 500 mg/kg dose regimen of C.oil. In the present study, C.oil thus seems to be an
efficacious and safe anti-platelet agent which was protective against intravascular thrombosis.
© 2010 Elsevier Ltd. All rights reserved.

The diversity of traditional medicinal plants has been a fertile centuries in Southeast Asia. Besides its use in Indian cooking for
ground for the source of a number of modern medicines. Besides flavour and food preservation, turmeric has also been used exten-
expanding the herbal therapeutic and preventive armamentarium, sively in Ayurvedic medicines to treat common ailments such as
traditional medicines also offer new avenues to identify new stomach upset, flatulence, dysentery, ulcers, arthritis, sprains,
pharmacophores and novel drug targets [1]. Turmeric, derived from wounds, acnes, and skin and eye infections [2]. It is attributed with
the rhizomes of Curcuma longa, is one of the oldest remedy used for numerous pharmacological activities including antioxidant, antimi-
crobial, anti-inflammatory and anti-proliferative properties [3,4]. The
volatile curcuma oil (C.oil) is however under scrutiny for various
Abbreviations: p.o., per oral; iNOS, inducible nitric oxide synthase; eNOS, biological activities. Till date, Curcuma oil has been reported for
endothelial nitric oxide synthase; nNOS, neuronal nitric oxide synthase; NO, nitric antimicrobial, antifungal, antiviral [5], anti-inflammatory, wound
oxide; ADP, adenosine diphosphate; PMA, 12-phorbol 13-myristate acetate; EGTA, healing activity and, of late, for its potent effect against human oral
ethylene glycol tetraacetic acid; HRP, horseradish peroxidase; CMC, carboxymethyl
submucosal fibrosis [6]. Thus, further evaluations against various
cellulose; TTC, 2,3,5-triphenyl tetrazolium chloride; CK-MB, creatine kinase-MB; MPO,
myeloperoxidase; HTA-Br, hexadecyl trimethyl ammonium bromide; PRP, platelet biological activities, fractionation and identification of the mechanism
rich plasma; HEPES, (N-[2-hydroxyethyl]piperazine-N’-[2-ethanesulfonic acid]); SDS, of action prior its therapeutic use are needed.
sodium dodecyl sulphate; PMSF, phenyl methyl sulphonyl fluoride; BSA, bovine serum Three fractions have been isolated so far from Curcuma oil.
albumin; MCAo, middle cerebral artery occlusion. Fraction A is enriched with ar-turmerone and turmerone, fraction B
⁎ Corresponding author. Department of Pharmacology, Central Drug Research
Institute (CSIR), Lucknow-226001, India. Tel.: +91 522 2612411 18x4254; fax: +91
consists of curcumene and zingiberine, while fraction C has germacrone,
522 2623405. curcumerone, zedoarone, sedoarondiol, isozedoaronidiol, curcumenone,
E-mail address: madhu_dikshit@cdri.res.in (M. Dikshit). and curlone [7,8]. Since C oil is highly lipophilic in nature its accessibility

0049-3848/$ – see front matter © 2010 Elsevier Ltd. All rights reserved.
doi:10.1016/j.thromres.2010.11.007
112 P. Prakash et al. / Thrombosis Research 127 (2011) 111–118

