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Journal : Nusantara Medical Science Journal

ROLES OF VITAMIN C AND VITAMIN E ON DOXORUBICIN-INDUCED RENAL AND LIVER TOXICITY IN RATS Yulia Yusrini Djabir; Usmar Usmar; Elly Wahyudin; Sukamto S Mamada; Ika Reskia N Hamka; Dila Pramitha S. Putri; Irma Amalia
Nusantara Medical Science Journal Volume 1 No. 2 April - Juni 2016
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.v1i2.2213

Abstract

ABSTRACT Introduction: Doxorubicin (DOX) is a chemotherapy agent that has potent effects against various cancer types. However, DOX may elicit renal and liver toxicity. Objectives: To examine the role of vitamin C and vitamin E in reducing DOX renal and liver toxicity. Methods: Male rats (220-330 g) were assigned to one of the treatment groups. Group I was healthy controls. Group II was given DOX (20 mg/kg b.wt). Group III was given vitamin C (250 mg/kg b.wt) for 7 days prior to DOX injection. Group IV was given vitamin E (250 mg/kg b.wt) for 7 days prior to DOX injection. Group V was given oil vehicle for 7 days prior to DOX injection. Results: Vitamin C was effective to reduce both renal and liver dysfunction. However, vitamin E protective effects were only convincing in lowering DOX-induced renal toxicity but not liver toxicity. Both vitamins prevented elevated DOX-induced oxidative stress. Conclusion: Both vitamin C and vitamin E can help to reduce DOX toxicity in rat kidney, but only vitamin C that has clear benefits on improving liver toxicity after DOX injection. Keywords: Doxorubicin, renal toxicity, liver toxicity, vitamin E, vitamin C
The protective effect of Paliasa (Kleinhovia hospita L.) leaf extract against elevated total bilirubin serum induced by toxic dose of antituberculosis in rats Yulia Yusrini Djabir; Imelda Dhea Meylin; Rosany Tayeb
Nusantara Medical Science Journal Volume 4 No. 2 Juli - Desember 2019
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.v4i2.6474

Abstract

Liver dysfunction is implicated with the use of Antituberculosis (AT) leading to low compliance of TB patients to AT regimen. One of biomarker that is important to measure liver dysfunction is total bilirubin serum. Paliasa leaves have been emiprically used to improve liver function in South Sulawesi. This study aimed to determine the effect of ethanolic extract of Paliasa leaves on total bilirubin serum in rats. Twenty rats were devided into five groups: Group I served as the healthy control was only given NaCMC suspension, group II was treated with 178 mg/200gBB of AT suspension, while group III, group IV and group V  were given Paliasa extract 125 mg/kgBB, 250mg/kgBB and 500 mg/kgBB, respectively, 4 hours prior to AT suspension administration. Treatments were performed once a day for 28 days. Blood sampling was carried out 24 hours following the last treatment. The total bilirubin levels were measured using Humalyzer 3500. The results showed that the administrations of AT suspension for 28 days significantly increased rat total bilirubin levels. Paliasa leaf extract in all given dose was able to reduce the total bilirubin levels of rats compared to the group given only AT suspension. However, statistical significance was only reached by the groups that were treated with Paliasa extract 250 and 500 mg/kgBB. Therefore it is concluded that ethanol extract at a dose of 250 and 500 mg/kgBB has protective effect against AT-induced elevation of total bilirubin serum in rats.
Case Reports on Severe Antituberculosis-Drug Induced Hepatotoxicity in Tuberculosis Patients: The Post-Incidence Therapy Nasrawati Basir; Yulia Yusrini Djabir; Arif Santoso
Nusantara Medical Science Journal Volume 5 No. 1 Januari - Juni 2020
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.v5i1.13450

Abstract

Introduction:  The first-line regimen for tuberculosis (TB) treatment comprises Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol. However, these drugs are known to potentially cause hepatotoxicity. This study aimed to evaluate hepatotoxicity incidence in patients during intensive phase of anti-tuberculosis treatment focusing on post-incidence therapy. Methods:  The study involved pulmonary TB patients who were admitted to the National Lung Health Center due to hepatotoxicity after receiving fixed-dose combination of antituberculosis drugs (FDC-AT) in September-October 2019. Drug-related hepatotoxicity is defined as an increase in serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels greater than 2.5 times of the normal upper limit (ULN) with an increase in bilirubin level. Results:  There were 8 patients admitted to the center due to hepatotoxicity, 4 of them experienced grade 3 (severe) hepatotoxicity, during which the ALT, AST, bilirubin levels increased 5-10 times of the ULN. The post-hepatotoxicity treatment includes the cessation of FDC-AT treatment followed by hepatoprotective supplements. Following two weeks of treatments, the biomarker levels of two out of four patients went back to normal and the AT therapy was resumed. Meanwhile, the other two patients continued to receive the hepatoprotective therapy for up to 8 weeks. However, when the treatment failed to bring the transaminase level back to normal, a different AT regimen was prescribed. Conclusions: The cessation of FDC-AT and the use of hepatoprotective supplements for two to eight weeks were able to alleviate the AT-induced severe hepatotoxicity. A close monitoring of liver biomarkers is warranted to prevent the incidence of hepatotoxicity in patients receiving antituberculosis