Journals / Pamukkale Tıp Dergisi / 2018 / Cilt: 11 - Sayı: 3

Can Leflunomide prevent Methotrexate induced liver toxicity?

Leflunomid Methotrexat'a bağlı karaciğer toksisitesini önleyebilir mi?

Pages
321–327
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

DISCUSSION AND CONCLUSION: Leflunomide treatment ameliorated Methotrexate induced liver toxicity in an experimental model.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:INTRODUCTION: Long-term clinical use of Methotrexate is to connect with a raised risk of liver injury and fibrosis.
📊
Key Findings & Data:METHODS: Thirty-nine rats were divided into 4 groups.
💡
Conclusion & Impact:DISCUSSION AND CONCLUSION: Leflunomide treatment ameliorated Methotrexate induced liver toxicity in an experimental model.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Leflunomid · methotrexat · karaciğer toksisitesi

Abstract

INTRODUCTION: Long-term clinical use of Methotrexate is to connect with a raised risk of liver injury and fibrosis. Leflunomide is a is a disease-modifying drug. Leflunomide has a powerful inhibitory effect on nuclear factor kappa B activation. Leflunomide also presents antioxidant activity. In this experimental study, we aimed to investigate the effects of Leflunomide treatment on Methotrexate -induced hepatotoxicity. METHODS: Thirty-nine rats were divided into 4 groups. A single dose of 20mg/kg Methotrexate was injected intraperitoneally for Methotrexate-induced hepatotoxicity. After induction, Leflunomide (10 mg/kg) was administered into the stomach for consecutive 5 days. Then, serum samples and homogenated liver tissues were collected for analyzed serum alanine aminotransferase, alkaline phosphatase, superoxide dismutase activity, myeloperoxidase activity, glutathione levels and assessment of histopathology. RESULTS: Leflunomide treatment significantly ameliorated total histopathologic score according to semiquantitative scale compared to the untreated group, (Pathological score 1.1+0.7 versus 5.1+2 respectively, p<0,01). Leflunomide treatment significantly ameliorated Kuppfer cell activation. (Elevation of the activated Kupffer cells score were 0.2+0.6 and 2.5+1.01 respectively, p = 0.001). The serum alanine aminotransferase, alkaline phosphatase levels were lower and glutathione levels, myeloperoxidase activity, and superoxide dismutase activity were similar between Leflunomide treated and untreated Methotrexate toxicity groups. DISCUSSION AND CONCLUSION: Leflunomide treatment ameliorated Methotrexate induced liver toxicity in an experimental model.

Özet

GİRİŞ ve AMAÇ: Uzun dönem Methotrexat kullanımı artmış karaciğer hasarı ve fibrozis riski ile ilişkilidir. Leflunomid hastalık modifiye edici bir ilaçtır. Leflunomid nükleer faktör kappa B aktivasyonunun güçlü bir inhibitörüdür. Aynı zamanda anti-oksidan aktivitesi de vardır. Bu deneysel çalışmada Methotrexat'ın neden olduğu karaciğer toksisitesinde Leflunomid tedavisinin etkinliği araştırılmıştır. YÖNTEM ve GEREÇLER: 39 rat 4 gruba ayrılmıştır. Methotrexat'a bağlı karaciğer toksisitesi tek doz 20mg/kg Methotrexat'ın periton içine injeksiyonu ile oluşturulmuştur. Ardından Leflunomid 5 gün boyunca 10 mg/kg dozda verilmiştir. Ardından serum örnekleri ve homojenize karaciğer örnekleri toplanmıştır. Serum alanin aminotransferaz, alkalin fosfataz, superoxide dismutaz, myeloperoxidaz aktivitesi, glutatyon düzeyleri çalışılmış ve histopatolojik değerlendirme yapılmıştır. BULGULAR: Leflunomid tedavisi tedavi almayan gruba göre karaciğer semikantitatif skalaya bağlı histopatolojik değerlendirmede anlamlı düzelme sağlamıştır (Patolojik skor 1.1+0.7 ve 5.1+2, p<0,01). Leflunomid tedavisi Kuppfer hücre aktivasyonunu anlamlı derecede iyileştirmiştir. (Aktive Kuppfer hücre skorunda yükselme 0.2+0.6 ve 2.5+1.01, p = 0.001). Leflunomid tedavisi alan grupta Methotrexat toksisite grubuna göre serum alanin aminotransferaz, alkalin fosfataz düzeyleri düşük, glutatyon seviyesi, superoxide dismutaz ve myeloperoxidaz aktivitesi benzer bulunmuştur. TARTIŞMA ve SONUÇ: Bu deneysel modelde Leflunomid tedavisi Methotrexat'a bağlı karaciğer toksisitesini iyileştirmektedir.

