Protective effect of linoleic acid on liver toxicity induced by methotrexate / Efecto protector del ácido linoleico sobre la toxicidad hepática inducida por metotrexato

SUMMARY: We aimed to investigate the protective effect of linoleic acid on liver toxicity induced by methotrexate. The study was carried out in partnership with the Department of Anatomy and Department of Medical Pharmacology of Çukurova University Faculty of Medicine, using the laboratory facilities of the Department of Medical Pharmacology. Human hepatocyte cell line (CRL- 11233) cells obtained from the American Type Culture Collection Organization (ATCC) were used. Expressions of apoptotic pathway markers, apoptosis inducing factor (AIF), BAX, BCL 2, GADD 153, 78-kDa glucose-regulated protein (GRP78), and CASPASE-3 were evaluated. All analyzes were examined in four groups (Group 1; control, Group 2; linoleic acid given, Group 3; methotrexate given and Group 4; linoleic acid and methotrexate given). The mean ± standard error values of the obtained results as nanogram / milliliter (ng / ml) are in Group I, Group II, Group III and Group IV, respectively; AIF values, 0.4150 ± 0.1208, 0.3633 ± 0.2389, 1.792 ± 0.3611 and 1.077 ± 0.1646, BAX values, 0.900 ± 0.1864, 1.002 ± 0.2098, 8.352 ± 1.467 and 4.295 ± 1.522, BCL 2 values, 13.93 ± 1.198, 13.92 ± 1.739, 2.938 ± 1.059 and 9.250 ± 1.492, GADD 153, 0.7333 ± 0.1751, 0.7067 ± 0.2115, 1.650 ± 0.2950 and 1.237 ± 0.1805, GRP78, 0.4767 ± 0.1804, 0.5233 ± 0.1590, 2.183 ± 0.2639 and 1.112 ± 0.2693, CASPASE-3 values , 1.127 ± 0.2033, 0.8317 ± 0.3392, 13.50 ± 1.871 and 8.183 ± 1.030. It was determined that linoleic acid has a protective effect on methotrexate-induced liver toxicity.

Nuestro objetivo fue investigar el efecto protector del ácido linoleico sobre la toxicidad hepática inducida por metotrexato. El estudio se llevó a cabo en colaboración con el Departamento de Anatomía y el Departamento de Farmacología Médica de la Facultad de Medicina de la Universidad de Çukurova, utilizando las instalaciones del laboratorio del Departamento de Farmacología Médica. Se usaron células de la línea celular de hepatocitos humanos (CRL-11233) obtenidas de la American Type Culture Collection Organisation (ATCC). Se evaluaron las expresiones de marcadores de vías apoptóticas, factor inductor de apoptosis (AIF), BAX, BCL 2, GADD 153, proteína regulada por glucosa de 78 kDa (GRP78) y CASPASE-3. Todos los análisis se examinaron en cuatro grupos (Grupo 1; control, Grupo 2; se administró ácido linoleico, Grupo 3; se administró metotrexato y Grupo 4; se administró ácido linoleico y metotrexato). Los valores medios ± error estándar de los resultados obtenidos como nanogramo/mililitro (ng/ml) se encuentran en el Grupo I, Grupo II, Grupo III y Grupo IV, respectivamente; Valores de AIF, 0,4150 ± 0,1208, 0,3633 ± 0,2389, 1,792 ± 0,3611 y 1,077 ± 0,1646, valores de Bax, 0,900 ± 0,1864, 1,002 ± 0,2098, 8,352 ± 1,467 y 4,295 ± 1,522, BCL 2 valores, 13,93 ± 1,199. 2,938 ± 1,059 y 9,250 ± 1,492, GADD 153, 0,7333 ± 0,1751, 0,7067 ± 0,2115, 1,650 ± 0,2950 y 1,237 ± 0,1805, Grp78, 0,4767 ± 0,1804, 0,5233 ± 0,1590, 2,183, ± 1,263. 1,127 ± 0,2033, 0,8317 ± 0,3392, 13,50 ± 1,871 y 8,183 ± 1,030. Se determinó que el ácido linoleico tiene un efecto protector sobre la toxicidad hepática inducida por metotrexato.

