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Alleviation of Cyclophosphamide-induced Hemorrhagic Cystitis by Dietary Pomegranate: A Comparative Experimental Study With Mesna

Mahmoudi, Negin, MD*; Eftekharzadeh, Sahar, MD, MPH*; Golmohammadi, Marzieh, BSc*; Khorramirouz, Reza, MD*; Hashemi, Javad, PhD; Kashani, Zeinab, BSc*; Alijani, Maryam, BSc*; Hamidieh, Amir Ali, MD; Kajbafzadeh, Abdol-Mohammad, MD*

Journal of Pediatric Hematology/Oncology: November 2018 - Volume 40 - Issue 8 - p 609–615
doi: 10.1097/MPH.0000000000001203
Original Articles

In this study, we investigated the effects of pomegranate on alleviating cyclophosphamide-induced hemorrhagic cystitis (HC). Initially, 16 Sprague-Dawley rats were allocated into 4 groups: group 1 (control), group 2 (CP) in which HC was induced by cyclophosphamide; group 3 (CP+M), HC-induced rats that received Mesna regimen, and group 4 (CP+P), which compromised rats that had been on a 14-day diet of pomegranate juice before HC induction. Cystometry was performed a few hours before euthanasia; after euthanasia, aortic blood samples and bladder tissue samples were obtained to perform TUNEL assay, and histopathologic and biochemical assessments. Urodynamic findings revealed that mean detrusor pressure in CP+P was significantly lower compared with that in CP and CP+M (P<0.05). Histopathologically, urothelium destruction and inflammation were lower in CP+P and CP+M compared with that in CP. Collagen destruction was less prominent in CP+P compared with that in CP and CP+M. Tissue and plasma levels of malondialdehyde were significantly lower in CP+P versus CP (P<0.05). Catalase activity and total protein thiol group levels in plasma and bladder tissue were higher in CP+P versus CP (P<0.05). The TUNEL positivity in CP+P was significantly weaker than that in CP, indicating less DNA fragmentation and apoptosis. Pomegranate’s characteristics could significantly affect the inflammatory and destructive process of hemorrhagic cystitis.

*Department of Pediatric Urology, Pediatric Urology Research Center, Pediatrics Center of Excellence

Department of Clinical Biochemistry

Hematology-Oncology and Stem Cell Transplantation Research Centre, Tehran University of Medical Sciences, Tehran, Iran

Supported by Tehran University of Medical Sciences & Health Services grant.

The authors declare no conflict of interest.

Reprints: Abdol-Mohammad Kajbafzadeh, MD, No. 62, Dr. Qarib’s St, Keshavarz Blvd, Pediatric Urology Research Center, Children’s Medical Center, Pediatric Center of Excellence, Tehran 14194 33151, Iran (e-mail: kajbafzd@sina.tums.ac.ir).

Received December 7, 2017

Accepted March 20, 2018

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