Research Article
BibTex RIS Cite

Biochemical and histomorphometric comparison of antioxidant (Taurine) and ozone therapy effects on ESWL-induced oxidative damage in rabbit kidney tissue

Year 2026, Volume: 19 Issue: 2 , 373 - 382 , 13.04.2026
https://doi.org/10.31362/patd.1756853
https://izlik.org/JA69HL23AL

Abstract

Purpose: This study aimed to investigate the role of free radicals in kidney injury induced by extracorporeal shock wave lithotripsy (ESWL) and to compare the protective effects of taurine and ozone therapy.

Methods: Thirty male New Zealand rabbits were divided into five groups: control, ESWL, ESWL + ozone, ESWL + taurine, and ESWL + ozone + taurine. ESWL was applied in a single session at 14 kV and 2500 shocks. Ozone was administered intraperitoneally and taurine orally for 15 days. Histopathological evaluations and biochemical analyses, including MDA, SOD, CAT, and GSH-Px levels, were performed on renal tissues.

Results: ESWL significantly increased tissue MDA levels and decreased antioxidant enzyme levels. Taurine and ozone treatments reduced oxidative stress by lowering MDA levels and enhancing antioxidant enzyme activity. Histologically, less tissue damage was observed in the treatment groups.

Conclusion: Taurine and ozone therapies effectively reduced ESWL-induced kidney damage both biochemically and histologically. These findings support the potential protective role of these agents in clinical settings.