Research progress on protective effect of traditional Chinese medicine and natural medicine on methotrexate-induced liver toxicity / 中国中药杂志

Methotrexate(MTX) is a commonly used antimetabolite, which can be used in the treatment of a variety of diseases. However, hepatotoxicity in the use of MTX severely limits its clinical use. Therefore, how to prevent and treat hepatotoxicity of MTX has become an urgent clinical problem. This paper summarizes and analyzes relevant literatures on the prevention and treatment of hepa-totoxicity caused by MTX with traditional Chinese medicines and natural medicines in recent years. MTX-induced hepatotoxicity mechanisms include folate pathway, oxidative stress damage and adenosine pathway, of which oxidative stress theory is the main research direction. A total of 14 kinds of traditional Chinese medicine and natural medicine extracts including white peony root, and 21 kinds of natural monomer compounds, including berberine, play an anti-MTX-induced hepatotoxic effect by resisting oxidative stress, inhibiting inflammation and regulating signal pathways. According to current studies on the prevention and treatment of hepatotoxicity induced by MTX with traditional Chinese medicines and natural medicines, there are insufficiencies, such as partial and superficial mechanism studies, inadequate combination of experimental research and clinical practice, non-standard experimental design and lack of application of advanced technologies and methods. This paper systematically reviewed the effects and mechanisms of traditional Chinese medicines and natural medicines against hepatotoxicity induced by MTX and defined current studies and deficiencies, in the expectation of proposing new study strategies and directions and providing scientific basis for rational clinical use of MTX and development of new drugs against MTX hepatotoxicity.

Investigation of Protective Effect of Matricaria Chamomilla L. Extract on Methotrexate-Induced Hepatotoxicity in Wistar Rat

Abstract Methotrexate (MTX) was shown to cause oxidative stress and liver damage. The objective was to investigate the possible protective effects of Matricaria Chamomilla L. (chamomile) extract with anti-oxidant and anti-inflammatory properties on the methotrexate-induced liver toxicity. Twenty four Wistar rats were divided into four groups. MTX group was injected intraperitoneally on days 7 and 14 with 20 mg/kg methotrexate. Groups CE200 (chamomile extract 200 mg/kg/day) and CE300 (chamomile extract 300 mg/kg/day) received the same dose of methotrexate added with chamomile extract orally for 15 days at 200 mg/kg and 300 mg/kg respectively and the last group was healthy control group. Results of biochemical analyses indicated serum liver biomarkers (aminotransferases), alkaline phosphatase (ALP), albumin, and liver content of anti-oxidant enzymes (catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)), reduced glutathione (GSH) and total anti-oxidant capacity (TAC) significantly increased (P <0.05-0.001) to normal in the CE treated groups compared to those of the MTX group. Serum bilirubin and hepatic malondialdehyde (MDA) levels significantly increased (P ˂0.001) in MTX group compared to those of the control group and decreased in CE200 and CE300 groups compared to those of the MTX group. Histopathological study showed inflammatory damage, necrotic cells and lipid infiltration in MTX group. In the groups treated with the chamomile extract, a significant improvement was observed in liver tissue in response to increased dose of the extract. In conclusion, chamomile extract administration could have a protective role in methotrexate-induced liver toxicity in rats through improving anti-oxidant defense system.