to the brain is facilitated and has been found to be protective against studies, euthanasia and disposal of carcass of animals. All the
stroke [9]. Neuroprotective action of C.oil is due to its action at multiple procedures involved were subject to IAEC guidelines.
targets that are activated in the ischemic and neurodegenerative
disorders [10]. C.oil significantly reduced expression of iNOS, nNOS and 1.3. Myocardial Ischemia Reperfusion injury in rat
eNOS, NO content as well as oxidative stress. Moreover, significant
inhibition of NO-induced peroxynitrite formation led to significant Wistar rats were divided into vehicle (0.25% CMC) treated sham,
reduction in the neuronal apoptosis [11]. C.oil thus seems to be promising vehicle treated MI/RP, ramipril (3 mg/kg), aspirin (30 mg/kg) or C.oil
against neuro-cerebrovascular disorders, however, its role against (500 mg/kg) treated MI/RP groups, and each group consisted of at
myocardial ischemia-reperfusion injury and intravascular thrombosis least six rats. All the drugs, compounds or vehicle were administered
remains unexplored. Since cardiovascular diseases are the most orally for 3 days and the animals were subjected to MI/RP procedure.
prevalent cause of morbidity and mortality worldwide [12,13], the Rats were anesthetized with ketamine (80 mg/kg) and xylazine
present study was therefore undertaken to investigate the efficacy of C.oil (10 mg/kg). The animals were tied in the supine position on the
against myocardial ischemia-reperfusion injury (MI/RP) and thrombosis temperature-controlled pad and the animals were ventilated with a
in rats. The present study was also extended to assess its pharmacokinetic rodent ventilator (Harvard Apparatus, England) at tidal volume of
properties by measuring the circulating levels of marker compounds. 1 ml /100 g body weight and rate of 80 breaths/min. Myocardial
ischemia was produced by one stage occlusion of the left anterior
1. Materials and methods descending coronary artery (LAD), 3–4 mm from its origin. The
animals then underwent 30 min of ischemia and the myocardium was
Adenosine 5’-diphosphate (ADP), thrombin, collagen, 12-phorbol reperfused by releasing the suture for a period of 180 min. Successful
13-myristate acetate (PMA), arachidonic acid, calcium ionophore reperfusion was confirmed by the visualization of arterial blood flow
(A23187), epinephrine, ferric chloride, heparin, apyrase, EGTA, aprotinin, through the artery [14], while Sham operated animals were used as
ticlopidine hydrochloride, protease inhibitors and anti-mouse HRP control. At the end of reperfusion period (180 min), animals were
conjugated secondary antibody were procured from Sigma (USA). Equine sacrificed for biochemical and histological studies.
tendon fibrillar Collagen type I was procured from Chrono-Log Corp
(USA). STA thrombin reagents, Neoplastin CI plus, Fibri-Prest, CK Prest 1.4. Assessment of Infarct Size
were purchased from Stago (France). Aspirin was obtained as a gift from
Alta Laboratories (India). Warfarin was received as a gift from Themis The hearts were cut transversely across the left ventricle to obtain
(India). Anti phosphotyrosine clone PY20 and 4 G10 were obtained from slices ~0.1 cm in thickness. Slices were placed in 1% pre-warmed TTC at
Santa Cruz biotechnology (USA) and Millipore (USA) respectively. All 37 °C for 45 min followed by rinsing with distilled water to remove any
other reagents used in the experiments were from Sigma-Aldrich (USA). traces of TTC. The Viable tissue stains pale red and the dead tissue
Reference standards of ar-turmerone, α,β-turmerone, Curlone and DHP remains uncolored. Infarct size was observed under surgical microscope
(Internal Standard) were provided by the Medicinal and Process (Leica) and quantified (Leica Qwin software). Percentage infarct size
Chemistry Division of CDRI, Lucknow, India. High-performance liquid (%IS) is the percentage area of whole section of myocardium that
chromatography (HPLC) grade methanol and acetonitrile were purchased stained with TTC [15].
from Sisco Research Laboratories Pvt. Limited (Mumbai, India). AQ11
Glacial acetic acid AR was purchased from E Merck Limited (Mumbai, 1.5. Biochemical Estimation
India). Heparin sodium injection I.P. (1000 IU/mL) was purchased from
Gland Pharma (Hyderabad, India). CK-MB concentration in serum was analyzed as per manufac-
turer's protocol (Merck). The change in absorbance (ΔA) per min was
measured spectrophotometrically using SHIMADZU UV-Visible Spec-
1.1. Instrumentation trophotometer (UV-1201) at 340 nm.
Cardiac tissue was weighed, snap frozen and homogenized in
The samples were analyzed on an API-4000 mass spectrometer potassium phosphate buffer, followed by mixing with 1% HTA-Br and
with electrospray ionization and a triple quadrupole analyzer was left overnight at 4 °C, subsequently centrifuged at 12000 rpm for
(Applied Biosystems, Toronto, Canada) coupled with HPLC system 10 min at the room temperature. MPO activity was measured by adding
consisting of Series 200 pumps and auto sampler with temperature 50 μl of supernatant to a reaction mixture containing O-dianisidine
controlled Peltier-tray and degasser (Perkin- Elmer instruments, dihydrochloride (7.09 mM) and H2O2 (44 mM) and potassium phos-
Norwalk, USA) was used to inject 40 μL aliquots of the processed phate buffer (50 mM, pH 6). The change in absorbance (ΔE) was
samples. The chromatographic separation was performed on a measured at 1 min interval over 5 min at 460 nm at 37 °C by using molar
Brownlee C18 column (50 × 4.5 mm, 5.0 μm) with guard column of coefficient [ε = 10,062 × (M × cm) -1 ] for oxidized O-dianisidine
the same make at the ambient temperature. Mobile phase consists of dihydrochloride [16].
acetonitrile and Milli-Q water (90:10 v/v) at a flow rate of 0.4 ml/min.
Mobile phase was duly filtered through 0.22 μm Millipore filter 1.6. Platelet aggregation and Coagulation parameters
(Billerica, USA) and degassed ultrasonically for 15 min prior to use.
Chromatographic runs were performed at room temperature by Rats were anaesthetized under anesthetic ether and blood (9 ml)
injecting 20 μL of the test samples. Auto-sampler carry-over effect was was drawn by cardiac puncture and mixed with 1 ml of 1.9% tri- Sodium
determined by injecting the highest calibration standard followed by citrate. Blood was centrifuged at 300 g for 20 min and the platelet rich
an injection of a blank sample. plasma (PRP) was collected for aggregation and immunoblotting
studies. Platelet aggregation in rat PRP was monitored according to
1.2. Animals the protocol described earlier [17]. Aggregation was induced by
adenosine-5’-diphosphate (ADP (10 μM)), thrombin (0.64U/ml),
Male Sprague Dawley/Wistar rats (220-300 g) and Swiss albino collagen (10 μg/ml), calcium ionophore A23187 (2.5 μg/ml) or PMA
mice (20-25 g) were kept in polypropylene cages and maintained at (1.5 μM) and was monitored on a dual channel aggregometer
24 ± 0.5 °C, 12 h day/night cycle and were provided with chow pellets (Chrono log Corp.,US). At least 6 animals were used for each group.
and water ad libitum. Prior approval from the Institutional Animal Coagulation parameters, prothrombin time (PT), activated partial
Ethics Committee (IAEC) was sought for maintenance, experimental thromboplastin time (aPTT) and thrombin time (TT) were measured
P. Prakash et al. / Thrombosis Research 127 (2011) 111–118 113

