The Protective Effect of Nitroglycerin, N-Acetyl Cysteine and Metoprolol in CCL4 Induced Animal Model of Acute Liver Injury

Is Glyceryl Trinitrate, a Nitric Oxide Donor Responsible for Ameliorating the Chemical-Induced Tissue Injury In Vivo?

Oxidative stress induced by well-known toxins including ferric nitrilotriacetate (Fe-NTA), carbon tetrachloride (CCl₄) and thioacetamide (TAA) has been attributed to causing tissue injury in the liver and kidney. In this study, the effect of glyceryl trinitrate (GTN), a donor of nitric oxide and NG-nitroarginine methyl ester (l-NAME), a nitric oxide inhibitor on TAA-induced hepatic oxidative stress, GSH and GSH-dependent enzymes, serum transaminases and tumor promotion markers such as ornithine decarboxylase (ODC) activity and [³H]-thymidine incorporation in rats were examined. The animals were divided into seven groups consisting of six healthy rats per group. The six rats were injected intraperitoneally with TAA to evaluate its toxic effect, improvement in its toxic effect if any, or worsening in its toxic effect if any, when given in combination with GTN or l-NAME. The single necrogenic dose of TAA administration caused a significant change in the levels of both hepatic and serum enzymes such as glutathione S-transferase (GST), glutathione reductase (GR), glutathione peroxidase (GPx), γ-glutamyl transpeptidase (GGT), glucose 6-phosphate dehydrogenase (G6PD), alanine aminotransferase (AST) and aspartate aminotransferase (ALT). In addition, treatment with TAA also augmented malondialdehyde (MDA), ornithine decarboxylase (ODC) activity and [³H]-thymidine incorporation in rats liver. Concomitantly, TAA treatment depleted the levels of GSH. However, most of these changes were alleviated by the treatment of animals with GTN dose-dependently. The protective effect of GTN against TAA was also confirmed histopathologically. The present data confirmed our earlier findings with other oxidants including Fe-NTA and CCl₄. The GTN showed no change whatsoever when administered alone, however when it was given along with TAA then it showed protection thereby contributing towards defending the role against oxidants-induced organ toxicity. Overall, GTN may contribute to protection against TAA-induced oxidative stress, toxicity, and proliferative response in the liver, according to our findings.

Effect of a Low Dose of Carvedilol on Cyclophosphamide-Induced Urinary Toxicity in Rats—A Comparison with Mesna

One of the major side effects of cyclophosphamide (CPX)—an alkylating anticancer drug that is still clinically used—is urotoxicity with hemorrhagic cystitis. The present study was designed to evaluate the ability of carvedilol to protect rats from cyclophosphamide-induced urotoxicity. Rats were injected intraperitoneally (i.p.) with CPX (200 mg/kg) and administered carvedilol (2 mg/kg) intragastrically a day before, at the day and a day after a single i.p. injection of CPX, with or without mesna (40, 80, and 80 mg/kg i.p. 20 min before, 4 h and 8 h after CPX administration, respectively). Pretreatment with carvedilol partly prevented the CPX-induced increase in urinary bladder and kidney index, and completely protects from CPX-evoked alterations in serum potassium and creatinine level, but did not prevent histological alterations in the urinary bladder and hematuria. However, carvedilol administration resulted in significant restoration of kidney glutathione (GSH) level and a decrease in kidney interleukin 1β (IL-1β) and plasma asymmetric dimethylarginine (ADMA) concentrations. Not only did mesna improve kidney function, but it also completely reversed histological abnormalities in bladders and prevented hematuria. In most cases, no significant interaction of carvedilol with mesna was observed, although the effect of both drugs together was better than mesna given alone regarding plasma ADMA level and kidney IL-1β concentration. In conclusion, carvedilol did not counteract the injury caused in the urinary bladders but restored kidney function, presumably via its antioxidant and anti-inflammatory properties.

Serum Vitamin Levels among Iraqi Cancer Patients Receiving Chemotherapy

BACKGROUND: Cancers are an abnormal irregular growth of cells. There is an interaction between cancer cells, immune cells, and neurotransmitters with nutritional elements and vitamins. With the administration of chemotherapeutic agents, many studies have highlighted the importance of these interactions and the role of chemotherapeutic drugs in augmenting or ameliorating such changes. Therefore, early detection of vitamins level changes is vital to improve patients’ short-term outcome and quality of life. AIM: The aim was assessment of serum vitamins level changes in patients with cancer pre- and post-chemotherapy. MATERIALS AND METHODS: A cohort study was carried out on newly diagnosed patients with cancer in Al-Amal National Radiation Oncology Hospital/Baghdad/Iraq during the period from January 2019 to July 2019. Assessments of the studied samples were conducted as a baseline before receiving chemotherapy and after the third cycle of chemotherapy. Weight, height and body mass index (BMI) were measured for each subject enrolled in the study. Serum level of the following vitamins: A, B1, B2, B3, B6, B12, folic acid, D, and E was measured using ELISA technique. RESULTS: One Hundred patients who were diagnosed with different types of cancer were enrolled in this study. Seventy seven (77%) females and twenty three (23%) males. Mean age was 50.15 years ranged between (18-75) years old, BMI range (16-42). Serum vitamin levels that have shown a significant decrease post chemotherapy as compared with baseline were: A (0.64 ± 0.23 vs 0.64 ± 0.23, P=0.0003), E (19.47 ± 4.714 vs 14.70 ± 5.354, P<0.0001), B12 (366.0 ± 95.94 vs 291.1 ± 102.6, P<0.001), B9 (16.13 ± 4.13 vs 16.13 ± 4.13, P<0.0001) whereas vitamins B6 and D which showed lower than normal baseline level underwent significant increase after chemotherapy yet remained below normal (vitamin B6 4.19 ± 1.94 vs 8.22 ± 5.39; vitamin D 21.11 ± 7.21 vs 26.55 ± 15.22). CONCLUSION: Our findings highlight the importance of updating and tailoring our regimens to suit the changes of the nutritional elements and parameters of performance status of cancer patients in terms of outcome and patient satisfaction.

Nitroglycerin ameliorates liver injury and regulates adaptive immunity in mice

This study aimed to assess the protective effect of nitroglycerin, a commonly used drug in cardiovascular diseases, on mice with acute liver injury induced by carbon tetrachloride (CCl₄ ). The mice were randomly divided into three groups: control, CCl₄ , and CCl₄  + nitroglycerin. They were killed at 0, 6, 12, 24, and 48 h after treatment. Blood and liver tissue samples were collected for analysis. Analysis of the amounts of serum alanine aminotransferase (ALT)/aspartate aminotransferase (AST), hepatic glutathione (GSH), and malondialdehyde (MDA) showed that nitroglycerin protected against CCl₄ -induced acute liver injury. Liver histological analysis provided further evidence of the protective effect of nitroglycerin. Furthermore, we found that nitroglycerin suppressed the increase of T helper 17 (Th17) cells in CCl₄ -induced acute liver injury mice. The results indicate that nitroglycerin is a potential candidate for hepatic disease.