Therapeutic effect of thymoquinone against methotrexate- induced damage on sperm parameters in mice / Efecto terapéutico de la tiroyoquinona contra el daño inducido por metotrexato en los parámetros espermáticos en ratones

Methotrexate drug is commonly used to treat cancer; it is known to cause reproductive damage. Thymoquinone, as a natural component of herbs has many healthy benefits shown in researches. The present study aimed to investigate probable therapeutic effects of Thymoquinone against Methotrexate-induced damage on sperm parameters in mice. In this experimental study, 30 male mice (25-30 g) were divided into five groups of six in each group. The mice were received normal saline (control group), Methotrexate (20 mg/kg), Methotrexate (20 mg/kg) + Thymoquinone (2, 10 and 20 mg/kg) by intraperitoneal injection. On the day after the last injection, the sperm parameters including motility, viability and count of sperms were assessed. Data analysis was performed using one-way ANOVA followed by Tukey test. Methotrexate alone showed a significant reduction in sperm parameters compared to the control group (P=0.00). In groups treated with Methotrexate and Thymoquinone, sperm parameters (motility ,viability, count sperm) did not show any significant differences with control group (P=0.00). Thymoquinone, as a potent antioxidant, could compensate for the toxicity induced by Methotrexate. These medical trends may be useful for diminishing the side effects of Methotrexate on the male reproductive system.

El metotrexato es un fármaco utilizado comúnmente para tratar el cáncer pero además causa daño en los órganos reproductivos. Durante las investigaciones se ha demostrado que la timoquinona, un componente natural de las hierbas, tiene numerosos beneficios. El objetivo del estudio fue investigar el probable efecto terapéutico de la timoquinona contra el daño inducido por metotrexato, en los parámetros espermáticos en ratones. En este estudio experimental, se dividieron 30 ratones machos (25-30 g) en cinco grupos de seis en cada uno. Los ratones recibieron solución salina normal (grupo control), metotrexato (20 mg / kg), metotrexato (20 mg / kg) + timoquinona (2, 10 y 20 mg / kg) por inyección intraperitoneal. El día después de la última inyección, se evaluaron los parámetros espermáticos, incluida la motilidad, la viabilidad y el recuento de espermatozoides. El análisis de los datos se realizó utilizando test de ANOVA seguido de la prueba de Tukey. Durante el uso exclusivo de metotrexato se observó una reducción significativa en los parámetros espermáticos en comparación con el grupo control (P = 0.00). En los grupos tratados con metotrexato y timoquinona, los parámetros espermáticos (motilidad, viabilidad, conteo de espermatozoides) no mostraron diferencias significativas con el grupo control (P = 0.00). Como potente antioxidante, la timoquinona podría compensar la toxicidad inducida por metotrexato. Estas tendencias médicas pueden ser útiles para disminuir los efectos secundarios de metotrexato en el sistema reproductivo masculino.

Ameliorative effect of propolis against hepatorenal alterations induced by methotrexate: morphohistopathological study / Efecto protector del propóleo en las alteraciones hepatorrenales inducidas por el metotrexato: estudio morfohistopatológico

Methotrexate (MTX) is widely used in the treatment of some forms of cancer but having severe side effects. The present work aimed to investigate the protective role of propolis treatment against alterations induced by MTX on the hepatic and renal tissues. Rabbits were exposed to MTX (0.25 mg/kg), with or without propolis (50 mg/kg) while hepatic and renal biopsies were examined for histological and histochemical abnormalities. Methotrexate induced hydropic degeneration, pyknosis, sinusoidal dilatation and bile duct hyperplasia in the liver together with renal tubular degeneration, glomerular shrinkage and hyaline droplet precipitation. While propolis partially ameliorated some of the morphometric and biochemical alterations, none of the hepatic alterations induced by MTX was protected by propolis treatment. Nevertheless glomerular shrinkage and renal tubule degeneration were partially protected in animals received both MTX plus propolis. It is concluded that propolis treatment has little or no ameliorative effect in protecting the hepatic and renal tissues from MTX toxicity.