in the plasma within 2 h of sample collection from all the groups. All mice and results have been depicted as percent increase from control
the assays were performed by using commercially available kits as per [18].
manufacturer's instructions (Stago, France) and were measured by
using a Semi automated Coagulometer (Start4, Young Instruments, 1.8.4. Plasma pharmacokinetics
Stago, France) [18]. The in vivo oral pharmacokinetic study was performed in male SD
rats. C.oil was administered orally at a dose of 500 mg/kg. Blood
1.7. Immunoblotting samples were collected into microfuge tubes containing heparin as an
anti-coagulant at pre-defined time intervals. Plasma was harvested by
Acid-citrate-dextrose was added to platelet rich plasma and was centrifuging the blood at 13000 rpm for 10 min and stored frozen at –
spun at 800 g for 10 min. Platelets were then washed twice with 70 ± 10 °C until analysis. Plasma (100μL) samples analysis was done
buffer (20 mM HEPES, 138 mM NaCl, 2.9mMKCl, 1mMMgCl2 , using validated LC-MS/MS method. Along with the plasma samples,
0.36 mM NaH2PO4, 1 mM EGTA, 4.77 mM trisodium citrate, and QC samples were distributed among calibrators and unknown
2.35 mM citric acid, 5mMglucose and Apyrase 1U/ml, pH 6.5) and samples.
the cells were finally suspended in the HEPES-buffered Tyrode
solution (pH 7.4) at 2 × 108 platelets/mL [19].
1.8.5. Statistical analysis
Platelet activation was triggered in washed platelets by the
Values have been reported as the Mean ± SEM in control and drug
addition of ADP, collagen or thrombin. The reaction was stopped by
treated groups. Comparisons between the different groups were
the sample buffer (2% SDS, 0.062 M Tris-HCl, 0.01% Bromophenol blue,
performed by one way ANOVA and differences were considered
10% glycerol, 20% β-mercaptoethanol, pH 6.8) [20] containing 2 mM
significant at p b 0.05.
PMSF, 10 mM sodium fluoride and 1 mM sodium orthovanadate. The
samples were immediately boiled for 3 min and were run on SDS-
PAGE (8%), transferred on a nitrocellulose membrane (Bio-Rad, 2. Results
Hercules, CA), blocked with TBST (10 mM Tris-base, 100 mM NaCl,
and 0.01% Tween 20) containing 5% BSA for 1 h and then probed with 2.1. Effect of C.oil on myocardial ischemia reperfusion injury in rat
the primary antibodies for 2 h: anti-p-Tyr (PY20:4 G10 1:1) and anti-
β-actin (diluted 1:10000 in TBST). Membranes were washed, TTC staining of coronary artery ligated and reperfused hearts was
incubated with horseradish peroxidase-linked anti-mouse IgG (dilut- used to assess the infarct area (pale white), non-infarct area (red
ed 1:10000 in TBST) for 2 h and immunoreactive bands were detected colored, Fig. 1A) and percent infarct size (%IS, Fig. 1B). Infarct size
by enhanced chemiluminescence. following MI/RP was 21% ± 2% in control group, which was reduced to
8 ± 1% with ramipril pre-treatment (p b 0.01, Fig. 1B). However C.oil
1.8. Antithrombotic efficacy of C.oil (500 mg/kg (p.o. for 3 days) or aspirin (30 mg/kg) treated rats
exhibited no significant reduction in infarct area in MI/RP group
1.8.1. Collagen-epinephrine induced thrombosis in mice (Fig. 1B).
To assess the antithrombotic efficacy of C.oil, mice were divided Ischemia-reperfusion mediated cell death was assessed by
into vehicle, aspirin and C.oil treated groups, and each group included measuring creatine kinase-MB (CK-MB) activity. A significant increase
ten animals. Pulmonary thromboembolism was induced by injecting a in serum CK-MB activity was observed after myocardial ischaemia-
mixture of collagen (150 μg/ml) and adrenaline (50 μg/ml) into the reperfusion (450 ± 40 Vs 87 ± 6 U/L, Fig. 1C). Administration of
tail vein to achieve final doses of collagen (1.5 mg/kg) and adrenaline ramipril prevented rise of CK-MB activity (254 ± 11 U/L), while C.oil
(0.5 mg/kg) to induce hind limb paralysis or death. Results have been as well as aspirin failed to prevent the elevation in CK-MB following
reported as percentage protection, which represents protection MI/RP (Fig. 1C).
against collagen and epinephrine induced thrombosis and expressed The accumulation of polymorphonuclear leucocytes (PMNs) was
as [18]: monitored by measuring MPO activity in infarct and non-infarct
zones. MPO activity in the vehicle treated ischemic zone was 103 ±
2 μM/min/100 mg tissue, which was significantly more (p b 0.001) to
Percent Protection = ð1−Ptest = Pcontrol Þ × 100 the sham-operated group 18 ± 2 μM/min/100 mg tissue. Ramipril
treatment blunted the increase in MPO activity (53 ± 3 μM/min/
Ptest - number of animals paralyzed/dead in test compound-treated 100 mg tissue), while C.oil or aspirin (104 ± 3 μM/min/100 mg tissue)
group; Pcontrol - number of animals paralyzed/dead in vehicle treated did not prevent rise in the MPO activity Fig. 1D, suggesting that C.oil
group. failed to offer cardioprotection against MI/RP injury in the rats.

