Ramipril and Olmesartan: Unveiling their pleiotropic potential as immunomodulators

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Abstract
BACKGROUND: Studying the pleiotropic effects of medicines can reveal their unexplored therapeutic advantages. It promotes repurposing established drugs or identifying compounds that affect multiple targets. The widely prescribed antihypertensive agents, ramipril and olmesartan, because of their ability to reduce C-reactive protein activity, may also modulate the immune system. AIM: The study aims to demonstrate the potential immunomodulatory effects of ramipril and olmesartan, which would be beneficial for the management of inflammation in patients with coexisting hypertension. MATERIALS AND METHODS: The anti-inflammatory properties of the drugs were studied in acute and chronic models of inflammation. The immunomodulatory action was evaluated using a neutrophil adhesion test, proinflammatory and anti-inflammatory cytokine assay, and hemagglutination antibody titer assay. Histopathological analyses of rat paw edema were also performed. RESULTS: Both drugs demonstrated enhanced neutrophil adhesion, increased hemagglutination antibody titers, reduced paw edema, and improvement in cellular and structural changes associated with inflammation. Drug treatment also inhibited proinflammatory cytokine production while promoting anti-inflammatory cytokine production. CONCLUSION: The results indicate the immunomodulatory potential of ramipril and olmesartan at equipotent antihypertensive doses, compared with the standard drugs, in Wistar albino rats. The results reveal that olmesartan exhibits superior immunomodulatory properties compared with Ramipril.

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