El metotrexato (MTX) es ampliamente utilizado en el tratamiento de algunas formas de cáncer, pero tiene efectos secundarios graves. El presente trabajo tuvo como objetivo investigar el papel protector del tratamiento con própoleo frente a las alteraciones inducidas por el MTX en los tejidos hepático y renal. Se expusieron conejos a MTX (0,25 mg / kg), en grupos con y sin propóleo (50 mg / kg), y se realizaron biopsias hepáticas y renales, que fueron examinadas buscando anomalías histológicas e histoquímicas. El metotrexato indujo la degeneración hidrópica, picnosis, dilatación sinusoidal e hiperplasia del conducto biliar en el hígado, junto con la degeneración tubular renal, la contracción glomerular y la precipitación hialina. Mientras que el propóleo parcialmente mejoró algunas de las alteraciones morfométricas y bioquímicas, ninguna de las alteraciones hepáticas inducidas por MTX fue protegido por el tratamiento con propóleo. Sin embargo, la contracción glomerular y la degeneración de los túbulos renales fueron parcialmente protegidos en animales que recibieron MTX más propóleo. Se concluye que el tratamiento con propóleo tiene poco o ningún efecto mejorador en la protección de los tejidos hepáticos y renales sometidos a la toxicidad de MTX.

Role of ginseng as hepatoprotective, antioxidant and anti -inflammatory against methotrexate induced liver injury in rats

Background Ginseng, an ancient and famous medicinal herb in the Orient, has been used as a valuable tonic and for the treatment of various diseases including hepatic disorders. Ginseng extracts and individual ginsenosides have shown a wide array of beneficial role in the regulation of regular liver functions and the treatment of liver disorders

Objective: This study tries to determine the hepatoprotective , antioxidant and anti-inflammatory effects of ginseng on Methotrexate [MTX]-induced hepatotoxicity

Materials and Methods: forty rats [weigh 150-180 g] were used. The rats were kept in animal house for one week and had access to water and food . Temperature was kept at 37 [degree sign]C. After one week, the rats were randomly divided into four equal groups: Group [A] [control] received normal saline ; group [B ]received Ginseng[1.8 ml/kg/day] orally ; group[ C] received MTX [100 micro g/kg] intraperitoneally and group [D] received MTX [100 micro g/kg] intraperitoneally with ginseng [1.8 ml/kg/day] orally. After six weeks, the rats were decapitated and evaluation of liver function was done

Results: Ginseng treatment markedly suppressed the serum alanine aminotransferase [ALT] , aspartate aminotransferase [AST] and serum gama glutamil transpeptidase [?GTP] activiteis . Ginseng was attributed to stimulate anti-oxidant protein contents, such as glutathione peroxidase [GPX]. The marked increase of proinflammatory cytokines [ TNF alpha ] in MTX treated rats group was additionally attenuated by ginseng,

Conclusion: Ginseng effectively prevent liver injury, mainly through down regulation of oxidative stress and inflammatory response

Rutin ameliorates methotrexate induced hepatic injury in rats

PURPOSE: To investigate the possible protective effect of rutin on methotrexate induced hepatotoxicity in rats. METHODS: Twenty-two rats were divided into three experimental groups; Control-saline, Mtx, Mtx+Rutin. Hepatic tissue was taken for histological assessment and biochemical assays. Oxidative stress parameters malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were investigated. Liver markers aspartate aminotransferase (AST), alanine aminotransferase (ALT) were analyzed in serum. RESULTS: Mtx+Rutin group showed lower histological injury compared to Mtx group, MDA and ALT levels were increased, while SOD and GSH-Px were decreased in Mtx group compared with Control-saline group. MDA and ALT levels were increased, while SOD and GSH-Px were decreased in Mtx group, compared with Mtx +Rutin group. Serum AST levels were similar among the groups. CONCLUSION: Rutin may be a potential adjuvant drug to reduce the hepatic side effects observed during Mtx therapy for various clinical conditions.

Does alfa lipoic acid prevent liver from methotrexate induced oxidative injury in rats?