1.8.2. Ferric chloride induced arterial thrombosis in rats 2.2. Effect of C.oil on platelet activation and coagulation cascade
SD rats were anesthetized by urethane (1.25 g/kg, ip), carotid following MI/RP
artery was carefully dissected and a pulsed Doppler Probe (DBF-120A-
CPx, CBI-8000, Crystal Biotech, USA) was placed to record the blood ADP induced aggregagtion was significantly more (pb 0.05) in MI/RP
flow. A square (1 × 1mm) piece of Whatmann Chromatography paper rats (55 ± 3%) as compared to vehicle treated sham operated rats
was immersed in 20% FeCl3 solution for 5 min and placed on the (42.0 ± 2%, Fig. 2A). Moreover, the observed platelet hyperactivation in
carotid artery and blood flow was monitored. Thrombosis was MI/RP rats was persistent even in washed platelet suspension in absence
monitored as the reduction in carotid artery blood flow and the of any plasma components. ADP induced aggregation in washed
time at which the blood-flow velocity was reduced to zero was platelets of MI/RP and sham operated rats was 69 ± 2% and 55 ± 4%
recorded as time to occlusion (TTO) [21]. (Pb 0.05) respectively (data not shown). Both the standard drugs,
aspirin and ramipril were also effective in restoring the platelet function
1.8.3. Bleeding time in mice to those of sham operated groups (Fig. 2A). C.oil (500 mg/kg)
The tail of mice (approximately 2 mm from tip) was incised with a pretreatment significantly reduced ADP (5 μM) induced platelet
sharp razor blade. The time elapsed from the tip incision to the aggregagtion in PRP in comparison to the vehicle treated MI/RP controls,
stoppage of bleeding was determined as the bleeding time. The indicating that C.oil might exhibit a specific anti-platelet mechanism of
change in bleeding time was compared from that of vehicle treated action.
114 P. Prakash et al. / Thrombosis Research 127 (2011) 111–118

