EJMS

Abstract

Background: Cyclosporin, a drug used in immunosuppression protocols for hematopoietic stem cell transplantation that has a narrow therapeutic index, may cause various adverse reactions, including nephrotoxicity. This has a direct clinical impact on the patient. Cyclosporin induced kidney fibrosis is an important obstacle to successful long-term outcomes in organ transplantation and autoimmune diseases. Aim of the Work:This study aims to summarize available side effects to the use of cyclosporin in respect to its risk factor for the development of nephrotoxicity and the possible protective role of vitamin E. Material and Methods:The present study was carried out on forty adult male albino rats. Their average weight was 200 grams. They were divided into four equal groups. Group I (control group) received no medications. Group II (cyclosporin group) received a daily intraperitoneal injection of 30 mg/kg cyclosporin for one month. Group III (vitamin E) received 100 mg vitamin E/kg per day orally for one month. Group IV (cyclosporin and vitamin E) received a daily cyclosporin30 mg/kg intraperitoneally plus 100 mg vitamin E/kg orallyfor one month. At the end of the experiment, the rats from each group were sacrificed.Specimensof the kidney from all groups were taken and processed for histological, electron microscopical and morphometric studies. Results: cyclosporin treatment showed marked degenerative effects of the glomerulus, dilated proximal, distal and collecting tubules with disturbance of their lining epithelium. Indented nucleus and destructed mitochondria were observed in both proximal and distal convoluted tubules. Significant decrease in the wall thickness of proximal convoluted tubules and high significant decrease in the wall thickness of distal convoluted tubules. Vitamin E treatment after cyclosporine demonstrated mild changes of the glomerulus. The proximal convoluted tubules showed normal shaped nucleus and mitochondria with thick basement membrane. The distal convoluted tubules revealed normal shaped nucleus, destructed mitochondria and wide intercellular separation. No significant changes in the thickness of the wall of the proximal and distal convoluted tubules could be detected. Conclusion:Vitamin E reduces the toxic changes of the cyclosporin treatment on the kidney. So, it is recommended to add vitamin E with cyclosporin to reduce its nephrotoxicity.