PURPOSE: To determine the antioxidant and anti-inflammatory effects of alfa lipoic acid (ALA) on the liver injury induced by methotrexate (MTX) in rats. METHODS: Thirty two rats were randomly assigned into four equal groups; control, ALA, MTX and MTX with ALA groups. Liver injury was performed with a single dose of MTX (20 mg/kg) to groups 3 and 4. The ALA was administered intraperitonealy for five days in groups 2 and 4. The other rats received saline injection. At the sixth day the rats decapitated, blood and liver tissue samples were removed for TNF-α, IL-1β, malondialdehyde, glutathione, myeloperoxidase and sodium potassium-adenosine triphosphatase levels measurement and histological examination. RESULTS: MTX administration caused a significant decrease in tissue GSH, and tissue Na+, K+ ATPase activity and which was accompanied with significant increases in tissue MDA and MPO activity. Moreover the pro-inflammatory cytokines (TNF-α, IL- β) were significantly increased in the MTX group. On the other hand, ALA treatment reversed all these biochemical indices as well as histopathological alterations induced by MTX. CONCLUSION: Alfa lipoic acid ameliorates methotrexate induced oxidative damage of liver in rats with its anti-inflammatory and antioxidant effects. .

Protective effect of ellagic acid and pumpkin seed oil against methotrexate-induced small intestine damage in rats.

Gastrointestinal toxicity is one of the most serious side effects in the methotrexate (MTX) treatment. This study was designed to investigate whether ellagic acid (EA) and/or pumpkin seed oil (PSO) had a protective effect on MTX-induced small intestine damage. Forty albino rats were randomized into five groups of 8 rats each. Group I served as a normal control group. In Group II, MTX was administered as a single dose (20 mg/kg) intraperitoneally. Groups III, IV and V were pre-treated respectively with either PSO (40 mg/kg), EA (10 mg/kg) or 0.2% DMSO (vehicle control) orally every day by gavage for 5 days and then they received MTX. All animals were sacrificed 5 days after the intraperitoneal injection of MTX for histopathological examination, estimation of serum prostaglandin E2 (PGE2) level, assay of tissue malondialdehyde (MDA), reduced glutathione (GSH) and nitric oxide (NO) levels and myloperoxidase (MPO), xanthine oxidase (XO) and adenosine deaminase (AD) activities. Administration of EA and/or PSO decreased the intestinal damage, PGE2, MDA and NO levels and MPO, XO and AD activities and increased GSH level. These results suggest that EA and PSO protect the small intestine of rats from MTX-induced damage through their antioxidant and anti-inflammatory effects and thus have potential as a promising drug in the prevention of undesired side effects of MTX.

Methotrexate-induced intestinal mucositis delays gastric emptying and gastrointestinal transit of liquids in awake rats / Mucosite induzida pelo metotrexato retarda o esvaziamento gástrico e o trânsito gastrointestinal de líquidos em ratos acordados

CONTEXT: Methotrexate and other anticancer agents can induce intestinal mucositis, which is one of the most common limiting factor that prevent further dose escalation of the methotrexate. OBJECTIVES: To evaluate the gastric emptying and gastrointestinal transit of liquids in methotrexate-induced intestinal mucositis. METHODS: Wistar rats received methotrexate (2.5 mg/kg/day for 3 days, subcutaneously) or saline. After 1, 3 and 7 days, sections of duodenum, jejunum and ileum were removed for assessment of epithelial damage and myeloperoxidase activity (biochemical marker of granulocyte infiltration). Others rats were pre-treated with methotrexate or saline, gavage-fed after 3 or 7 days with a standard test liquid meal, and sacrificed 10, 20 or 30-min later. Gastric and small intestine dye recoveries were measured by spectrophotometry. RESULTS: After 3 days of methotrexate, there was an epithelial intestinal damage in all segments, with myeloperoxidase activity increase in both in duodenum and ileum. Seven days after methotrexate, we observed a complete reversion of this intestinal damage. There was an increase in gastric dye recoveries after 10, 20, and 30-min post-prandial intervals after 3 days, but not after 7 days, of methotrexate. Intestine dye recoveries were decreased in the first and second segments at 10 min, in the third at 20 min, and in the second and third at 30 min, only after 3 days of methotrexate treatment. CONCLUSION: Methotrexate-induced intestinal mucositis delays gastric emptying and gastrointestinal transit of liquids in awake rats.