Fig. 1. Effect of C.oil in myocardial ischemia-reperfusion mediated cardiac injury (A) TTC stained sections of the heart obtained from vehicle, MI/RP, ramipril (3 mg/kg), aspirin
(30 mg/kg), and C.oil (500 mg/kg) treated rats followed by coronary artery ligation and reperfusion. Bar diagrams representing (B) percent infarct size. (C) Serum CK-MB level.
(D) Myeloperoxidase activity in myocardial ischemic zone (left ventricle) following coronary artery ligation and reperfusion. Results are expressed as Mean ± SEM. *p b 0.05,
***p b 0.001 vs Sham, ###p b 0.001 vs MI/RP. (n = 8-10 animals/group).

Furthermore, significant decrease in prothrombin time was significant difference in prothrombin time among ramipril (19 ±
observed in MI/RP rats (18 ± 0.3 sec) in comparison to Sham operated 0.4 sec), aspirin (19 ± 0.2 sec), or C.oil treated (22 ± 0.6 sec) groups,
animals (21 ± 0.5 sec) following cardiac injury. However there was no in comparison to vehicle treated MI/RP rats (Fig. 2B).

Fig. 2. Effect of C.oil on platelet aggregation and coagulation cascade in rats, ex vivo. Bar diagram representing (A) ADP induced platelet aggregation, (B) Prothrombin time, in rats
pretreated with vehicle, ramipril (3 mg/kg), aspirin (30 mg/kg), and C.oil (500 mg/kg) following coronary artery ligation and reperfusion and, (C) platelet aggregation induced by
various agonists in rats pretreated with vehicle, C.oil (500 mg/kg) and C.oil (1 g/kg), p.o., 1 h, (ex vivo). Results are expressed as Mean ± SEM. (*p b 0.05, **p b 0.01 & ***p b 0.001 vs
control, #p b 0.05 vs MI/RP). (n = 6 animals/group).
P. Prakash et al. / Thrombosis Research 127 (2011) 111–118 115

