Deneysel koroziv özofajit modelinde prednisolon ve balın etkinliklerinin karşılaştırılması

Yıl 2020, , 108 - 111, 01.02.2020

Eyüp Gemici , Ahmet Sürek , Murat Çikot , Damlanur Sakız , Mehmet Karabulut , Murat Gönenç , Halil Alış

https://doi.org/10.28982/josam.674809

Öz

Amaç: Bal antiödem etkisi, granülasyonu hızlandırıcı etkisi, enzimatik debridman ve immün sistemi güçlendirici etkisi bilinen bir doğal gıdadır. Bu deneysel çalışmanın amacı bir alkali ajan olan sodyum hidroksit ile oluşturulan koroziv özofajitte darlık gelişimi üzerine balın ve prednisolonun etkilerini araştırıldı.
Yöntemler: Bu çalışma, ağırlıkları 200-250 gram arasında değişen Wistar tipi albino sıçanlar üzerinde gerçekleştirildi. Denekler, eşit sayıda dört gruba bölündü. Birinci, ikinci ve üçüncü gruplar özofajit modeli grupları olup, bu gruplardaki tüm deneklerde %37,5’luk sodyum hidroksit ile koroziv özofajit oluşturuldu. Birinci gruba herhangi bir tedavi uygulanmazken, ikici gruba oral bal tedavisi ve üçüncü gruba intraperitoneal prednisolon tedavisi uygulandı. Kontrol grubunun özofagusuna herhangi bir işlem yapılmadan şam laparotomi uygulandı. Tüm denekler 28. gün sakrifiye edildi ve deneklerin distal özofaguslarından alınan 20 mm uzunluğundaki örnekler histopatolojik incelemeye tabi tutuldu. Grupların doku hasarı skorları ve stenoz indeksi skorları ölçülerek kıyaslandı.
Bulgular: Çalışmaya toplam 32 denek dahil edildi ve her bir grupta sekiz denek mevcuttu. Stenoz indeksi skoru ortalama değeri ve doku hasarı skoru ortalama değeri balla tedavi edilen grupta, prednisolon verilen ve tedavi verilmeyen gruplara kıyasla anlamlı olarak düşüktü (P=0,001).
Sonuç: Bal, prednisolona kıyasla, alkalen ajanla oluşturulan deneysel koroziv özofajit modelinde gelişen özofagus darlıkları üzerinde daha anlamlı düzeyde olumlu etkiye sahiptir.

Anahtar Kelimeler

Kostik özofagus yanığı, Koroziv özofajit, Bal, Prednisolon, Darlık, Darlık indeksi, Doku hasarı

The comparison of prednisolone and honey activities in the experimental corrosive esophagitis model

Öz

Aim: Honey is well known for its beneficial wound healing-related effects, including anti-edematous effects, stimulation of granulation tissue formation, chemical debridement, and immune system enhancement. In this experimental study, the effects of honey and prednisolone on stricture formation in sodium hydroxide-induced corrosive esophagitis were investigated.
Methods: This study was carried out on Wistar albino rats weighing between 200-250 grams. Rats were divided into four equal groups. Corrosive esophagitis induced by 37.5% sodium hydroxide was formed in three groups. The first group received no specific treatment. The second group was treated with honey via the oral route, and the third group was treated by prednisolone intraperitoneally. The control group underwent a sham laparotomy. All subjects were sacrificed by the end of the 28th day. A 20-mm long segment of the distal esophagus was harvested for histopathological examination. The tissue damage scores and stenosis index scores of the groups were measured and compared.
Results: A total of 32 rats were included in the study, with eight subjects in each group. The mean values of stenosis index score and tissue damage score were significantly lower in the honey-treated group (P=0.001).
Conclusion: Oral honey treatment seems to reduce the severity of esophageal strictures associated with corrosive esophagitis, when compared to untreated and prednisolone-treated groups.

Anahtar Kelimeler

Caustic esophageal burn, Corrosive esophagitis, Honey, Prednisolone, Stricture, Stenosis index, Tissue damage