CONTEXTO: Metotrexato e outros agentes anticâncer podem induzir uma mucosite intestinal, que é um dos fatores de limitante mais comum que limitam o aumento escalonado da dose do metotrexato. OBJETIVOS: Avaliar o esvaziamento gástrico e o trânsito gastrointestinal de líquidos na mucosite intestinal induzida por metotrexato. MÉTODOS: Ratos Wistar, receberam metotrexato (2.5 mg/kg/dia por 3 dias, subcutâneo) ou salina. Após 1, 3 ou 7 dias, secções do duodeno, jejuno e íleo foram retirados para análise morfométrica e dosagem da atividade de mieloperoxidase (marcador bioquímico da infiltração de neutrófilos). Outros ratos foram pré-tratados com metotrexato ou salina, após 3 ou 7 dias, foram alimentados mediante gavagem com uma refeição teste e sacrificados após 10, 20 e 30 minutos. As retenções fracionais do corante no estômago e em três segmentos do intestino delgado foram determinados por espectrofotometria. RESULTADOS: Após 3 dias do metotrexato, houve lesão do epitélio intestinal em todos os segmentos, com aumento da atividade de mieloperoxidase, no duodeno e íleo. Sete dias após o metotrexato, foi observada completa reversão da lesão intestinal. Observou-se ainda retardo no esvaziamento gástrico após 10 min, 20 min e 30 min, após 3 dias, mas não após 7 dias do tratamento com metotrexato. A retenção fracional dos segmentos do intestino foi reduzida no primeiro e segundo segmentos após 10 min, e no terceiro segmento após 30 min da administração da refeição, somente 3 dias após o tratamento com metotrexato. CONCLUSÃO: A mucosite intestinal induzida por metotrexato retarda o esvaziamento gástrico e o trânsito gastrointestinal de líquidos em ratos acordados.

A comparison of vitamin A and leucovorin for the prevention of methotrexate-induced micronuclei production in rat bone marrow

INTRODUCTION: Methotrexate, a folate antagonist, is a mainstay treatment for childhood acute lymphoblastic leukemia. It is also widely used in a low dose formulation to treat patients with rheumatoid arthritis. In rats, methotrexate is known to induce micronuclei formation, leading to genetic damage, while vitamin A is known to protect against such methotrexate-induced genetic damage. Leucovorin (folinic acid) is generally administered with methotrexate to decrease methotrexate-induced toxicity. OBJECTIVES: We aimed to determine whether vitamin A and leucovorin differed in their capacity to prevent formation of methotrexate-induced micronuclei in rat bone marrow erythrocytes. The present study also aimed to evaluate the effect of combined treatment with vitamin A and leucovorin on the formation of methotrexate-induced micronuclei. METHODS: Male and female Wistar rats (n=8) were injected with 20 mg/kg methotrexate (single i.p. dose). The control group received an equal volume of distilled water. The third and fourth groups of rats received vitamin A (5000 IU daily dose for 4 successive days) and leucovorin (0.5 mg/kg i.p. dose for 4 successive days), respectively. The fifth and sixth groups of rats received a combination of vitamin A and a single dose of methotrexate and a combination of leucovorin and methotrexate, respectively. The last group of rats received a combination of leucovorin, vitamin A and single dose of methotrexate. Samples were collected at 24 hours after the last dose of the treatment into 5 percent bovine albumin. Smears were obtained and stained with May-Grunwald and Giemsa. One thousand polychromatic erythrocytes were counted per animal for the presence of micronuclei and the percentage of polychromatic erythrocyte was determined. RESULTS: Comparison of methotrexate-treated rats with the control group showed a significant increase in the percentage of cells with micronuclei and a significant decrease polychromatic...