2.3. Effect of C.oil on platelet aggregation (ex vivo) in rats ability of C.oil to prevent protein tyrosine phosphorylation correlated
with its potency to inhibit platelet aggregation.
To systematically analyse the effect of C.oil on platelet aggregation,
rats were thus treated with C.oil (500 mg/kg) and blood was collected 2.5. Antithrombotic efficacy of C.oil
1 h and 24 h post oral dosing and the platelet rich plasma was
separated from the blood. C.oil significantly reduced ADP (31 ± 3%), 2.5.1. Collagen-epinephrine induced thrombosis in mice
collagen (28 ± 7%) and thrombin (34 ± 5%) induced aggregation in Effect of C.oil was evaluated against collagen-epinephrine induced
comparison to control (Fig. 2C). The inhibitory effect of C.oil on platelet thrombosis in mice at three time points (1, 2 and 24 h, p.o.) at 500 mg/kg
aggregation was sustained even after 24 h of C.oil administration. C oil and at 1 g/kg dose. The protection obtained at 500 mg/kg, 1 h, p.o. was
exerted significant inhibitory effect against ADP, collagen and thrombin 43± 7%, which was comparable to the effect of aspirin (38 ± 3%).
induced aggregation (pb 0.001, Fig. 2C), while PMA, calcium ionophore However, at 1 g/kg the protection was significantly more in comparison
(A23187) and arachidonic acid induced aggregation were not affected to aspirin treated group (63 ± 5% vs 38± 3%, Fig. 4A). Efficacy of C.oil
(Fig. 2C). (1 g/kg) remained consistent even after 2 (60 ± 3%) and 24 h (50 ± 5%)
Moreover, thrombin time (TT), prothrombin time (PT) and of its administration, while the plasma levels of its marker components
activated partial thromboplastin time (aPTT) in control group and reached maximum at 2 h, suggesting that the anti-thrombotic efficacy of
C.oil treated groups at both 500 mg/kg and 1 g/kg dose remained C.oil was either due to some other components or the level achieved at
unaltered and there was no evident modification of the coagulation 1 h was sufficient to protect animals against thrombosis and further
cascade even after 24 h of its administration (data not shown). modulation in the level did not affect anti-thrombotic efficacy.

2.5.2. Ferric chloride induced thrombosis in rats


2.4. Platelet protein tyrosine phosphorylation after C.oil treatment Application of ferric chloride to the adventitial surface of the
carotid artery led to the formation of a stable thrombus. Complete
Effect of C.oil on platelet signal transduction pathways was cessation of blood flow in the vehicle treated control group was at
eventually evaluated following ADP, thrombin and collagen mediated 14 ± 1 min. C.oil significantly augmented the time to occlusion
platelet activation. Platelets exhibit high level of non-receptor protein (TTO) at 500 mg/kg and 1 g/kg dose (p.o., 1 h). Anti-platelet drugs
tyrosine kinase (PTK) activity [22]. The activation of platelets with like aspirin (16 ± 1 min) and ticlopidine (13 ± 2 min) did not
agonists such as thrombin, collagen and ADP leads to several events enhance TTO at the doses used. Prolongation in TTO observed
(including shape change, granule secretion, binding of soluble after pretreatment with C.oil was 22 ± 3 min and 20 ± 2 min at
fibrinogen to its receptor and aggregation) that are primarily 500 mg/kg and 1 g/kg (1 h) respectively (Fig. 4B). The delay in
regulated through a number of intracellular signalling proteins, occlusion time was significantly more than aspirin and ticlopidine
including tyrosine kinases. In the present study, collagen, ADP and treated groups and remained consistent even after 24 h.
thrombin induced phosphorylation of multiple proteins in platelets
ranging from ~ 120-90, 80-85, 70-75 and 60-55 kDa after 1 min of 2.5.3. Bleeding time in mice
stimulation was monitored (Fig. 3A, B). Aspirin and C.oil (500 mg/kg Bleeding time in control vehicle group was 4 ± 1 min, which was
and 1 g/kg) reduced tyrosine phosphorylation of various proteins in significantly prolonged in the aspirin treated group (8± 4 min). C.oil,
ADP, thrombin and collagen stimulated platelets (Fig. 3A, B). The after 1 h, led to 18% and 25% increase in the bleeding time at 500 mg/kg

