Effect of antioxidant supplementation on digestive enzymes in radiation induced intestinal damage in rats

Molecular mechanisms underlying methotrexate-induced intestinal injury and protective strategies

Methotrexate (MTX) is a folic acid reductase inhibitor that manages various malignancies as well as immune-mediated inflammatory chronic diseases. Despite being frequently prescribed, MTX's severe multiple toxicities can occasionally limit its therapeutic potential. Intestinal toxicity is a severe adverse effect associated with the administration of MTX, and patients are significantly burdened by MTX-provoked intestinal mucositis. However, the mechanism of such intestinal toxicity is not entirely understood, mechanistic studies demonstrated oxidative stress and inflammatory reactions as key factors that lead to the development of MTX-induced intestinal injury. Besides, MTX causes intestinal cells to express pro-inflammatory cytokines like interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), which activate nuclear factor-kappa B (NF-κB). This is followed by the activation of the Janus kinase/signal transducer and activator of the transcription3 (JAK/STAT3) signaling pathway. Moreover, because of its dual anti-inflammatory and antioxidative properties, nuclear factor erythroid-2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) has been considered a critical signaling pathway that counteracts oxidative stress in MTX-induced intestinal injury. Several agents have potential protective effects in counteracting MTX-provoked intestinal injury such as omega-3 polyunsaturated fatty acids, taurine, umbelliferone, vinpocetine, perindopril, rutin, hesperidin, lycopene, quercetin, apocynin, lactobacillus, berberine, zinc, and nifuroxazide. This review aims to summarize the potential redox molecular mechanisms of MTX-induced intestinal injury and how they can be alleviated. In conclusion, studying these molecular pathways might open the way for early alleviation of the intestinal damage and the development of various agent plans to attenuate MTX-mediated intestinal injury.

Radiation-induced gastric injury during radiotherapy: molecular mechanisms and clinical treatment

Radiotherapy (RT) has been the standard of care for treating a multitude of cancer types. Radiation-induced gastric injury (RIGI) is a common complication of RT for thoracic and abdominal tumors. It manifests acutely as radiation gastritis or gastric ulcers, and chronically as chronic atrophic gastritis or intestinal metaplasia. In recent years, studies have shown that intracellular signals such as oxidative stress response, p38/MAPK pathway and transforming growth factor-β signaling pathway are involved in the progression of RIGI. This review also summarized the risk factors, diagnosis and treatment of this disease. However, the root of therapeutic challenges lies in the incomplete understanding of the mechanisms. Here, we also highlight the potential mechanistic, diagnostic and therapeutic directions of RIGI.

Characterization of Early and Late Damage in a Mouse Model of Pelvic Radiation Disease

Pelvic radiation disease (PRD), a frequent side effect in patients with abdominal/pelvic cancers treated with radiotherapy, remains an unmet medical need. Currently available preclinical models have limited applications for the investigation of PRD pathogenesis and possible therapeutic strategies. In order to select the most effective irradiation protocol for PRD induction in mice, we evaluated the efficacy of three different locally and fractionated X-ray exposures. Using the selected protocol (10 Gy/day × 4 days), we assessed PRD through tissue (number and length of colon crypts) and molecular (expression of genes involved in oxidative stress, cell damage, inflammation, and stem cell markers) analyses at short (3 h or 3 days after X-ray) and long (38 days after X-rays) post-irradiation times. The results show that a primary damage response in term of apoptosis, inflammation, and surrogate markers of oxidative stress was found, thus determining a consequent impairment of cell crypts differentiation and proliferation as well as a local inflammation and a bacterial translocation to mesenteric lymph nodes after several weeks post-irradiation. Changes were also found in microbiota composition, particularly in the relative abundance of dominant phyla, related families, and in alpha diversity indices, as an indication of dysbiotic conditions induced by irradiation. Fecal markers of intestinal inflammation, measured during the experimental timeline, identified lactoferrin, along with elastase, as useful non-invasive tools to monitor disease progression. Thus, our preclinical model may be useful to develop new therapeutic strategies for PRD treatment.