References

  • Hill AJ, Basourakos SP, Lewicki P, et al. Incidence of Kidney Stones in the United States: The Continuous National Health and Nutrition Examination Survey. J Urol. 2022;207(4):851-856. doi:10.1097/JU.0000000000002331
  • Walsh PC, Retik AB, Vaughan ED, Wein AJ. Urinary stone disease and endourology. In: Campbell’s Urology. 8th ed. Philadelphia, PA: Saunders; 2006.
  • Chow GK, Streem SB. Extracorporeal lithotripsy: update on technology. Urol Clin North Am. 2000;27(2):315 322. doi:10.1016 /s0094-0143(05)70260-3
  • Kaude JV, Williams CM, Millner MR, Scott KN, Finlayson B. Renal morphology and function immediately after extracorporeal shock wave lithotripsy. AJR Am J Roentgenol. 1985;145(2):305 313. doi:10.2214/ajr.145.2.305
  • Rubin JI, Arger PH, Pollack HM, Banner MP, Coleman BG, Mintz MC, VanArsdalen KN. Kidney changes after extracorporeal shock wave lithotripsy: CT evaluation. Radiology. 1987;162(1):21 24.
  • Delius M, Jordan M, Eizenhoefer H, et al. Biological effects of shock waves: kidney haemorrhage by shock waves in dogs—administration rate dependence. Ultrasound Med Biol. 1988;14(7):689 694. doi:10.1016/0301-5629(90)90024-7
  • Gillenwater JY. Extracorporeal shock wave lithotripsy for the treatment of urinary calculi. In: Gillenwater JY, Grayhack JT, Howards SS, Duckett JW, eds. Adult and Pediatric Urology. 2nd ed. St Louis, MO: Mosby Year Book; 1991:695 710.
  • Stoller ML. Extracorporeal shock wave lithotripsy. In: Tanago EA, McAninch JW, eds. Smith’s General Urology. 14th ed. Stamford, CT: Appleton & Lange; 1995:305 313.
  • Sharples EJ, Patel N, Brown P, et al. Erythropoietin protects the kidney against the injury and dysfunction caused by ischemia reperfusion. J Am Soc Nephrol. 2004;15(7):2115 2124. doi:10.1097/01.ASN.0000135059.67385.5D
  • Yagi K. Lipid peroxides in hepatic, gastrointestinal and pancreatic diseases. Adv Exp Med Biol. 1994;366:165 169.
  • Miranda KM, Espey MG, Wink DA. A rapid simple spectrophotometric method for simultaneous detection of nitrate and nitrite. Nitric Oxide. 2001;5(1):62 71. doi:10.12691/ajfn-11-3-5
  • Sedlak J, Lindslay RH. Estimation of total protein bound and nonprotein sulfhydryl groups in tissue with Ellman’s reagent. Anal Biochem. 1968;25(1):192 205. doi:10.1016/0003-2697(68)90092-4
  • McCord JM. Human disease, free radicals and the oxidant/antioxidant balance. Clin Biochem. 1993;26(6):351 357. doi:10.1016/0009-9120(93)90111-i
  • Ray G, Batra S, Shukla NK, et al. Lipid peroxidation, free radical production and antioxidant status in breast cancer. Breast Cancer Res Treat. 2000;59(3):163 170. doi:10.1023/a:1006357330486
  • Halliwell B, Gutteridge JMC. Free Radicals in Biology and Medicine. 2nd ed. Oxford, UK: Clarendon Press; 1989. doi:10.1007/0-387-26741-7-3
  • Rikans LE, Hornbrook KR. Lipid peroxidation, antioxidant and aging. Biochim Biophys Acta. 1997;362(2):116 127. doi:10.1016/s0925-4439(97)00067-7
  • Nath KA, Croatt AJ, Hostetter TH. Oxygen consumption and oxidant stress in surviving nephrons. Am J Physiol. 1990;258(6Pt2):F1354 1362. doi:10.1152/ajprenal.1990.258.5.F1354
  • Waz WR, Feld LG. Reactive oxygen molecules in the kidney. Adv Exp Med Biol. 1994;366:171 183. doi:10.1007/978-1-4615-1833-4_13
  • Dröge W, Schulze Osthoff K, Mihm S, et al. Functions of glutathione and glutathione disulfide in immunology and immunopathology. FASEB J. 1994;8(10):1131 138.
  • Hayes JD, McLellan LI. Glutathione and glutathione dependent enzymes represent a co ordinately regulated defence against oxidative stress. Free Radic Res. 1999;31(4):273 300. doi:10.1080/10715769900300851
  • Haddad JJ, Olver RE, Land SC. Antioxidant/pro oxidant equilibrium regulates HIF 1 alpha and NF kappa B redox sensitivity: evidence for inhibition by glutathione oxidation in alveolar epithelial cells. J Biol Chem. 2000;275(28):21130 2140. doi:10.1074/jbc.M000737200
  • Aksoy Y, Malkoc I, Atmaca AF, et al. The effects of extracorporeal shock wave lithotripsy on antioxidant enzymes in erythrocytes. Cell Biochem Funct. 2006;24(4):467 469. doi:10.1002/cbf.1239