Kaynakça

• 1. Kurowski JA, Kay M. Caustic Ingestions and Foreign Bodies Ingestions in Pediatric Patients. Pediatr Clin North Am. 2017;64:507-24.
• 2. Miller CK, Rutter MJ, von Allmen D, Stoops M, Putnam P, Stevens L, Willging JP. Swallowing dynamics status post caustic ingestion in a pediatric patient: A multidisciplinary case report. Int J Pediatr Otorhinolaryngol. 2016;86:4-8.
• 3. Nur-Ahmad L, Mohammad-Javad F, Ali-Asghar S, Azim H. Comparing the effects of silver sulfadiazine and cerium nitrate silver sulfadiazine on burn-wound healing and survival rate of rat animal model. J Surg Med. 2019;3:433-6.
• 4. Paydar S, Akrami M, Dehghanian A, Alavi MR, Heidarpour M, Bahari KA, et al. A Comparison of the Effects of Alpha and Medical-Grade Honey Ointments on Cutaneous Wound Healing in Rats. J of Pharmaceutics. 2016;2016:9613908.
• 5. French VM, Cooper RA, Molan PC. The antibacterial activitiy of honey against coagulase-negative staphylococci. J Antimicrop Chemother. 2005;56:28-31.
• 6. Ahmed S, Sulaiman SA, Baig AA, Ibrahim M, Liaqat S, Fatima S, et al. Honey as a Potential Natural Antioxidant Medicine: An Insight into Its Molecular Mechanisms of Action. Oxid Med Cell Longev. 2018;2018:8367846.
• 7. Aciksari K, Yanar HT, Hepgul G, Ozucelik DN, Yanar F, Agcaoglu O, et al. The Effect of Beta-Aminopropionitrile and Prednisolone on the Prevention of Fibrosis in Alkali Esophageal Burns: An Experimental Study. Gastroenterol Research and Practice. 2013;2013:574260.
• 8. Çalışkan C, Bölükbaşı H, Fırat O, Yeniay L, Özütemiz O, Korkut MA. Stricture-prevention effects of pentoxifylline and trimetazidine in an experimental corrosive esophagitis model. J Academ Gastroenterol. 2009;8:6-11.
• 9. Browne J, Thompson J. Caustic ingestion. In: Cummings CW, Flint PW, Haughey BH, Robbins KT, Thomas JR, eds. Cummings Otolaryngology: Head & Neck Surgery 4th ed. St Louis, MO: Elsevier Mosby. 2005;4330-41.
• 10. Holinger LD. Caustic esophageal burns. In: Raffensperger JG. Swenson’s pediatric surgery. 5th ed. New York: Appleton & Lange. 1990;827-31.
• 11. Okata Y, Hisamatsu C, Hasegawa T, Okita Y. Development of a model of benign esophageal stricture in rats: the optimal concentration of sodium hydroxide for stricture formation. Pediatr Surg Int. 2011;27:73-80.
• 12. Guven A, Gundogdu G, Sadir S, Topal T, Erdogan E, Korkmaz A, et al. The efficacy of ozone therapy in experimental caustic esophageal burn. J Pediatr Surg. 2008;43:1679-84.
• 13. Berthet B, Costanzo J, Arnaud C, Choux R, Assadourian R. Influence of epidermal growth factor and interferon gamma on healing of oesophageal corrosive burns in the rat. British J Surg. 1994;81:395-8.
• 14. Pul M, Yılmaz N, Değer O, Gürses N. Indomethasin for prevention of stricture formation due to alcali-induced corrosive esophageal burns in the rat. Pediatr Surg Int. 1990;5:416-7.
• 15. Turkyilmaz Z, Sonmez K, Demirtola A, Karabulut R, Poyraz A, Gulen S, et al. Mitomycin C prevents strictures in caustic esophageal burns in rats. J Surg Res. 2005;123:182-7.
• 16. Contini S, Tesfaye M, Picone P, Pacchione D, Kuppers B, Zambianchi C, et al: Corrosive esophageal injuries in children. A shortlived experience in Sierra Leone. Int J Pediatr Otorhinolaryngol. 2007;71:1597-604.
• 17. Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract. A comprehensive review. World J Gastroenterol. 2013;19:3918-30.
• 18. Gumurdulu Y, Karakoc E, Kara B, Tasdogan BE, Parsak CK, Sakman G. Turk J Gastroenterol. 2010;21:7-11.
• 19. Guven A, Demirbag S, Uysal B, Topal T, Erdogan E, Korkmaz A, et al. Effect of 3-amino benzamide, a polyadenosine diphosphate-ribose polymerase inhibitor, in experimental caustic esophageal burn. J Pediat Surg. 2008;43:1474-9.
• 20. Middelkamp JN, Cone AJ, Ogura JH, Higgins CR, Lowe GA. Endoscopic diagnosis and steroid and antibiotic therapy of acute lye burns of the esophagus. Laryngoscope. 1961;71:1354-62.
• 21. Anderson KD, Rouse TM, Randolph JG. A controlled trial of corticosteroids in children with corrosive injury of the esophagus. N Engl J Med. 1990;323:637-40.
• 22. Kirsh MM, Ritter F. Caustic ingestion and subsequent damage to the oropharyngeal and digestive passages. Ann Thorac Surg. 1976;21:74-82.
• 23. Ferguson MK, Migliore M, Staszak VM, Little AG. Early evaluation and therapy for caustic esophageal injury. Am J Surg. 1989;157:116-20.
• 24. Molan PC. The evidence supporting the use of honey as a wound dressing. Int J Low Extrem Wounds. 2006;5:40-54.
• 25. Medhi B, Puri A, Upadhyay S, Kaman L. Topical application of honey in the treatment of wound healing: a metaanalysis. Altern. Med. 2008;10:166-9.
• 26. Molan PC. The evidence and the rationale for the use of honey as a wound dressing. Wound Practice and Research. 2011;19:204-20.
• 27. Tonks AJ, Cooper RA, Jones KP, Blair S, Parton J, Tonks A. Honey stimulates inflammatory cytokine production from monocytes. Cytokine. 2003;7:242-7.
• 28. Zostmes T, Van den Bougard AE, Hazen M. Honey for wounds, ulsers and scin graft preservation. Lancet. 1993;341:756-7.
• 29. Mohamed SS, Al-Douri AS. The effect of honey on the healing of oral ulcers (clinical study). Al–Rafidain Dental J. 2008;8:157-60.
• 30. Jeffrey AE, Echazarreta CM. Medical uses of honey. Rev Biomed. 1996;7:43-9.