Fig. 3. Effect of C.oil on protein tyrosine phosphorylation.Washed platelets from control and treated rats were stimulated with (A) ADP (10 μM), thrombin (1U/ml) and (B) collagen
(10 μg/ml) for 1 min and samples were lysed at different time points. Protein tyrosine phosphorylation was detected by immunoblotting with anti-phosphotyrosine 4 G10 and PY20.
The blots shown are representative of three separate experiments.
116 P. Prakash et al. / Thrombosis Research 127 (2011) 111–118

Fig. 4. Effect of C.oil on arterial thrombosis and hemostasis in animal models. Bar diagram representing (A) percent protection in collagen-epinephrine induced pulmonary
thromboembolism in mice pretreated with Aspirin (30 mg/kg), C.oil (500 mg/kg) and C.oil (1 g/kg) p.o.1, 2 and 24 h. (n = 40 animals/group) (B) Total time to occlusion in FeCl3-
induced arterial thrombosis in rats pretreated with Aspirin (30 mg/kg), Ticlopidine (200 mg/kg), C.oil (500 mg/kg) and C.oil (1 g/kg) (n = 8-10 animals/group) (C) Bleeding time in
mice treated with Aspirin (30 mg/kg), C.oil (500 mg/kg, p.o.,1 h), C.oil (500 mg/kg, p.o., 24 h) and C.oil (1 g/kg, p.o., 1 h). Results are expressed as Mean ± SEM (*p b 0.05 from aspirin
treated group).

and 1 g/kg respectively. Bleeding time remained mildly affected even established curcumin as a pleotropic molecule, which is useful for
after 24 h (Fig. 4C). neurodegenerative, cardiovascular, pulmonary, metabolic, arthritic
and autoimmune diseases [24]. Studies using C.oil exhibited neuro-
2.5.4. Quantification of bisabolane sesquiterpenoid markers in C.oil protective effects against cerebral stroke in rat MCAo model [9–11].
Principal component analysis of bisabolane sesquiterpenoid However effect of C.oil was not investigated against myocardial
markers ar-turmerone, α, β-turmerone and curlone in C.oil was done ischemia-reperfusion injury. In the present study, C.oil failed to
by the HPLC-tandem mass spectrometry technique. Table 1 shows salvage the injured myocardium at the same dose which was most
abundance of ar-turmerone, α,β-turmerone and curlone in C.oil, protective against cerebral ischemia [11]. Curcumin was found
amounting to nearly 45 to 55% of total oil content. protective against myocardial ischemia in cats [25]. C.oil however,
failed to exhibit cardio-protective activity, as evident from unaltered
2.5.5. Plasma Pharmacokinetics infarct size, MPO activity in the infarct tissue [26] and CK-MB release
The in vivo pharmacokinetic studies further explored the oral in the serum following MI/RP in rats. The widely used antithrombotic
bioavailability of ar-turmerone (12.66%), which was substantially drug aspirin was also ineffective in ameliorating the reperfusion
higher than α, β-turmerone (10.47%) and curlone (6.82%). Plasma mediated injury. The neuroprotective effects of C.oil on the basis of
elimination half life of ar-turmerone (7.2 h) was also higher than available data might be attributed to the reduction of NOS expression,
α, β-turmerone (5.6 h) and Curlone (6.8 h). Peak plasma levels of NO mediated peroxynitrite formation, oxidative stress and neuronal
ar-turmerone (386.0 ± 30.04 ng/ml), α, β-turmerone (389.7 ± apoptosis [11]. Reports from literature in rat MI/RP model paradox-
61.0 ng/ml) and Curlone (27.2 ± 2.7) were observed at 2 h (Fig. 5 A, ically indicate that unlike cerebral ischemia, induction of iNOS
B, C). Overall systemic availability of ar-turmerone, α, β-turmerone and prevented cardiac injury in rats [27]. Reported attenuation of NOS
curlone was found to be 3534.43, 2882.4 and 287.5 h*ng/mL respec- expression by Coil might be the reason for its ineffectiveness in the
tively and the three markers were detectable in plasma up to 48, 36 and prevention of MI/RP injury in the rat model.
24 h respectively indicating their prolonged systemic availability. In the present study, MI/RP was accompanied with platelet
activation in response to ADP, both in the presence and absence of
3. Discussion plasma, indicating that the platelet activation subsequent to reperfu-
sion injury was not due to plasma derived factors. This is in close
Curcumin and curcuma oil, the two major components isolated agreement with the clinical scenario in which enhanced platelet
from Curcuma longa L. (Zingiberaceae), exhibit important therapeutic aggregation has been observed in patients with recent coronary
potential [23]. Extensive research within the past decade has events [28,29]. Anti-platelet effect of curcumin is already well-
established in diverse experimental settings [30–32]. It was further
mimicked by C.oil in reversing ADP mediated platelet aggregation in
Table 1 MI/RP model, which was comparable to the inhibitory effect conferred
Quantification of bisabolane sesquiterpenoid markers in C.oil by HPLC- tandem mass by aspirin. This paved the way for detailed investigation of
spectometry.
antithrombotic properties of C.oil in rats after oral administration.
Marker-1 Marker-2 Marker-3 C.oil dose dependently reduced ADP, collagen and thrombin
Ar-turmerone (%) α,β-turmerone (%) Curlone (%) induced platelet aggregation, which indicated the presence of potent
anti-platelet compounds as its constituents. C.oil contains ar-turmerone,
21 to 25 20-28 2.3-3.0
α,β-turmerone and curlone as three major components amounting to
P. Prakash et al. / Thrombosis Research 127 (2011) 111–118 117

