effects of amphotericin B and amphotericin B-liposome on rat renal cortex: a comparative histological and immunohistochemical study

ABSTRACT

The polyene macrolide amphotericin B has remained the drug of choice in fighting systemic fungal infections for more than 30 years. However its toxic effects, particularly nephrotoxicity, remain serious side effects. The aim of this work was to compare between the nephrotoxicity of amphotericin B [fungizon] and amphotericin B liposome [ambisome] using different histological and immunohistochemical methods. Thirty adult male albino rats were divided into control group and experimental group The control group was divided into two subgroups [5 rats each] one of them received no treatment and the other received intra-peritoneal injection of saline once daily. The experimental group was divided into two subgroups I and II. The subgroup I received intra-peritoneal injection of fungizon in a dose 10 mg/kg once daily. The subgroup II received intra-peritoneal injection of amBisome in a dose 10 mg/kg once daily. All rats received the injections for one month. The specimens were processed for histological and immunohistochemical examination. Light and electron microscopic examinations of subgroup I revealed severe pathological changes in both distal and proximal convoluted tubules and glomeruli. But these changes were very mild in subgroup II. These changes were represented by mononuclear cellular infiltration, irregular thickening of glomerular basement membrane and distortion of foot processes of podocytes of the affected glomeruli. The cells of pCT and dCT showed cytoplasmic vacuolations, destruction of microvilli with changes in mitochondria. Immunohistochemical examination using caspase 3 method revealed more apoptotic changes in subgroup I than in subgroup II. It was concluded that AmBisome is more safe than fungizon on the kidney and this is very important for nephrologists and intensive care specialists