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Kaya K, Ciftci O, Basak Turkmen N, Taşlıdere A, Gül CC. β-Glucan ameliorates cisplatin-induced oxidative and histological damage in kidney and liver of rats. Biotech Histochem 2024; 99:92-100. [PMID: 38444353 DOI: 10.1080/10520295.2024.2320626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
We investigated the effects of β-glucan (βg) on kidney and liver damage caused by cisplatin (CP), an antineoplastic agent widely used to treat many types of cancer, in a rat model. The side effects of CP in many tissues and organs limit its usage. βg is a natural polysaccharide that is an effective free radical scavenger. A total of 28 rats were randomly divided into four groups. Group 1 was a non-intervention control, only feed and water were given. Group 2 was administered 7 mg/kg CP in a single dose. Group 3 was administered 50 mg/kg βg orally for 14 days. Group 4 was administered βg for 14 days, following a single dose of CP. At the end of the experiment, kidney and liver tissues were evaluated biochemically and histopathologically. Increased thiobarbituric acid-reactive substances (TBARS) levels, as well as decreased catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) activities, and reduced glutathione (GSH) levels, as well as histological damage, were noted in both the kidney and liver tissues of the CP group. However, βg treatment prevented the oxidative and histopathological effects of CP. The study demonstrates the protective efficacy of βg against CP-induced kidney and liver damage through the effect of its antioxidant properties.
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Affiliation(s)
- Kürşat Kaya
- Department of Medicinal Biochemistry, Faculty of Medicine, Pamukkale University, Denizli, Türkiye
| | - O Ciftci
- Department of Pharmacology, Faculty of Medicine, Pamukkale University, Denizli, Türkiye
| | - N Basak Turkmen
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, İnönü University, Malatya, Türkiye
| | - A Taşlıdere
- Department of Histology and Embryology, Faculty of Medicine, İnönü University, Malatya, Türkiye
| | - C C Gül
- Department of Histology and Embryology, Faculty of Medicine, İnönü University, Malatya, Türkiye
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Aissous I, Benrebai M, Ameddah S, Menad A, Erenler R, Benayache S, Benayache F. The preventive effects of Centaurea maroccana Ball. extract against oxidative stress induced by cisplatin in mice brains: in vitro and in vivo studies. Drug Chem Toxicol 2023; 46:1162-1175. [PMID: 36330673 DOI: 10.1080/01480545.2022.2139841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/28/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
Since antiquity, Centaurea species have been used in folk medicine to treat several diseases owing to their potential biological activities that distinguish this genus such as antioxidant, anticancer, and anti-inflammatory effect. The current study aimed to investigate the possible neuroprotective effects of the n-butanol extract of Centaurea maroccana (BECM) against cisplatin (CP) induced neurotoxicity in mice. BECM's potential neuroprotective properties were studied in vitro and in vivo models. Male Swiss albino mice were orally received BECM (200 mg/kg) for 10 days before a single intraperitoneal injection of cisplatin (8 mg/kg). Vitamin E (100 mg/kg) was given daily by gavage as a positive control. In vitro results revealed that BECM inhibited lipid peroxidation (LPO) levels and acetylcholinesterase (AChE) activity. In vivo findings showed that BECM pretreatment was able to regulate lactate dehydrogenase (LDH) levels and to improve CP-induced cholinergic dysfunction by inhibiting AChE activity in mice brains. Moreover, BECM attenuated CP-provoked oxidative stress by suppressing LPO levels, increasing total antioxidant capacity (TAC) and enhancing the activities of antioxidant enzymes (catalase (CAT), superoxide dismutase (SOD), reduced glutathione (GSH), glutathione peroxidase (GPx) and glutathione S-transferase (GST)) in both brain cytosolic and mitochondrial fractions. The histological analysis exhibited neurotoprotective effect of BECM by protecting the cerebral cortex and reducing the histomorphological alterations resulted by cisplatin. Interestingly, our extract achieved neuroprotection comparable to vitamin E in most evaluated parameters. It appears that protective potency of BECM against CP-induced neurotoxicity could be related to its richness in polyphenols confirmed by liquid-chromatography tandem mass spectrometry analysis (LC-MS/MS).