Fig. 5. Plasma concentration time profile of (A) Ar-turmerone, (B) α,β-Turmerone (C) Curlone, after administration of single dose of C.oil (500 mg/kg) in rats by oral route. Results at
each time point are expressed as Mean ± SEM.

nearly 45 to 55% of total oil, and are supposedly responsible for its broad tyrosine residues which regulate various platelet functional responses
range of therapeutic benefits [7,8]. Ar-turmerone has been shown to [34]. The tyrosine phosphorylation was significantly attenuated after
inhibit collagen (IC50, 14.4 μM) and arachidonic acid (IC50, 43.6 μM) the C.oil treatment, thus demonstrating its involvement in the
induced platelet aggregation [33]. However, C.oil collectively reduced modulation of specific signaling mechanisms during platelet activation.
thrombin, collagen and ADP induced aggregation, while it was not Anti-thrombotic activity of C.oil appears to be platelet mediated as
effective against AA, PMA or A23187, suggesting that the overall anti- under similar experimental conditions coagulation parameters (TT, PT
platelet effect of C.oil was possibly at the membrane/receptor level, and aPTT) in the rat plasma were not altered.
unlike curcumin, which modulates cycloxygenase (COX) activity. It also The ex vivo anti-platelet property of C.oil observed in rats was
seems that apart from ar-turmerone other constituents might also further translated and verified in animal models of thrombosis. The
possess platelet inhibitory activity, necessitating detailed exploration of time course of the antithrombotic effect of C.oil after oral adminis-
C.oil components for their anti-platelet effects. Platelet stimulation with tration was studied in the mice model of collagen-epinephrine
ADP, collagen and thrombin, phosphorylated multiple proteins at induced pulmonary thromboembolism. The model is characterized
118 P. Prakash et al. / Thrombosis Research 127 (2011) 111–118

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Acknowledgment [28] Coulter SA, Cannon CP, Ault KA, Antman EM, Van de Werf F, Adgey AA, et al.
High levels of platelet inhibition with abciximab despite heightened platelet
The authors are thankful to Council of Scientific and Industrial activation and aggregation during thrombolysis for acute myocardial infarction:
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Research (CSIR), India and Central Drug Research Institute (CDRI), 2000;101(23):2690–5.
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