Histological and histochemical studies on the effects of methotrexate on the liver of adult male albino rat / Estudios Histológico e Histoquímico del Efecto del Metotrexato en el Hígado de Rata Macho Albina Adulta

El metotrexato es ampliamente usado en la terapia de varias enfermedades malignas. El presente trabajo fue diseñado para investigar los cambios histológicos e histoquímicos del hígado de rata albina, después de administrar dicho fármaco. Se usaron 15 ratas albinas, machos, adultas, que fueron divididas en 3 grupos: El grupo I no tuvo tratamiento correspondiendo al control. A los grupos II y III se les administró, por vía intraperitoneal, una solución salina normal y metotrexato, respectivamente, con una dosificación de 0,5 mg por Kg de peso, dos veces por semana, con una duración total de 3, 6 y 9 semanas. Las ratas fueron sacrificadas y los hígados extraídos y procesados para los estudios histológico e histoquímico. El examen de los hígados del grupo III mostró infiltración celular mononuclear y un incremento en la cantidad de fibras colágenas en la vía portal. Hubo áreas focales de necrosis de células hepáticas con distorsión de la arquitectura hepática normal. Además, hubo un gradual y progresivo decrecimiento del contenido de glicógeno en los hepatocitos. La actividad de deshidrogenasa succínica y fosfatas alcalinas también disminuyó, pero sí hubo un aumento de la actividad de las fosfatasas ácidas en las áreas degeneradas y pérdida de actividades en áreas de necrosis celular masiva. En conclusión, inyecciones repetidas de metotrexato causan daño hepático de maginitud definida. Esta hepatotoxicidad progresó a medida que las dosis se fueron acumulando. El presente estudio muestra evidencias claras de la potencia citotóxica de este medicamento.

Methotrexate (MTX) is widely used in the therapy of various types of malignancy. The present work was designed to investigate the histological and histochemical changes in the liver of albino rat following methotrexate administration. Fifteen adult male albino rats were used in the present work. They were divided into three main groups: Group I was kept without treatment and served as control. Groups II and III were given intraperitoneal injections of normal saline and MTX, respectively, at a dosage of (0.5 mg/Kg) twice weekly for total durations of 3, 6 and 9 weeks. The rats were sacrificed and the livers were excised and processed for histological and histochemical study. Examination of sections of the livers of group III showed mononuclear cell infiltration and an increase in the amount of collagen fibers in the portal tracts. There were focal areas of liver cell necrosis with distortion of the normal hepatic architecture. Moreover, there was a gradual and progressive decrease of glycogen content in the hepatocytes. Furthermore, succinic dehydrogenase and alkaline phosphatase activity were also decreased. In addition there was an increase in acid phosphatase activities in the degenerated areas and loss of activities in areas of massive cellular necrosis. It was concluded that repeated injections of MTX causes hepatic damage of a definite magnitude. This hepatotoxicity progressed with increasing cumulative doses of methotrexate. The present study provided further evidence to the cytotoxic potency of this antifolate.

CMF with or without medical castration in pre-menopausal women with node positive breast cancer

The prognosis of breast cancer in young women is generally considered to be unfavorable. Thus adjuvant therapy post surgical intervention is essential in many patients especially those with high risk [e.g large tumors or positive nodes]. However the presence of steroid hormone receptors in the primary tumors of young ladies may represent a suitable target for therapy in this group of patients. In the current study 100 premenopausal women with positive axillary lymph nodes and have estrogen and/or progestrone receptor positive tumors were randomized after local therapy of the breast cancer into two groups; Group I received adjuvant chemotherapy CMF for a total of six cycles then medical castration with LHRH agonist for two years and Group II received the same chemotherapy as in group I for six cycles. Adjuvant radiotherapy was given in the majority of patients in both treatment groups. After median follow up of six years, there was no statistical significance difference between both groups as regard the disease free or overall survival P=0.537 and 0.526 respectively. The toxicity reported in both groups was quite mild with only increase in the rate of hot flashes in the medical castration group. This study confirm the safety and tolerability of addition of medical castration to adjuvant chemotherapy which can be easily accepted by young women because of its reversible action, however it didn't answer many important questions about the optimum duration of ovarian suppression and the need for combined hormonal therapy like addition of tamoxifen to ovarian castration and sequence of different therapy

