EJMS

Abstract

Background: Dexamethasone is a potent synthetic glucocorticoid that shows a high incidence of side-effects such as gastric mucosal erosions and ulceration, hemorrhagic lesions and dilatation of gastric glands. Misoprostol which is a prostaglandin E analogue has been shown to be beneficial in preventing these hazardous effects on gastric mucosa. Aim of Work: To clarify the role of misoprostol as a prostaglandin E analogue in prevention of dexamethasone induced gastric mucosal damage. Material and methods: Forty adult male albino rats were divided in to four groups; group I, normal control (n=10) received nothing. Group II, sham control (n=10) received the vehicle only. Group III, dexamethasone treated (n=10), received an oral dose of dexamethasone dissolved in saline (4mg/kg) by gastric gavage daily for four days. Group IV, dexamethasone and misoprostol (n=10) treated received an oral dose of dexamethasone (4 mg/kg) and misoprostol (300 micro/kg) dissolved in saline daily for four days. The rats were sacrificed by cervical dislocation 24 after hours after each experimental period. The stomach was excised and the mucosal surface of the stomach was exposed by a pair of scissors along the greater curvature; thereafter the stomach wall was washed with saline, pinned on a wax platform. Sections were stained with H &E for routine histopatholgical examination .PAS for measurement of mucus and PCNA immunohistochemical stain for assessment of proliferating stem cells. Results: Histopathological examination showed damage in the gastric mucosa in the form of gastric erosions with cellular exfoliation and ulcerations, dilated gastric glands, hemorrhage, foveolar hyperplasia and lymphocytic infiltration. On the cellular level cellular hyperplasia and hypertrophy, vacuolated oxyntic and peptic cells with pyknotic nuclei and apoptotic like bodies were observed. Apparent decrease in mucus and diminution of the proliferating stem cells were also detected. Misoprostol administration showed an obvious improvement such that the mucosal epithelial lining and the architecture of gastric glands were almost restored and it significantly increased mucus and proliferating stem cells. Conclusion: The present study revealed that coadminstration of dexamethasone and misoprostol prevented most of the negative effects caused by dexamethasone and accelerated the healing of gastric mucosa.