Pathogenesis and therapy of radiation enteritis with gut microbiota

Radiotherapy is widely used in clinic due to its good effect for cancer treatment. But radiotherapy of malignant tumors in the abdomen and pelvis is easy to cause radiation enteritis complications. Gastrointestinal tract contains numerous microbes, most of which are mutualistic relationship with the host. Abdominal radiation results in gut microbiota dysbiosis. Microbial therapy can directly target gut microbiota to reverse microbiota dysbiosis, hence relieving intestinal inflammation. In this review, we mainly summarized pathogenesis and novel therapy of the radiation-induced intestinal injury with gut microbiota dysbiosis and envision the opportunities and challenges of radiation enteritis therapy.

Vitamins and Radioprotective Effect: A Review

The radioprotective effect ex vivo, in vitro and in vivo of vitamins was reviewed using PubMed and Embase and conducted according to the PRISMA statement. A total of 38 articles were included in this review, which includes the radioprotective effect of vitamins from ex vivo, in vitro and in vivo studies. Vitamins A, C, D and E were used alone, in combination or with other nutritional and non-nutritional compounds. The use of vitamins in natural form or supplementation can be useful to reduce the radiation effect in the body, organs and/or cells. Only four (A, C, D and E) out of thirteen vitamins have been detected with radioprotective properties being mainly vitamin E followed by vitamin C, A and D.

Effects of lycopene in intestinal ischemia reperfusion injury via intestinal immunoglobulin A

BACKGROUND

Intestinal ischemia causes an inflammatory response that may become intense by reperfusion and result in bacterial translocation. Intestinal immunoglobulin A is known to be a barrier against bacterial translocation. Lycopene is a compound with antioxidant and anti-inflammatory properties. We hypothesized that lycopene has positive effects in ischemia-reperfusion of the intestine through the intestinal IgA.

MATERIAL AND METHODS

Twenty-eight Wistar albino rats were separated into four groups: sham, control, lycopene-administered-before-ischemia (L-pre), and lycopene-administered-after-reperfusion groups. Histopathologic changes, intestinal immunoglobulin A levels, and bacterial translocation were evaluated after the ischemia-reperfusion period of 0.5-12 h.

RESULTS

Histopathologic changes, intestinal immunoglobulin A, and bacterial translocation levels in the L-pre group were similar to those in the sham group. Administration of the lycopene after reperfusion showed just a slight protective effect. However, the L-pre group had significantly fewer histopathologic changes when compared with changes in the control (P = 0.011). Intestinal immunoglobulin A level in the L-pre group was found to be higher than that in the control group (P = 0.014). Bacterial translocation levels in the blood and mesenteric lymph nodes, in the L-pre group, were lower than those in the control group (P = 0.0027 and P = 0.0097, respectively).

CONCLUSIONS

Lycopene limited intestinal damage, reduced loss of intestinal immunoglobulin A and decreased bacterial translocation when administered before the ischemia-reperfusion injury.

Evaluation of the protective effect of lycopene on growth performance, intestinal morphology, and digestive enzyme activities of aflatoxinB1 challenged broilers

The current study was conducted to investigate the protective efficiency of dietary lycopene (LYC) supplementation on growth performance, intestinal morphology, and digestive enzyme activities aflatoxinB₁ (AFB₁ ) challenged broilers. A total of 240 days old Arber across male broiler chicks were randomly allocated in five treatments and six replicates (eight birds per replicate); feed and water were provided ad libitum during the 42 days experiment. The treatment diets were as follows: (i) Basal diet (control), (ii) Basal diet + 100 µg/kg AFB₁ contaminated diet, (iii) Basal diet + 100 µg/kg AFB₁  + 100 mg/kg LYC1, (iv) Basal diet + 100 µg/kg AFB₁  + 200 mg/kg LYC2, and (v) Basal diet + 100 µg/kg AFB₁  + 400 mg/kg LYC3. The results showed that the addition of LYC to AFB₁ contaminated broiler diets significantly increased (p < .05) average daily gain (ADG) and decreased feed conversion ratio (FCR) compared to the AFB₁ diet. AFB₁ diet decreased the intestinal villus height (VH) and crypt depth ratio (VCR) while increasing the crypt depth (CD). However, dietary LYC supplemented diets relieved the intestinal morphological alterations. Dietary LYC supplementation (200 and 400 mg/kg) significantly improved (p < .05) intestinal digestive enzyme amylase and lipase activities with AFB₁ contaminated diet. These findings suggested that LYC is a promising feed supplement in the broiler industry, alleviating the harmful effects of AFB₁ .