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Affiliation(s)
- Imane Aissous
- Laboratory of Biology and Environment, Department of Animal Biology, Faculty of Sciences of Nature and Life, University of Mentouri Constantine 1, Constantine, Algeria
| | - Mouad Benrebai
- Laboratory of Biology and Environment, Department of Animal Biology, Faculty of Sciences of Nature and Life, University of Mentouri Constantine 1, Constantine, Algeria
| | - Souad Ameddah
- Laboratory of Biology and Environment, Department of Animal Biology, Faculty of Sciences of Nature and Life, University of Mentouri Constantine 1, Constantine, Algeria
| | - Ahmed Menad
- Laboratory of Biology and Environment, Department of Animal Biology, Faculty of Sciences of Nature and Life, University of Mentouri Constantine 1, Constantine, Algeria
| | - Ramazan Erenler
- Plant Research Laboratory, Department of Chemistry, Faculty of Arts and Sciences, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Samir Benayache
- Research Unit, Valorization of Natural Resources, Bioactive Molecules, Physicochemical and Biological Analysis (VARENBIOMOL), University of Mentouri Constantine 1, Constantine, Algeria
| | - Fadila Benayache
- Research Unit, Valorization of Natural Resources, Bioactive Molecules, Physicochemical and Biological Analysis (VARENBIOMOL), University of Mentouri Constantine 1, Constantine, Algeria
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Khalil EA, Swelim H, El-Tantawi H, Abdellatif A. Sea urchin (Diadema savignyi) extract as a novel protective agent against cisplatin induced neurotoxicity in rats. BMC Pharmacol Toxicol 2023; 24:11. [PMID: 36823675 PMCID: PMC9948489 DOI: 10.1186/s40360-023-00651-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
Neurotoxicity is a severe side effect of platinum compounds used for cancer chemotherapy such as Cisplatin. This neurotoxicity leads to severe cognitive and nervous dysfunction, therefore, limiting the dose of Cisplatin and compromising the treatment protocol.The present study investigates the neuroprotective effect of Sea Urchins which is a marine animal known for its rich bioactive compounds. Male Sprague Dawley rats received Cisplatin (2 mg/kg body weight) for 4 weeks, two times per week, followed by Sea Urchin extracts (50 and 100 mg/kg body weight) twice weekly for 4 weeks.Results show that rats treated with Urchin's extracts showed a significant improvement in the thermal (heat and cold) sensitivity compared to untreated rats. Liver enzymes Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) and Urea levels were also significantly decreased back to normal following treatment with sea urchin extracts. Brain tissue oxidative stress marker Nitric oxide (NO) and lipid peroxidation marker Malondialdehyde (MDA) increased significantly in the cisplatin-treated rats while the reduced glutathione levels (GSH) and catalase activity (CAT) showed a significant decrease. Treatment with sea Urchin extracts reversed these changes.Histological and immunohistochemical examination of the cerebral cortex reveled degenerative changes such as karyopyknosis and shrunken necrotic ghost like neurons in the cisplatin treated groups. There was also strong positive Glial fibrillary acidic protein (GFAP) reactivity and a negative B-cell leukemia/lymphoma 2 protein (Bcl2) reaction in most apparent neurons, indicating strong apoptotic changes. Treatment with Urchin extracts reversed these changes. Quantification of cerebral cortex neurons also revealed the strong effect of the extracts. Cisplatin treated groups showed 3708 cells/ mm3 compared to 8091 cells/mm3 in the normal rats. Extract treatment increased the neuronal numbers to almost normal levels. Quantification of the Immuno-histochemical expression of GFAP showed an increase by 10-folds after cisplatin administration. A remarkable decline from the cisplatin group was seen in the extract treated groups.In Conclusion, Sea Urchins extracts possess a strong neuroprotective activity and could provide a novel therapeutic method to prevent Cisplatin-induced neurotoxicity.
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Affiliation(s)
- Eman A Khalil
- Department of Biology, School of Sciences and Engineering, The American University in Cairo, Cairo, 11835, Egypt
| | - Hamdy Swelim
- Department of Zoology, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Hala El-Tantawi
- Department of Zoology, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Ahmed Abdellatif
- Department of Biology, School of Sciences and Engineering, The American University in Cairo, Cairo, 11835, Egypt.