  • Li X, He D, Zhang L, Cheng X, Sheng B, Luo Y. A novel antioxidant agent, astragalosides, prevent shock wave induced renal oxidative injury in rabbits. Urol Res. 2006;34(4):277 282. doi:10.1007/s00240-006-0057-1
  • Orestano F, Caronia N, Gallo G. Functional aspects of the kidney after shock wave lithotripsy. In: Lingeman JE, Newman DM, eds. Shock wave Lithotripsy 2: Urinary and Biliary Lithotripsy. New York, NY: Plenum Press; 1989:15 17.
  • Back W, Kohrmann KU, Bensemann J, Rassweiler J, Alken P. Histomorphologic and ultrastructural findings of shockwave induced lesions in the isolated perfused kidney of the pig. J Endourol. 1994;8(4):257 261. doi:10.1089/end.1994.8.257
  • Al Awadi KA, Kehinde EO, Loutfi I, et al. Treatment of renal calculi by lithotripsy: minimizing short term shock wave induced renal damage by using antioxidants. Urol Res. 2008;36(1):51 60. doi:10.1007/s00240-007-0126-o
  • Serel TA, Ozguner F, Soyupek S. Prevention of shock wave induced renal oxidative stress by melatonin: an experimental study. Urol Res. 2004;32(1):69 71. doi:10.1007/s00240-003-0397-z
  • Biri H, Oztürk HS, Büyükkoçak S, et al. Antioxidant defense potential of rabbit renal tissues after ESWL: protective effects of antioxidant vitamins. Nephron. 1998;79(2):181 185. doi:10.1159/000045022
  • Huxtable R. Physiological actions of taurine. Physiol Rev. 1992;72(1):101 163. doi:10.1152/physrev.1992.72.1.101
  • Chesney RW. Taurine: its biological role and clinical implications. Adv Pediatr. 1985;32:1 42.
  • Hagar HH, El Etter E, Arafa M. Taurine attenuates hypertension and renal dysfunction induced by cyclosporine A in rats. Clin Exp Pharmacol Physiol. 2006;33(2):189 196. doi:10.1111/j.1440-1681.2006.04345.x
  • Park E, Schuller Levis G, Quinn MR. Taurine chloramine inhibits production of nitric oxide and TNF alpha in activated RAW 264.7 cells by mechanisms that involve transcriptional and translational events. J Immunol. 1995;154(9):4778 4784.
  • Cunningham C, Tipton KF, Dixon HB. Conversion of taurine into N chlorotaurine (taurine chloramine) and sulphoacetaldehyde in response to oxidative stress. Biochem J. 1998;330(Pt 3):939 945. doi:10.1042/bj3300939
  • El Abhar HS, El Gaward HM. Modulation of cortical nitric oxide synthase, glutamate, and redox state by nifedipine and taurine in PTZ kindled mice. Epilepsia. 2003;44(3):276-281. doi:10.1046/j.1528-1157.2003.22302.x
  • Guz G, Oz E, Lortlar N, et al. The effect of taurine on renal ischemia/reperfusion injury. Amino Acids. 2007;32(3):405 411. doi:10.1007/s00726-006-0383-1
  • Gürer H, Özgünes H, Saygin E, Ercal N. Antioxidant effect of taurine against lead induced oxidative stress. Arch Environ Contam Toxicol. 2001;41(3):397 402. doi:10.1007/s002440010265
  • Bocci V. Ozone as Janus: this controversial gas can be either toxic or medically useful. Mediators Inflamm. 2004;13(1 2):3 11. doi:10.1080/0962935062000197083
  • Souza YM, Fontes B, Martins JO, et al. Evaluation of the effects of ozone therapy in the treatment of intra abdominal infection in rats. Clinics (Sao Paulo). 2010;65(2):195 202. doi:10.1590/s1807-593220100000200012
  • Pryor WA. Mechanisms of radical formation from reactions of ozone with target molecules in the lung. Free Radic Biol Med. 1994;17(3):451 465. doi:10.16/0891-5849(94)90172-4
  • Bhalla DK, Gupta SK, Reinhart PG. Alteration of epithelial integrity, alkaline phosphatase activity, and fibronectin expression in lungs of rats exposed to ozone. J Toxicol Environ Health A. 1999;57(5):329 343. doi:10.1080/009841099157647
  • Morsy M, Hassan WN, Zalat SI. Improvement of renal oxidative stress markers after ozone administration in diabetic nephropathy in rats. Diabetol Metab Syndr. 2010;2:29. doi:10.1186/1758-5996-2-29
  • Barber E, Menéndez S, León OS, et al. Prevention of renal injury after induction of ozone tolerance in rats submitted to warm ischaemia. Mediators Inflamm. 1999;8(1):37 41. doi:10.1080/09629359990702

