ABSTRACT-Brain inflammation underlies the pathogenesis of Alzheimer's disease (AD) and nonsteroidal anti-inflammatory drug therapy may delay the onset of AD. We investigated, in vivo, the effects of NOflurbiprofen on brain inflammation in rats injected with quisqualic acid into the nucleus basalis and on the release of nitric oxide from the drug in naive rat brains. We showed that the excitotoxin-induced microglia reaction, the expression of inducible nitric oxide synthase-positive cells and the production of interleukin1b and prostaglandin-E2 in the injected area were attenuated by the NO-flurbiprofen (15 mg / kg, p.o.) treatment. An oral administration of NO-flurbiprofen (25, 50 and 100 mg/kg) to naive rats was followed by significant increases in cortical nitrite levels. This drug may have important therapeutic implications for the treatment of AD.Keywords: Nucleus basalis, Alzheimer's disease, Nitric oxide-releasing nonsteroidal anti-inflammatory drug,Inflammatory mediatorRecent studies have demonstrated a role for immune activation in the most common neurodegenerative disease in aging humans, namely Alzheimer's disease (AD) (1). Abnormal deposition of complement components, acutephase reactants, as well as various cytokines, and up-regulation of inducible cyclooxygenase (COX-2) are among the features detected in AD brain (2, 3). The neuritic plaques, a histopathological hallmark of the disease, are typically surrounded by reactive astrocytes and microglia, which are capable of producing and releasing proteases, complement components, reactive oxygen and nitrogen intermediates and cytokines. Epidemiological studies (1) reporting that chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) reduces the risk and delays the clinical expression of AD (4, 5) and that AD and rheumatoid arthritis are diagnosed in the same individuals less frequently than expected (6) support the hypothesis that inflammation is closely related to the clinical manifestation of AD. Most NSAIDs have numerous gastrointestinal side effects (7) that significantly limit their usefulness in the long-term therapy that is necessary for AD patients (8).A new class of nitric oxide (NO)-releasing NSAID derivatives, including NO-flurbiprofen (HCT-1026), generated by the incorporation of a nitroxybutyl moiety through an ester linkage to the parent NSAID, exhibits, in experiments in animals and healthy volunteers, a reduced gastrointestinal toxicity when compared with the corresponding parent NSAID (9 -11). NO plays an important role in gastric mucosal defense, and it is believed that NO-NSAIDs spare the gastrointestinal tract by local release of NO. This leads to an increase in mucosal blood flow and thus to the prevention of the pathogenic events subsequent to the suppression of prostaglandin synthesis (11,12).We showed that quisqualic acid injection into the nucleus basalis (NB) of rats induces an intense glia reaction and the production of inflammatory mediators and that the administration of the NSAID nimesulide significantly attenuates th...