الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
T
he present study aimed to evaluate the possible protective and curative effects of pentoxifylline on diabetic nephropathy.
The rats were randomly divided into five groups as follows:
1. group I (twenty rats): served as control group. It was further subdivided into two equal subgroups:
group Ia: It received 200ml/kg distilled water using gastric intubation daily.
group Ib: It was injected intra-peritoneal with a single dose of one ml/kg body weight of sterile citrate buffer 0.1N solution.
2. group II (PTX treated group) (ten rats): It received a single daily dose of pentoxifylline throughout the duration of experiment (eight weeks) using gastric intubation.
3. group III (Diabetic nephropathy group) (ten rats): It was injected intra-peritoneal with STZ only.
4. group IV (DM+PTX as prophylactic treatment) (ten rats): Diabetic rats received a single daily dose of pentoxifylline as a protective treatment starting from one week after diabetes induction and lasting for further 7 weeks.
5. group V (DM+ PTX as curative treatment) (ten rats): Diabetic rats received a single daily dose of pentoxifylline as a curative treatment after 6th week of induction of diabetes for another 2 weeks (till the end of the experiment).
At the end of experimental period for each group, body weight was measured and blood samples were obtained from to measure blood glucose level. Kidneys were taken. Half of the collected specimens were processed for embedding in paraffin block stained with Hematoxylin and eosin (H & E) stain and anti-NF kappa immunohistochemical staining. The other half of specimens prepared for processing of semithin and ultrathin sections for electron microscopic examination. The result images of anti-NF kappa immunostained sections were analyzed for measuring the density of the stain. Data were analyzed using the computer program SPSS (Statistical package for social science) version 17.0.
Histological examination of the renal sections of diabetic nephropathy group revealed marked histo-pathological changes in the form of destructed renal corpuscles with wide irregular Bowman’s space and thickened parietal layer of Bowman’s capsule. The glomeruli were atrophied with loss of normal architecture of convoluted tubules and their lining cells were markedly degenerated.
In TEM examination, there was a thickening of the parietal layer of the Bowman’s capsule. There was a fusion of foot processes of podocyte with thick glomerular basement membrane. The lining cells of the proximal and distal convoluted tubules demonstrated destruction of apical microvilli, marked vacuolation, degenerated mitochondria and loss of basal infoldings. There was fat droplets deposition in the lining cells of proximal convoluted tubule.
These finding were markedly reduced after the protective and the curative treatment with pentoxifylline. There were normal glomeruli except there was relatively thickened parietal layer of Bowman’s capsule in some areas. Most of tubules had vesicular nuclei and normal architecture.
The results of measuring the density of positivity in NF kappa immunostained sections of groups IV and V showed a highly significant decrease in density of positivity as compared to DN group.
It is concluded that PTX has improved the histopathological changes of diabetic nephropathy either as a protective or curative treatment, so it is recommended to be used as adjuvant therapy in diabetes mellitus.
CONCLUSION
I
n conclusion, the current study demonstrated that the pentoxifylline is effective to alleviate renal damage in STZ induced diabetic rats via its anti-inflammatory effect.
Pentoxifylline had renoprotective effect and renocurative effect against diabetic nephropathy.
The diabetic rats which received pentoxifylline as a protective treatment showed thin parietal layer of the Bowman’s capsule apart from apparent thickening in some areas. The podocytes were normal. However, there was fusion of some foot processes. The lining cells of proximal convoluted tubules appeared normal apart from irregular nuclear membrane of some cells and appearance of some fat cells.
The lining cells of distal convoluted tubules appeared normal. However, there were some cells expelled into the lumen.
The diabetic rats which were treated with pentoxifylline as a curative treatment showed thin parietal layer of the Bowman’s capsule. The podocytes appeared normal except few cells showed some vacuolatios and fused foot processes. Most of convoluted tubules cells appeared similar to the control group. Cellular debris was expelled into the lumen of PCT and DCT. Some cells of DCT showed irregular nulear membrane.
The reaction of PCT and DCT to anti-nuclear factor kappa immunohistochemical stain in diabetic rats which received a single daily dose of pentoxifylline as a protective treatment (group IV) was less than that of diabetic rats which were treated with a single daily dose of pentoxifylline as a curative treatment (group V).
RECOMMENDATIONS
• Whenever diabetes mellitus had been discovered, it is better to receive pentoxifylline as an adjuvant therapy for protection from diabetic nephropathy.
• In cases of diabetic nephropathy, it is recommended to receive pentoxifylline to alleviate diabetic nephropathy and to prevent the progression of the disease.
• Further studies are required to investigate the synergetic effects of pentoxifylline if combined with other well-known medications used in diabetes mellitus and how pentoxifylline interacts with them.
• Further animal and clinical studies are needed to confirm the findings of the present study.