Tavşan böbrek dokusunda eswl ile indüklenen oksidatif hasar üzerine antioksidan (Taurin) ve ozon terapi etkilerinin biyokimyasal ve histomorfometrik karşılaştırılması

Year 2026, Volume: 19 Issue: 2 , 373 - 382 , 13.04.2026
https://doi.org/10.31362/patd.1756853
https://izlik.org/JA69HL23AL

Abstract

Amaç: Bu çalışmada, litotripsi sonrası oluşan böbrek hasarında serbest radikallerin rolü ve bu hasarın azaltılmasında taurin ve ozon tedavisinin etkileri karşılaştırılmıştır.

Gereç ve yöntem: Otuz erkek Yeni Zelanda tavşanı beş gruba ayrıldı: kontrol, ESWL, ESWL + ozon, ESWL + taurin ve ESWL + ozon + taurin. ESWL uygulaması tek seans 14 kV enerjiyle, 2500 atım olarak gerçekleştirildi. Ozon tedavisi intraperitoneal olarak, taurin ise oral yolla 15 gün süreyle verildi. Histopatolojik değerlendirme yanı sıra doku düzeyinde MDA, SOD, CAT, GSH-Px gibi biyokimyasal parametreler ölçüldü.

Bulgular: ESWL sonrası doku MDA düzeyleri anlamlı şekilde artarken, antioksidan enzim düzeyleri azaldı. Taurin ve ozon tedavileri, MDA düzeylerini düşürüp antioksidan enzim düzeylerini artırarak oksidatif stresi azalttı. Histopatolojik olarak da tedavi gruplarında daha az hasar izlendi.

Sonuç: Taurin ve ozon tedavisi, ESWL'nin neden olduğu böbrek hasarını hem biyokimyasal hem de histopatolojik olarak azaltmada etkili bulunmuştur. Bu sonuçlar, klinik uygulamalarda bu ajanların koruyucu potansiyelini desteklemektedir.

