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Background
Diclofenac(DF) is a phenylacetic acid derivative that is a nonsteroidal anti-inflammatory medication, and has been used to treat the pain and inflammation by inhibiting COX-1 and COX-2. Diclofenac(DF) is available in 2 enteral formulations, diclofenac sodium and diclofenac potassium. Diclofenac (DF) is one of the most popular drugs world-wide belonging to the family of nonsteroidal antiinflammatory drugs (NSAIDs). Adverse drug reactions (ADRs), which occur in about every fifth patient, are well-known side effects mainly caused by the NSAIDs' acidic properties. More serious are drug hypersensitivity reactions (DHRs) to Diclofenac(DF), which clinically manifest as Type-I-like allergic reactions with sudden and unpredictable occurrence and can progress into anaphylactic shock. Two pathomechanisms are currently thought to be involved in NSAIDs hypersensitivity reactions: (i) multiple NSAIDs hypersensitivity (also those involving Diclofenac(DF)) has been considered as pharmacokinetic disorders due to non-selective coinhibition of cyclooxygenase (COX)-1 leading to shifts in the prostaglandin and leukotriene levels; (ii) in contrast, for selective NSAID hypersensitivities including DF, an involvement of the immune system is still being postulated.
Figure 1. Chemical structures of diclofenac and some derivates: (A) diclofenac, (B) 4′-hydroxydiclofenac, (C) DCF lactam, (D) aceclofenac, (E) DCF-Ahx (Ahx = 6-aminohexanoic acid). (Source:Stephan Schmidt. et al., 2024.)
Diclofenac(DF) is used in human medicine as well as in veterinary medicine. Diclofenac(DF) is administered in the form of pills or ointments. Orally absorbed Diclofenac(DF) is excreted to 65–70% via urine and 20–30% via faeces. It is largely metabolized. The main metabolite is 4′-hydroxydiclofenac, which is produced by action of the enzyme CYP2C9. Of ointments, only 6% Diclofenac(DF) is absorbed through the skin, the rest is washed off. Owing to the wash-off of ointments, by excretions and improper disposal into toilets, Diclofenac(DF) appears in wastewater and finally in sewage treatment plants. However, Diclofenac(DF) is only insufficiently removed from wastewaters with an elimination rate of 21–40%. Diclofenac(DF) accumulates along the food chain and is harmful for many species, for example fish, or the almost exterminated Indian vulture. Among pharmaceutical compounds, diclofenac is one of the most frequently analysed substances in the context of aquatic pollution.
References
1. Stephan Schmidt. et al., Re-assessment of monoclonal antibodies against diclofenac for their application in the analysis of environmental waters. Anal. Methods. 2024, , 16, 3349-3363.
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References
Modelling the fate of micropollutants in integrated urban wastewater systems: Extending the applicability to pharmaceuticals
WATER RESEARCH
Authors: Compagni, Riccardo Delli; Polesel, Fabio; Borries, Kerstin J. F. von; Zhang, Zhen; Turolla, Andrea; Antonelli, Manuela; Vezzaro, Luca
Pharmaceutical active compounds (PhACs) are a category of micropollutants frequently detected across integrated urban wastewater systems. Existing modelling tools supporting the evaluation of micropollutant fate in such complex systems, such as the IUWS_MP model library (which acronym IUWS stands for Integrated Urban Wastewater System), do not consider fate processes and fractions that are typical for PhACs. This limitation was overcome by extending the existing IUWS_MP model library with new fractions (conjugated metabolites, sequestrated fraction) and processes (consumption-excretion, deconjugation). The performance of the extended library was evaluated for five PhACs (carbamazepine, ibuprofen, diclofenac, paracetamol, furosemide) in two different integrated urban wastewater systems where measurements were available. Despite data uncertainty and the simplicity of the modelling approach, chosen to minimize data requirements, model prediction uncertainty overlapped with the measurements ranges across both systems, stressing the robustness of the proposed modelling approach. Possible applications of the extended IUWS_MP model library are presented, illustrating how this tool can support urban water managers in reducing environmental impacts from PhACs discharges. (c) 2020 Elsevier Ltd. All rights reserved.
Effects of chronic exposure to a pharmaceutical mixture on the three-spined stickleback (gasterosteus aculeatus) population dynamics in lotic mesocosms
Pharmaceutical substances are ubiquitous in the aquatic environment and their concentration levels typically range from ng/L up to several pg/L. Furthermore, as those compounds are designed to be highly biologically active, assessing their impacts on non-target organisms is important. Here, we conducted a mesocosm experiment testing a mixture of five pharmaceuticals (diclofenac, carbamazepine, irbesartan, acetaminophen and naproxen) on fish, three-spined stickleback (Gasterosteus aculeatus). The mixture concentration levels were chosen on the basis of the contamination of the Meuse river in Belgium which had been measured previously during a monitoring campaign undertaken in 2015 and 2016. Three nominal mixture concentration levels were tested: the lowest concentration level mixture was composed by environmentally-relevant concentrations that approximate average realistic values for each pharmaceuticals (Mxl); the two other levels were 10 and 100 times these concentrations. Although no impact on stickleback prey was observed, the mixture significantly impaired the survival of female fish introduced in the mesocosms at the highest treatment level without causing other major differences on fish population structure. Impacts on condition factors of adults and juveniles were also observed at both individual and population levels. Using a modelling approach with an individual-based model coupled to a bioenergetic model (DEB-IBM), we concluded that chronic exposure to environmentally-relevant concentrations of five pharmaceuticals often detected in the rivers did not appear to strongly affect the three-spined stickleback populations. Mechanisms of population regulation may have counteracted the mixture impacts in the mesocosms.
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Figure 1. Chemical structures of diclofenac and some derivates: (A) diclofenac, (B) 4′-hydroxydiclofenac, (C) DCF lactam, (D) aceclofenac, (E) DCF-Ahx (Ahx = 6-aminohexanoic acid).
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