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Rahimi A, Asadi F, Rezghi M, Kazemi S, Soorani F, Memariani Z. Natural products against cisplatin-induced male reproductive toxicity: A comprehensive review. J Biochem Mol Toxicol 2021; 36:e22970. [PMID: 34820939 DOI: 10.1002/jbt.22970] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/09/2021] [Accepted: 10/26/2021] [Indexed: 12/17/2022]
Abstract
Cisplatin is widely used as one of the most effective anticancer agents in the treatment of some neoplasms. Reproductive toxicity is the most common outcome associated with cisplatin testicular damage. Alternative natural medicines for treating male testicular disorders and infertility have received extensive attention in research. Natural products, medicinal herbs, and their secondary metabolites have been shown as promising agents in the management of testicular damage induced by chemotherapy drugs. This study aimed to review the research related to natural substances that are promising in mitigation of the cisplatin-induced toxicity in the reproductive system. PubMed and Scopus were searched for studies on various natural products for their potential protective property against reproductive toxicity induced by cisplatin from 2000 to 2020. Eligibility was checked based on selection criteria. Fifty-nine articles were included in this review. Mainly in animal studies, several natural agents have positively affected cisplatin-reproductive-toxicity factors, including reactive oxygen species, inflammatory mediators, DNA damage, and activation of the mitochondrial apoptotic pathway. Most of the natural agents were investigated in short-term duration and high doses of cisplatin exposure, considering their antioxidant activity against oxidative stress. Considering antioxidant properties, various natural products might be effective for the management of cisplatin reproductive toxicity. However, long-term recovery of spermatogenesis and management of low-dose-cisplatin toxicity should be considered as well as the bioavailability of these agents before and after treatment with cisplatin without affecting its anticancer activity.
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Affiliation(s)
- Atena Rahimi
- Department of Pharmacology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Farideh Asadi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Maedeh Rezghi
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Soharb Kazemi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farangiz Soorani
- Department of Pharmacology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Memariani
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Department of traditional Persian Medicine, School of traditional Medicine, Babol University of Medical Sciences, Babol, Iran
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Mokhtar HEL, Hulail MAE, Mahmoud SM, Yousef DM. Impact of cisplatin administration on cerebellar cortical structure and locomotor activity of infantile and juvenile albino rats: the role of oxidative stress. Anat Sci Int 2021; 97:30-47. [PMID: 34386931 DOI: 10.1007/s12565-021-00624-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/01/2021] [Indexed: 11/30/2022]
Abstract
The central neurotoxicity of cisplatin (CisPt) has always raised questions especially during development, but few studies are available. Hence, this work was designed to assess the CisPt's impacts on the postnatal rat cerebellum via evaluation of locomotor activity, histological and immunohistochemical studies, and to focus on cerebellar oxidative stress-related alterations. Eighty newborn pups were divided into 2 equal experimental groups: the control group was kept without any treatment and CisPt-treated group received a single subcutaneous injection of CisPt (5 μg /g b.w.) in their nape at PD10. Ten rats at PD11, PD17, and PD30 ages were weighed, then deeply anesthetized and sacrificed. For locomotor assessment, 20 pups were divided equally into control and CisPt-treated groups and tested at PD11-13, PD15-17, and PD28-30 ages. CisPt-treated rats suffered from decreased motor activity and showed decreased body and cerebellar weights, reduced levels of enzymatic antioxidants (SOD and CAT), and non-enzymatic antioxidant defense (GSH), and increase of lipid peroxidation marker (MDA). Histopathologically, CisPt sowed deleterious changes within cerebellar cortical layers in the form of vacuolations, decreased thickness, and hemorrhage (in PD17), while Purkinje cells exhibited profound degenerative changes in the form of swelling, disrupted arrangement, distortion, and nuclear shrinkage. In CisPt-treated rats, GFAP demonstrated upregulated, hypertrophied, and branched Bergmann glial fibers and reactive astrogliosis. Immuno-localization of Ki-67-positive cells revealed defective migration associated with decreased proliferation in early ages in addition to glial proliferation in PD30. In conclusion, CisPt causes oxidative stress-related deleterious effects on structure of developing cerebellar cortex and affects locomotor activity.