References

  • Hill AJ, Basourakos SP, Lewicki P, et al. Incidence of Kidney Stones in the United States: The Continuous National Health and Nutrition Examination Survey. J Urol. 2022;207(4):851-856. doi:10.1097/JU.0000000000002331
  • Walsh PC, Retik AB, Vaughan ED, Wein AJ. Urinary stone disease and endourology. In: Campbell’s Urology. 8th ed. Philadelphia, PA: Saunders; 2006.
  • Chow GK, Streem SB. Extracorporeal lithotripsy: update on technology. Urol Clin North Am. 2000;27(2):315 322. doi:10.1016 /s0094-0143(05)70260-3
  • Kaude JV, Williams CM, Millner MR, Scott KN, Finlayson B. Renal morphology and function immediately after extracorporeal shock wave lithotripsy. AJR Am J Roentgenol. 1985;145(2):305 313. doi:10.2214/ajr.145.2.305
  • Rubin JI, Arger PH, Pollack HM, Banner MP, Coleman BG, Mintz MC, VanArsdalen KN. Kidney changes after extracorporeal shock wave lithotripsy: CT evaluation. Radiology. 1987;162(1):21 24.
  • Delius M, Jordan M, Eizenhoefer H, et al. Biological effects of shock waves: kidney haemorrhage by shock waves in dogs—administration rate dependence. Ultrasound Med Biol. 1988;14(7):689 694. doi:10.1016/0301-5629(90)90024-7
  • Gillenwater JY. Extracorporeal shock wave lithotripsy for the treatment of urinary calculi. In: Gillenwater JY, Grayhack JT, Howards SS, Duckett JW, eds. Adult and Pediatric Urology. 2nd ed. St Louis, MO: Mosby Year Book; 1991:695 710.
  • Stoller ML. Extracorporeal shock wave lithotripsy. In: Tanago EA, McAninch JW, eds. Smith’s General Urology. 14th ed. Stamford, CT: Appleton & Lange; 1995:305 313.
  • Sharples EJ, Patel N, Brown P, et al. Erythropoietin protects the kidney against the injury and dysfunction caused by ischemia reperfusion. J Am Soc Nephrol. 2004;15(7):2115 2124. doi:10.1097/01.ASN.0000135059.67385.5D
  • Yagi K. Lipid peroxides in hepatic, gastrointestinal and pancreatic diseases. Adv Exp Med Biol. 1994;366:165 169.
  • Miranda KM, Espey MG, Wink DA. A rapid simple spectrophotometric method for simultaneous detection of nitrate and nitrite. Nitric Oxide. 2001;5(1):62 71. doi:10.12691/ajfn-11-3-5
  • Sedlak J, Lindslay RH. Estimation of total protein bound and nonprotein sulfhydryl groups in tissue with Ellman’s reagent. Anal Biochem. 1968;25(1):192 205. doi:10.1016/0003-2697(68)90092-4
  • McCord JM. Human disease, free radicals and the oxidant/antioxidant balance. Clin Biochem. 1993;26(6):351 357. doi:10.1016/0009-9120(93)90111-i
  • Ray G, Batra S, Shukla NK, et al. Lipid peroxidation, free radical production and antioxidant status in breast cancer. Breast Cancer Res Treat. 2000;59(3):163 170. doi:10.1023/a:1006357330486
  • Halliwell B, Gutteridge JMC. Free Radicals in Biology and Medicine. 2nd ed. Oxford, UK: Clarendon Press; 1989. doi:10.1007/0-387-26741-7-3
  • Rikans LE, Hornbrook KR. Lipid peroxidation, antioxidant and aging. Biochim Biophys Acta. 1997;362(2):116 127. doi:10.1016/s0925-4439(97)00067-7
  • Nath KA, Croatt AJ, Hostetter TH. Oxygen consumption and oxidant stress in surviving nephrons. Am J Physiol. 1990;258(6Pt2):F1354 1362. doi:10.1152/ajprenal.1990.258.5.F1354
  • Waz WR, Feld LG. Reactive oxygen molecules in the kidney. Adv Exp Med Biol. 1994;366:171 183. doi:10.1007/978-1-4615-1833-4_13
  • Dröge W, Schulze Osthoff K, Mihm S, et al. Functions of glutathione and glutathione disulfide in immunology and immunopathology. FASEB J. 1994;8(10):1131 138.
  • Hayes JD, McLellan LI. Glutathione and glutathione dependent enzymes represent a co ordinately regulated defence against oxidative stress. Free Radic Res. 1999;31(4):273 300. doi:10.1080/10715769900300851
  • Haddad JJ, Olver RE, Land SC. Antioxidant/pro oxidant equilibrium regulates HIF 1 alpha and NF kappa B redox sensitivity: evidence for inhibition by glutathione oxidation in alveolar epithelial cells. J Biol Chem. 2000;275(28):21130 2140. doi:10.1074/jbc.M000737200
  • Aksoy Y, Malkoc I, Atmaca AF, et al. The effects of extracorporeal shock wave lithotripsy on antioxidant enzymes in erythrocytes. Cell Biochem Funct. 2006;24(4):467 469. doi:10.1002/cbf.1239
  • Li X, He D, Zhang L, Cheng X, Sheng B, Luo Y. A novel antioxidant agent, astragalosides, prevent shock wave induced renal oxidative injury in rabbits. Urol Res. 2006;34(4):277 282. doi:10.1007/s00240-006-0057-1
  • Orestano F, Caronia N, Gallo G. Functional aspects of the kidney after shock wave lithotripsy. In: Lingeman JE, Newman DM, eds. Shock wave Lithotripsy 2: Urinary and Biliary Lithotripsy. New York, NY: Plenum Press; 1989:15 17.