Dietary vitamin E affects small intestinal histomorphology, digestive enzyme activity, and the expression of nutrient transporters by inhibiting proliferation of intestinal epithelial cells within jejunum in weaned piglets1

Vitamin E (VE) is an indispensable vitamin in piglet feed formula. Among other things, it affects tissues including small intestine tissues and in particular its major unit intestinal epithelial cells. Previously, limited in vivo experiments have focused on the effect of VE on the intestine, particularly digestion and absorption. VE has been shown to inhibit proliferation of some types of cells. This experiment was conducted to test the hypothesis that VE affects intestinal functions by influencing the intestinal epithelial cell proliferation. Thirty 21-d old weaned [(Yorkshire × Landrace) × Duroc] piglets with BWs of 6.36 ± 0.55 kg were randomly divided into five VE-containing feeding formula groups. The treatments were (i) 0 IU (control), (ii) 16 IU, (iii) 32 IU, (iv) 4. 80 IU, and (v) 5. 160 IU. The treatments lasted 14 d. At the end of the experiment, all subjects were sacrificed to obtain blood and tissue samples. The results suggest that VE did not affect the growth performance. VE did tend to decrease jejunal crypt depth (linear, P = 0.056) and villus width (linear, P < 0.05). Sucrase activity significantly decreased in the adding 80 IU VE compared with the control (P < 0.05). Jejunal crypt, cell proliferation in 80 IU group significantly decreased compared with the control group (P < 0.05). This study suggests that dietary VE may affect intestinal morphology and functions by inhibiting weaned piglet jejunal epithelial cell proliferation.

Therapeutic potential of natural plant products and their metabolites in preventing radiation enteropathy resulting from abdominal or pelvic irradiation

Radiation-induced gastrointestinal injury or radiation enteropathy is an imminent risk during radiation therapy of abdominal or pelvic tumors. Despite remarkable technological advancements in image-guided radiation delivery techniques, the risk of intestinal injury after radiotherapy for abdominal or pelvic cancers has not been completely eliminated. The irradiated intestine undergoes varying degrees of adverse structural and functional changes, which can result in transient or long-term complications. The risk of development of enteropathy depends on dose, fractionation, and quality of radiation. Moreover, the patients' medical condition, age, inter-individual sensitivity to radiation and size of the treatment area are also risk factors of radiation enteropathy. Therefore, strategies are needed to prevent radiotherapy-induced undesirable alteration in the gastrointestinal tract. Many natural plant products, by virtue of their plethora of biological activities, alleviate the adverse effects of radiation-induced injury. The current review discusses potential roles and possible mechanisms of natural plant products in suppressing radiation enteropathy. Natural plant products have the potential to suppress intestinal radiation toxicity.

Antioxidant Supplementation: A Linchpin in Radiation-Induced Enteritis

Radiation enteritis is one of the most feared complications of abdominal and pelvic regions. Thus, radiation to abdominal or pelvic malignancies unavoidably injures the intestine. Because of rapid cell turnover, the intestine is highly sensitive to radiation injury, which is the limiting factor in the permissible dosage of irradiation. Bowel injuries such as fistulas, strictures, and chronic malabsorption are potentially life-threatening complications and have an impact on patient quality of life. The incidence of radiation enteritis is increasing because of the current trend of combined chemotherapy and radiation. The consequences of radiation damage to the intestine may result in considerable morbidity and even mortality. The observed effects of ionizing radiation are mediated mainly by oxygen-free radicals that are generated by its action on water and are involved in several steps of signal transduction cascade, leading to apoptosis. The oxyradicals also induce DNA strand breaks and protein oxidation. An important line of defense against free radical damage is the presence of antioxidants. Therefore, administration of antioxidants may ameliorate the radiation-induced damage to the intestine.

Vitamin E pretreatment prevents histopathological effects in tilapia (Oreochromis niloticus) acutely exposed to cylindrospermopsin

