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Misoprostol protection against acetaminophen-induced hepatotoxicity in the rat

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Abstract

The hepatoprotective effects of misoprostol on acetaminophen (APAP)-induced toxicity were studied in the rat. Liver injury was evaluated at 36 hr after APAP administration by measuring serum ornithine carbamoyltransferase (OCT) and alanine aminotransferase (ALT) levels, by using tetranitroblue tetrazolium (TNBT) staining and by histological analysis. After APAP administration, peak serum levels of the drug were detected at 15 min. Liver GSH was depleted from control levels of 448±48 µg/g to 82±2 µg/g (P<0.01) within 3 hr. Serum ALT levels increased significantly after 16 hr and H&E staining revealed significant hepatic necrosis after 12 hr. Rats treated with misoprostol before and after APAP administration showed reduced OCT and ALT levels at 36 hr of overdose (454±446 IU/liter and 2571±2944 IU/liter, respectively) compared to those without misoprostol treatment (1348±480 IU/liter and 6077±3025 IU/liter, respectively,P<0.01). TNBT staining showed a reduced area of damage from 28.6±22.3% to 7.3±8.9% (P<0.01), and H&E staining also showed less extensive hepatic necrosis in rats treated with misoprostol before and after the overdose. In a time sequence study, misoprostol treatment starting within 10 hr of overdose showed the same protective effect as when it was given before and after APAP ingestion. No protection was detected when the treatment was started during the development of hepatic injury. However, misoprostol given when injury was established seemed to be protective. Our results show that misoprostol protects the liver against APAP-induced injury if given within 10 hr of overdose. Late administration of misoprostol may also be beneficial and thus may be considered in treating patients with APAP toxicity.

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References

  1. Rush BD, Wilkinson KF, Nichols NM, Ochoa R, Brunden MN, Ruwart MJ: Hepatic protection by 16,16-dimethyl prostaglandin E2 (DMPG) against acute aflatoxin B1-induced injury in the rat. Prostaglandins 37:683–693, 1989

    Google Scholar 

  2. Bursch W, Taper HS, Somer MP, Meyer S, Putz B, Schulte-Hermann R: Histochemical and biochemical studies on the effect of the prostacyclin derivative Iloprost on CCl4-induced lipid peroxidation in rat liver and its significance for hepatoprotection. Hepatology 9:830–838, 1989

    Google Scholar 

  3. Levine RA: Hepatic cytoprotection by prostaglandins: Theories unlimited. Hepatology 8:969–970, 1988

    Google Scholar 

  4. Araki H, Lefer AM: Cytoprotective actions of prostacyclin during hypoxia in the isolated perfused cat liver. Am J Physiol 238:H176-H181, 1980

    Google Scholar 

  5. Alvarez-Lopez A, de Hemptinne B, Hoebeke Y, Lambotte L: Prostaglandin E2 increases the tolerance of the rat liver to warm ischemia in absence of splanchnic congestion. Transplant Proc 19:4105–4109, 1987

    Google Scholar 

  6. Lim SP, Andrews FJ, Christophi C, O'Brien PE: Misoprestol hepatoprotection against ischemia-reperfusion-induced liver injury in the rat. Dig Dis Sci 37:1275–1281, 1992

    Google Scholar 

  7. Stachura J, Tarnawski A, Szczudrawa J, Bogdal J, Mach T, Barbara K, Kirchmayer S: Cytoprotective effect of 16,16-dimethyl prostaglandin E2 and some drugs on an acute galactosamine induced liver damage in rat. Folia Histochem Cytochem 18:311–318, 1980

    Google Scholar 

  8. Bursch W, Schulte-Hermann R: Cytoprotective effect of the prostacyclin derivative iloprost against liver cell death induced by the hepatotoxins carbon tetrachloride and bromobenzene. Klin Wochenschr 64(suppl VII):47'50, 1986

    Google Scholar 

  9. Stachura J, Tarnawski A, Ivey KJ, Mach T, Bogdal J, Szczudrawa J, Klimczyk B: Prostaglandin protection of carbon tetrachloride-induced liver cell necrosis in the rat. Gastroenterology 81:211–217, 1981

    Google Scholar 

  10. Ruwart MJ, Rush BD, Friedle NM, Piper RC, Kolaja GJ: Protective effects of 16,16-dimethyl PGE2 on the liver and kidney. Prostaglandins 21(suppl):97–102, 1981

    Google Scholar 

  11. Guarner F, Boughton-Smith NK, Blackwell GJ: Reduction by prostacyclin of acetaminophen induced liver toxicity in the mouse. Hepatology 8:248–253, 1988

    Google Scholar 

  12. Raheja KL, Linscheer WG, Cho CD, Coulson R: Failure of exogenous prostaglandin to afford complete protection against acetaminophen-induced hepatotoxicity in the rat. J Toxicol Environ Health 15:477–484, 1985

    Google Scholar 

  13. Nasseri-Sina P, Fawthrop DJ, Wilson J, Boobis AR, Davis DS: Cytoprotection by iloprost against paracetamol-induced toxicity in Hamster isolated hepatocytes. Br J Pharmacol 105:417–423, 1992

    Google Scholar 

  14. Misoprostol (Cytotec). Preclinical and clinical review. Glenview, Illinois, Physicians and Scientists Publishing, 1990

  15. Ohshita M, Takeda H, Kamiyama Y, Ozawa K, Honjo I: A direct method for the estimation of ornithine carbamoyl-transferase activity in serum. Clin Chim Acta 67:145–152, 1976

    Google Scholar 

  16. Reitman S, Frankel S: A colorimetric method for the determination of serum glutamic oxalacetic and glutamic pyruvic transaminases. Am J Clin Pathol 28:56–63, 1957

    Google Scholar 

  17. Frederiks WM, Fronik GM, Hesseling JMG: A method for quantitative analysis of the extent of necrosis in ischemic rat liver. Exp Mol Pathol 41:119–125, 1984

    Google Scholar 

  18. Mitchell JR, Jollow DJ, Potter WZ, Davis DC, Gillette JR, Brodie BB: Acetaminophen-induced hepatic necrosis. I. Role of drug metabolism. J Pharmacol Exp Ther 187:185–194 1973

    Google Scholar 

  19. Hissin PJ, Hilf R: A fluorometric method for determination of oxidized and reduced glutathione in tissues. Anal Biochem 74:214–226, 1976

    Google Scholar 

  20. Davis M, Simmons CJ, Harrison NG, Williams R: Paracetamol overdose in man: relationship between pattern of urinary metabolites and severity of liver damage. Q J Med 45:181–191, 1976

    Google Scholar 

  21. Davis M: Protective agents for acetaminophen overdose. Semin Liver Dis 6:138–147, 1986

    Google Scholar 

  22. Mant TGK, Tempowski JH, Volans GN, Talbot JCC: Adverse reactions to acetylcysteine and effects of overdose. Br Med J 289:217–219, 1984

    Google Scholar 

  23. Walker RM, Racz WJ, McElligott TF: Scanning electron microscopic examination of acetaminophen-induced hepatotoxicity and congestion in mice. Am J Pathol 113:321–330, 1983

    Google Scholar 

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This study is supported by the Australian National Health and Medical Research Council Grant 91/0662.

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Ping Lim, S., Andrews, F.J. & O'Brien, P.E. Misoprostol protection against acetaminophen-induced hepatotoxicity in the rat. Digest Dis Sci 39, 1249–1256 (1994). https://doi.org/10.1007/BF02093790

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