ABSTRACT
Objective: To determine the extent of damage to oral epithelium caused by high dose methotrexate [HDMTX] and the ameliorating role of folinic acid [FA] on damaging effect of methotrexate
Study Design: Experimental study
Place and Duration of Study: Anatomy Department of Post Graduate Medical Institute [PGMI], Lahore, from March to September 2013
Methodology: Forty-two albino rats were randomly allocated to 3 groups: Exp group-l was given HDMTX intramuscularly [I/M] on alternate days, Exp group-ll was given both MTX and FA [I/M] on alternate days, and the control group received no intervention. After 16 days, buccal mucosa was excised for histological analysis under light microscope using H and E stains to see the effect of intervention
Results: Exp group-l showed marked reduction in epithelial thickness compared to Exp group-ll, and the control [F = 46.44, p < 0.001] had significantly depleted basal layer [F = 6.32, p < 0.004], as well as inflammatory infiltrate with evidence of erosion and ulceration. Exp group-ll showed less atrophic changes, a few inflammatory cells, no erosion and ulceration compared to the Exp group-l. Assuming epithelial thickness of control group 100% intact, the Exp group-ll was found to have 78% intact and Exp group-l had only 38% thickness intact. Thus FA rescued epithelial thickness by 40%
Conclusion: Folinic acid considerably saved oral mucosa from the damaging effect of HDMTX, improving quality of life of patients