  • Back W, Kohrmann KU, Bensemann J, Rassweiler J, Alken P. Histomorphologic and ultrastructural findings of shockwave induced lesions in the isolated perfused kidney of the pig. J Endourol. 1994;8(4):257 261. doi:10.1089/end.1994.8.257
  • Al Awadi KA, Kehinde EO, Loutfi I, et al. Treatment of renal calculi by lithotripsy: minimizing short term shock wave induced renal damage by using antioxidants. Urol Res. 2008;36(1):51 60. doi:10.1007/s00240-007-0126-o
  • Serel TA, Ozguner F, Soyupek S. Prevention of shock wave induced renal oxidative stress by melatonin: an experimental study. Urol Res. 2004;32(1):69 71. doi:10.1007/s00240-003-0397-z
  • Biri H, Oztürk HS, Büyükkoçak S, et al. Antioxidant defense potential of rabbit renal tissues after ESWL: protective effects of antioxidant vitamins. Nephron. 1998;79(2):181 185. doi:10.1159/000045022
  • Huxtable R. Physiological actions of taurine. Physiol Rev. 1992;72(1):101 163. doi:10.1152/physrev.1992.72.1.101
  • Chesney RW. Taurine: its biological role and clinical implications. Adv Pediatr. 1985;32:1 42.
  • Hagar HH, El Etter E, Arafa M. Taurine attenuates hypertension and renal dysfunction induced by cyclosporine A in rats. Clin Exp Pharmacol Physiol. 2006;33(2):189 196. doi:10.1111/j.1440-1681.2006.04345.x
  • Park E, Schuller Levis G, Quinn MR. Taurine chloramine inhibits production of nitric oxide and TNF alpha in activated RAW 264.7 cells by mechanisms that involve transcriptional and translational events. J Immunol. 1995;154(9):4778 4784.
  • Cunningham C, Tipton KF, Dixon HB. Conversion of taurine into N chlorotaurine (taurine chloramine) and sulphoacetaldehyde in response to oxidative stress. Biochem J. 1998;330(Pt 3):939 945. doi:10.1042/bj3300939
  • El Abhar HS, El Gaward HM. Modulation of cortical nitric oxide synthase, glutamate, and redox state by nifedipine and taurine in PTZ kindled mice. Epilepsia. 2003;44(3):276-281. doi:10.1046/j.1528-1157.2003.22302.x
  • Guz G, Oz E, Lortlar N, et al. The effect of taurine on renal ischemia/reperfusion injury. Amino Acids. 2007;32(3):405 411. doi:10.1007/s00726-006-0383-1
  • Gürer H, Özgünes H, Saygin E, Ercal N. Antioxidant effect of taurine against lead induced oxidative stress. Arch Environ Contam Toxicol. 2001;41(3):397 402. doi:10.1007/s002440010265
  • Bocci V. Ozone as Janus: this controversial gas can be either toxic or medically useful. Mediators Inflamm. 2004;13(1 2):3 11. doi:10.1080/0962935062000197083
  • Souza YM, Fontes B, Martins JO, et al. Evaluation of the effects of ozone therapy in the treatment of intra abdominal infection in rats. Clinics (Sao Paulo). 2010;65(2):195 202. doi:10.1590/s1807-593220100000200012
  • Pryor WA. Mechanisms of radical formation from reactions of ozone with target molecules in the lung. Free Radic Biol Med. 1994;17(3):451 465. doi:10.16/0891-5849(94)90172-4
  • Bhalla DK, Gupta SK, Reinhart PG. Alteration of epithelial integrity, alkaline phosphatase activity, and fibronectin expression in lungs of rats exposed to ozone. J Toxicol Environ Health A. 1999;57(5):329 343. doi:10.1080/009841099157647
  • Morsy M, Hassan WN, Zalat SI. Improvement of renal oxidative stress markers after ozone administration in diabetic nephropathy in rats. Diabetol Metab Syndr. 2010;2:29. doi:10.1186/1758-5996-2-29
  • Barber E, Menéndez S, León OS, et al. Prevention of renal injury after induction of ozone tolerance in rats submitted to warm ischaemia. Mediators Inflamm. 1999;8(1):37 41. doi:10.1080/09629359990702
There are 42 citations in total.

Details

Primary Language English
Subjects Urology
Journal Section Research Article
Authors

Nart Görgü 0000-0003-1542-0393

Aykut Başer 0000-0003-0457-512X

Mehmet Murad Başar 0000-0002-4732-1923

Submission Date August 2, 2025
Acceptance Date September 29, 2025
Publication Date April 13, 2026
DOI https://doi.org/10.31362/patd.1756853
IZ https://izlik.org/JA69HL23AL
Published in Issue Year 2026 Volume: 19 Issue: 2

Cite

AMA 1.Görgü N, Başer A, Başar MM. Biochemical and histomorphometric comparison of antioxidant (Taurine) and ozone therapy effects on ESWL-induced oxidative damage in rabbit kidney tissue. Pam Med J. 2026;19(2):373-382. doi:10.31362/patd.1756853

Creative Commons Lisansı
Pamukkale Medical Journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License