Cylindrospermopsin (CYN) is a cyanotoxin frequently involved in blooms with a predominantly extracellular availability, which makes it easily taken up by a variety of aquatic organisms. CYN is a potent protein and glutathione synthesis inhibitor, and also induces genotoxicity, oxidative stress and several histopathological lesions. The present study investigates the protective role of a vitamin E pretreatment (700 mg vit E/kg fish bw/day, for 7 days) on the histopathological alterations induced in different organs of tilapia (Oreochromis niloticus) acutely exposed to a single oral dose of 400 µg pure CYN/kg bw fish. The major histological changes observed were degenerative glucogenic process and loss of the hepatic structure in the liver, glomerulopathy and tubular tumefaction in the kidney, myofibrolysis and edema in the heart, catarrhal enteritis and necrosis in the gastrointestinal tract, hyperemic processes in the gill lamellae, and high basophilia, degeneration and tumefaction of granular neurons in the brain. Vitamin E pretreatment was effective in preventing or ameliorating the abovementioned alterations induced by CYN. In addition, a morphometric study indicated that the average nuclear diameter of hepatocytes, and cross-sections of proximal and distal convoluted tubules, together with the cardiac fiber and capillaries diameters represent a useful tool to evaluate the damage induced by CYN. This is the first study reporting vitamin E prevention of histopathological damage in tissues (liver, kidney, heart, gastrointestinal tract, gills and brain) of fish intoxicated with CYN. Therefore, vitamin E can be considered a useful chemoprotectant in the treatment of histopathological changes induced in CYN-intoxicated fish. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1469-1485, 2016.

The influence of 1.4-naphtoquinone derivative and of vitamin E on nitroso-oxidative processes in digestive organ mucous membranes under the conditions of cyclooxygenase blockage, and against the background of low intensity X-ray irradiation

In recent years, the influence of chronic low intensity irradiation on the human body has increased. This is mediated not only by the consequences of technogenic catastrophies, but also due to application of radiation therapy of of radiation usage in industry. Hence, we investigated the influence of 1.4-naphtoquinone and vitamin Е on the nitroso-oxidative processes in the digestive organ mucous membranes, while affected by low intensity X-ray irradiation alone and in combination with the experimental blockage of COX, in rats. Our results show that X-ray irradiation of a total dose of 20 sGy during twenty days, induced an increase of the oxidative processes, as well as an increase in the activity of iNOS and myeloperoxidase in the mucous membranes of the stomach, small and large intestine. Both the effect of vitamin E and a 1.4-naphtoquinone derivative on the background of low intensity X-ray irradiation, and under the simultaneous effect of X-ray irradiation and COX blockage, brought about a decrease of the level of oxidative processes and of iNOS activity, whereas MPO activity increased. We also noted that the effect of vitamin E on the background of X-ray irradiation more significantly increased both the activity of SOD and catalase, when compared to the induced effect of the 1.4-naphtoquinone derivative. Under the conditions of COX-1/COX-2 blockage (as induced by way of indomethacin administration), against the background of X-ray irradiation, the content of TBA-active products (in the stomach and small intestine mucous membranes), the level of iNOS activity and the sum of nitrites and nitrates, were lower than that of independent effect. Тaking into account the prominent antioxidant and anti-inflammatory attributes of 1.4-naphtoquinone-3-[3-(3.5-di-tret-butyl-4-hydroxy-phenyl)-1.4-dihydronaphtalene-2-aminoil] butyrate, when compared to the effect of sole administration of vitamin E, both under the conditions of X-ray irradiation alone, and the simultaneous effect of X-ray irradiation and COX blockage, this derivative may be considered suitable as a perspective radiprotectant.

Cimetidine administration decreases radiogenic damage on the thyroid gland in mice

PURPOSE

To study if Cimetidine administration could ameliorate the thyroid damage in external radiation.

MATERIALS AND METHODS

Forty healthy male adult mice were used in the present study. The animals were randomized into four groups. Untreated mice (Group 1) that received 1 mg/kg saline intraperitoneally (IP). Group 2 received a single 10 Gy gamma radiation dose with 1 mg/kg saline IP and group 3 were treated with Cimetidine IP. Group 4 was irradiated 1 hour after treatment with Cimetidine. The serum were assayed for the contents of triiodothyronine (T3), tetraiodothyronine (T4), thyroid stimulating hormone (TSH), Free T4 (FT4) and Cortisol using a radioimmunological technique 7 days following radiation. The thyroid tissue was processed and stained with hematoxylin and eosin (H&E), and periodic acid-Schiff (PAS) for histological examination. Data were statistically analyzed using Tukey's post-hoc test and were considered significant at p < 0.05.

RESULTS

External radiation resulted in weight loss and reduction of serum thyroid hormone levels. However, Cimetidine administration prevented marked changes. Histological study showed that Cimetidine injection to irradiated mice minimized the thyroid damage.

CONCLUSIONS

These findings suggested that Cimetidine administration 1 hour before radiation exposure was potent in ameliorating the thyroid damages.