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Affiliation(s)
- Hanan E L Mokhtar
- Human Anatomy and Embryology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohey A E Hulail
- Human Anatomy and Embryology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Samar Mortada Mahmoud
- Human Anatomy and Embryology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Doaa Mohammed Yousef
- Human Anatomy and Embryology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Neamat‐Allah ANF, Abd El Hakim Y, Mahmoud EA. Alleviating effects of β‐glucan in Oreochromis niloticuson growth performance, immune reactions, antioxidant, transcriptomics disorders and resistance to Aeromonas sobriacaused by atrazine. AQUACULTURE RESEARCH 2020; 51:1801-1812. [DOI: 10.1111/are.14529] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/10/2020] [Indexed: 09/02/2023]
Affiliation(s)
- Ahmed N. F. Neamat‐Allah
- Department of Clinical Pathology Faculty of Veterinary Medicine Zagazig University Zagazig City Sharkia Province Egypt
| | - Yasser Abd El Hakim
- Department of Fish Diseases and Management Faculty of Veterinary Medicine Zagazig University Zagazig City Sharkia Province Egypt
| | - Essam A. Mahmoud
- Department of Clinical Pathology Faculty of Veterinary Medicine Zagazig University Zagazig City Sharkia Province Egypt
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Akaras N, Abuc OO, Koc K, Bal T, Geyikoglu F, Atilay H, Erol HS, Yigit S, Gul M. (1 → 3)-β-d-glucan enhances the toxicity induced by Bortezomib in rat testis. J Food Biochem 2020; 44:e13155. [PMID: 31960484 DOI: 10.1111/jfbc.13155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/01/2020] [Accepted: 01/02/2020] [Indexed: 12/17/2022]
Abstract
We aimed to determine the possible effects of the antioxidant agent (1 → 3)-β-D-glucan on bortezomib-induced rat testis damage. We used five groups of rats; control, (1 → 3)-β-D-glucan (75 mg/kg), bortezomib group, bortezomib + (1 → 3)-β-D-glucan groups (injection of (1 → 3)-β-D-glucan after bortezomib and sacrificed at 48th or 72nd h). The effects of these substances were assessed by measuring the levels of the antioxidant enzymes and LPO, and by performing immunohistochemical analysis with NF-κB. The histology of testis was evaluated using aniline blue staining. (1 → 3)-β-D-glucan leads to significant reductions in the levels of antioxidant enzymes and increased levels of LPO in testes. Moreover, it increased the NF-κB immunopositivity significantly in testis, especially in Bortezomib + (1 → 3)-β-D-glucan group at 48th h. The histological changes were observed in the bortezomib and/or (1 → 3)-β-D-glucan groups. Our results demonstrated that testis damage caused by the treatment with bortezomib was not eliminated by (1 → 3)-β-D-glucan and shockingly it increased the damage. PRACTICAL APPLICATIONS: The testis damage caused by the treatment with bortezomib was not eliminated by (1 → 3)-β-D-glucan and as a result, β-1,3-(D)-glucan enhanced the toxicity by leading a decrease in the levels of GSH, SOD, and CAT, thus caused an elevation in the immunoreactivity of NF-κB and altered the histopathological changes by enhancing the toxic effects of bortezomib. The findings of the previous studies about the antioxidative activity of (1 → 3)-β-D-glucan are controversial. So, it is necessary to consider the cytotoxicity of (1 → 3)-β-D-glucan in testis tissue. Thus, more studies on testis tissue are necessary to confirm that (1 → 3)-β-D-glucan is safe as an antioxidant.