🔖

Cite This Article

KUTLUANA, U., ORUÇ, N., TEKEKOĞLU, S. D., DEMİRKAN, N. Ç., AKDAĞ, B., YILMAZ, M., YÖNETÇİ, N., ÖZÜTEMİR, Ö. (2018). Can Leflunomide prevent Methotrexate induced liver toxicity?. Pamukkale Tıp Dergisi, Cilt: 11 - Sayı: 3, 321–327. https://ajindex.com/articles/286062

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (14)

  1. References 1.Feagan BG, Alfadhli A. Methotrexate in inflammatory bowel disease. Gastroenterol Clin North Am 2004
  2. 420 2. Richard S, Guerret S, Gerard F, Tebib JG, Vignon E. Hepatic fibrosis in rheumatoid arthritis patients treated with methotrexate: application of a new semi-quantitative scoring system. Rheumatology (Oxford)2000
  3. Beyeler C, Reichen J, Thomann SR, Lauterburg BH, Gerber NJ. Quantitative liver function in patients with rheumatoid arthritis treated with low dose methotrexate: A longitudinal study. Br J Rheumatol 1997
  4. Boffa MJ, Chalmers RJ, Haboubi NY, Shomaf M, Mitchell DM. Sequential liver biopsies during long-term methotrexate treatment for psoriasis: A reappraisal. Br J Dermatol 1995
  5. Neuman MG, Cameron RG, Haber JA, Katz GG, Malkiewicz IM, Shear NH. Inducers of cytochrome P450 2E1 enhance methotrexate induced hepatotoxicity. Clin Biochem 1999
  6. Mladenovıc V, Domljan Z, Rozman B et al. Safety and effectiveness of leflunomide in the treatment of patients with active rheumatoid arthritis. Results of a randomized, placebo-controlled, phase II study. Arthritis Rheum 1995
  7. MannaSK, Aggarwal BB. Immunosuppressive leflunomide metabolite (A77 1726) blocks TNF-dependent nuclear factor-kappa B activation and gene expression. J Immunol. 1999
  8. Bartlett RR, Anagnostopulos H, Zıelınskı T, Mattar T, Schleyerbach R. Effects of leflunomide on immune responses and models of inflammation. Springer Semin Immunopathol 1993
  9. 394 9. Özturk E, Demirbilek S, BegecZ, et al. Does leflunomide attenuate the sepsis-induced acute lung injury? Pediatr Surg Int 2008
  10. 905 10. Manna SK, Mukhopadhyay A, Aggarwal BB. Leflunomide suppresses TNF-induced cellular responses: effects on NF-kappa B, activator protein-1, c-Jun N-terminal protein kinase, and apoptosis. J Immunol. 2000
  11. Yao HW, Li J, Chen JQ, Xu SY. Inhibitory effect of leflunomide on hepatic fibrosis induced by CCl4 in rats. Acta Pharmacol Sin 2004
  12. Uraz S, Tahan V, Aygun C, et al. Role of ursodeoxycholic acid in prevention of methotrexate-induced liver toxicity. Dig Dis Sci 2008
  13. Akerboom TP, Sies H. Assay of glutathione, glutathione disulfide and glutathione mixed disulfides in biological samples. Methods Enzymol 1981
  14. Hillegass LM, Griswold DE, Brickson B, Albrightson WC, Assessment of myeloperoxidase activity in whole rat kidney. J Pharmacol Metho