Suppression of genotoxic effects of cyclophosphamid in mice by Nigella sativa seed extracts

The aim of this research is to study the genotoxic effects of Nigella sativa extracts [if any] in the lab animals and to test their capabilities as an antimutagens. Aquatic and ethanolic extracts were prepared from N. sativa seeds. Different doses [50, 100, 150, 200 mg/kg] of their extracts were given orally to mice for 7 days to check their genotoxic activity by using mitotic index chromosomal aberrations in bone marrow cells and micronuclei formation as well as sperm head abnormalities. There was a significant reduction in spontaneous as well as MTX-induced chromosomal aberrations and micronuclei frequencies of bone marrow cells as an influence of N. sativa extracts-treatments. Significant increase in cellular division was also observed. Furthermore, significant protection of sperms from MTX-effects was achieved by using N. sativa extracts. The ethanolic extracts were more effective than aquatic extract in its suppression to MTX genotoxic effects. These results indicated the potency of N. sativa seeds in protection against genotoxic effects of carcinogens

Longitudinal measurement of methotrexate liver concentrations do not correlate with liver damage, clinical efficacy or toxicity during a 3.5 years, double-blinded study in rheumatoid arthritis

In a 3 [1/2] year prospective, double-blind study of methotrexate used to treat RA, we examined whether methotrexate and methotrexate polyglutamates accumulation in the liver correlated with clinical efficacy or clinical/laboratory toxicity. We also validated a new histologic measure of liver histology [the Iowa Score] relative to the Roenigk grading system. Forty rheumatoid arthritis patients participated in a prospective, double-blind, 3 [1/2] year study of methotrexate treatment. Liver biopsies, liver methotrexate and methotrexate polyglutamate concentrations, laboratory tests, evaluation of disease activity and evaluation of adverse events were done prospectively at baseline, 1, 2 and 3 [1/2] years. Radiochemical ligand binding assays and HPLC methods were used to measure methotrexate and methotrexate polyglutamates. Statistical analysis included ANOVA, linear regression and logistic regression modeling. No significant changes in the mean values of AST, ALT, alkaline phosphatase, albumin or hemoglobin occurred. A surprisingly high percentage of patients had at least one abnormal alkaline phosphatase, AST or ALT [25 to 52%] although most abnormalities were small or transient. The last abnormal AST, the number of abnormal AST and ALT's plus female gender correlated with histological liver abnormalities [r[2] = 0.41] using a new histologic scoring system [the Iowa Score]. Histological abnormalities did not progress using either the Roenigk or Iowa Scores, although a slight numerical increase in fibrosis over time appeared possible. The amount of alcohol use correlated with fatty change and the methotrexate dose at biopsy was associated with liver histological abnormalities [p= 0.03 and 0.049, respectively]. Total liver methotrexate concentrations were stable from year 1 to year 3 [1/2] and the percentage of higher order polyglutamates were relatively high [38 to 56%] relative to monoglutamates. No correlation of these concentrations with clinical response or toxicity, histology or liver function tests could be documented. This analysis demonstrated the accumulation and stabilization of methotrexate concentrations in the liver and examined correlations between methotrexate liver concentrations, patient demographics, liver histology, concomitant medications and disease activity. No such correlations were found, decreasing the likelihood that methotrexate concentrations in serum would be useful measures to predict significant hepatotoxicity. This study longitudinally examines methotrexate concentrations and its polyglutamates in the liver and correlates them with histology, liver function tests, demographics and clinical efficacy and toxicity. While previously examined cross-sectional, such a study including methotrexate and metabolite concentrations has never been completed longitudinally. Correlations of histology with AST, ALT and alcohol were found, but no concentration to histology, clinical or toxicity relationships were seen. This implies a very low likelihood that serum methotrexate levels will be useful to measure or predict liver toxicity from methotrexate. In addition, this study validates a new, more sensitive [than the Roenigk score] histology liver scoring system [the Iowa Scale]