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Affiliation(s)
- Nurhan Akaras
- Department of Histology and Embryology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Ozlem Ozgul Abuc
- Department of Histology and Embryology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Kubra Koc
- Department of Biology, Faculty of Science, Ataturk University, Erzurum, Turkey
| | - Tugba Bal
- Department of Histology and Embryology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Fatime Geyikoglu
- Department of Biology, Faculty of Science, Ataturk University, Erzurum, Turkey
| | - Hilal Atilay
- Department of Histology and Embryology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Huseyin Serkan Erol
- Department of Biochemistry, Faculty of Veterinary Medicine, Kastamonu University, Kastamonu, Turkey
| | - Serdar Yigit
- Department of Histology and Embryology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Murat Gul
- Department of Urology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
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Kaya K, Ciftci O, Aydın M, Cetin A, Basak N. Favourable effect of β-glucan treatment against cisplatin-induced reproductive system damage in male rats. Andrologia 2019; 51:e13342. [PMID: 31274209 DOI: 10.1111/and.13342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 04/27/2019] [Accepted: 05/08/2019] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to investigate the potential beneficial effects of β-glucan treatment against oxidative, histological and spermatological damage caused by cisplatin on the male reproductive system. Twenty-eight Sprague Dawley male rats were used in the study. The rats were randomly divided into four equal-sized groups: a control group, cisplatin group (7 mg/kg in a single-dose cisplatin administered intraperitoneally), β-glucan group (β-glucan given at a dose of 50 mg kg-1 d-1 for 14 day) and a cisplatin plus β-glucan group (cisplatin and β-glucan administered together at the same dose). Cisplatin administration induced an increase in the level of thiobarbituric acid-reactive substances, a lipid peroxidation indicator. It induced a decrease in enzymatic (superoxide dismutase, catalase and glutathione peroxidase) activities and nonenzymatic (reduced glutathione) antioxidant levels. In addition, cisplatin caused both histological and spermatological damage, as shown by a decrease in sperm motility and epididymal sperm concentrations and an increase in abnormal sperm rates. The β-glucan treatment improved cisplatin-induced oxidative, histological and spermatological damage. This study revealed that β-glucan treatment provided prevention against male reproductive system damage caused by cisplatin. These preventative effects were likely due to its antioxidant properties.
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Affiliation(s)
- Kürşat Kaya
- Department of Biochemistry, Faculty of Pharmacy, Adiyaman University, Adiyaman, Turkey
| | - Osman Ciftci
- Department of Medicinal Pharmacology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Muhterem Aydın
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| | - Aslı Cetin
- Department of Histology and Embryology, Faculty of Medicine, Inönü University, Malatya, Turkey
| | - Neşe Basak
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Inönü University, Malatya, Turkey
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Kaya K, Çiftçi O, Öztanır MN, Taşlıdere E, Türkmen NB. Beta-glucan attenuates cerebral ischemia/reperfusion-induced neuronal injury in a C57BL/J6 mouse model. BRAZ J PHARM SCI 2019. [DOI: 10.1590/s2175-97902019000218312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Low-dose cisplatin causes growth inhibition and loss of autophagy of rat astrocytes in vitro. Neurosci Lett 2018; 682:112-117. [DOI: 10.1016/j.neulet.2018.06.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/04/2018] [Accepted: 06/15/2018] [Indexed: 12/23/2022]
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Taşlı NG, Uçak T, Karakurt Y, Keskin Çimen F, Özbek Bilgin A, Kurt N, Süleyman H. The effects of rutin on cisplatin induced oxidative retinal and optic nerve injury: an experimental study. Cutan Ocul Toxicol 2018; 37:252-257. [DOI: 10.1080/15569527.2018.1442842] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Nurdan Gamze Taşlı
- Department of Ophthalmology, College of Medicine, Erzincan University Hospital, Erzincan, Turkey
| | - Turgay Uçak
- Department of Ophthalmology, College of Medicine, Erzincan University Hospital, Erzincan, Turkey
| | - Yücel Karakurt
- Department of Ophthalmology, College of Medicine, Erzincan University Hospital, Erzincan, Turkey
| | - Ferda Keskin Çimen
- Department of Pathology, College of Medicine, Erzincan University Hospital, Erzincan, Turkey
| | - Aslı Özbek Bilgin
- Department of Pharmacology, College of Medicine, Erzincan University Hospital, Erzincan, Turkey
| | - Nezahat Kurt
- Department of Biochemistry, College of Medicine, Atatürk University Hospital, Erzurum, Turkey
| | - Halis Süleyman
- Department of Pharmacology, College of Medicine, Erzincan University Hospital, Erzincan, Turkey
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