Antioxidants Reveal Protection against the Biochemical Changes in Liver, Kidney and Blood Profiles after Clindamycin / Ibuprofen Administration in Dental Patients
The adverse effects of Clindamycin (Clind.) /
Ibuprofen (Ibu.) combination on liver, kidney, blood elements and the
significances of antioxidants (N-acetylcysteine and Zinc) against
these effects were evaluated. The study includes: Group I; control
n=30, Group II; patients on Clind.300mg/Ibu.400mg twice daily for a
week n=30, Group III; patients on Clind.300mg/Ibu.400mg+Nacetylcysteine
200mg twice daily for a week n=15 and Group IV;
patients on Clind.300mg/Ibu.400mg+Zinc50mg twice daily for a
week n=15. Serum malondialdehyde (MDA), alanine transferase
(ALT), aspartate transferase (AST), γ glutamyl transferase (GGT),
creatinine, blood urea nitrogen (BUN) were measured. Applying one
way ANOVA followed by Tuckey Kramer post test, Group II showed
significant increase in ALT, AST, GGT, BUN and decrease in Hb,
RBCs, platelets than Group I. Group III showed significant decrease
in ALT, AST, GGT, BUN than Group II. Moreover, Group IV
showed significant decrease in ALT, AST, GGT and increase in Hb,
RBCs, and platelets than Group II. Conclusively, Adding Zinc or Nacetylcysteine
buffer the oxidative stress and improve the therapeutic
outcome of Clindamycin/Ibuprofen combination.
[1] L. Von Konow, C.E. Nord, A. Nordenram, Anaerobic bacteria in dentoalveolar
infections, Int. J. Oral Surg. 10 (1981) 313-322.
[2] A.W. Chow, S.M. Rose, F.A. Brady, Orofacialodontogenic infections,
Ann Intern. Med. 88 (1978) 392-402.
[3] L. Winter Jr., E. Bass, B. Recant, J.F. Cahaly, Analgesic activity of
ibuprofen (Motrin) in postoperative oral surgery pain, Oral Surg. Oral
Med. Oral Pathol. 45 (1978) 159-166.
[4] S. Sevillano, A.M. De la Mano, I. De Dios et al., Major pathological
mechanisms of acute pancreatitis are prevented by N-acetylcysteine,
Digestion 68 (2003) 34–40.
[5] I. Dalle-Donne, R. Rossi, R.D. Colombo et al., Biomarkers of oxidative
damage in human disease, Clin. Chem. 52 (2006) 601–623.
[6] F. Santangelo, Intracellular thiol concentration modulating inflammatory
response: influence on the regulation of cell functions through cysteine
pro-drug approach, Curr. Med. Chem. 10 (2003) 2599-2610.
[7] E. Ristoff and A. Larsson, Inborn errors in the metabolism of
glutathione, Orphanet, J. Rare Dis. 2 (2007) 16.
[8] M. Battino, M.S. Ferreiro, I. Gallardo, H.N. Newma, P. Bullon, The
antioxidant capacity of saliva, J. Clin. Periodontol. 29 (2002) 189-194.
[9] E.M. Bulger and R.V. Maier, Antioxidants in critical illness, Arch. Surg.
136 (2001) 1201-1207.
[10] G.E. Sklar and M. Subramaniam, Acetylcysteine treatment for nonacetaminophen-
induced acute liver failure, Ann Pharmacother. 38
(2004) 498-500.
[11] S. Holt, D. Goodier, R. Marley, D. Patch, A. Burroughs et al.,
Improvement in renal function in hepatorenal syndrome with Nacetylcysteine,
Lancet 353 (1999) 294-295.
[12] L. Castro and B.A. Freeman, Reactive oxygen species in human health
and disease, Nutrition 17 (2001) 161-165.
[13] M. Hatakeyama, M. Tsudo, S. Minamoto, T. Kono, T. Doi et al.,
Interleukin-2 receptor β chain gene: generation of three receptor forms
by cloned human α and β chains cDNA's, Science 244 (1989) 551-556.
[14] K.I. Plaisance, G.L. Drusano, A. Forrest, R.J. Townsend, H.C.
Standiford, Pharmacokinetic evaluation of two dosage regimens of
clindamycin phosphate, Antimicrob. Agents Chemother. 33 (1989) 618-
620.
[15] D.C. Brater, C. Harris, J.S. Redfern, B.J. Gertz, Renal effects of COX-2-
selective inhibitors, Am. J. Nephrol. 21 (2001) 1-15.
[16] M.R. Griffin, A. Yared, W.A. Ray, Non-steroidal anti-inflammatory
drugs and acute renal failure in elderly persons, Am. J. Epidemiol. 151
(2000) 488-496.
[17] F.J. Taut, R. Breitkreutz, C.M. Zapletal, J.C. Thies, A. Babylon et al.,
Influence of N-acetylcysteine on hepatic amino acid metabolism in
patients undergoing orthotropic liver transplantation, Transpl. Int. 14
(2001) 329-333.
[18] P.R. Grant, A. Black, N. Garcia, J. Prieto, J.A. Garson, Combination
therapy with interferon-alpha plus N-acetyl cysteine for chronic hepatitis
C: a placebo controlled double-blind multicentre study, J. Med. Virol. 61
(2000) 439-442.
[19] O.V. Hein, R. Ohring, A. Schilling, M. Oellerich, V.W. Armstrong et
al., N-acetylcysteine decreases lactate signal intensities in liver tissue
and improves liver function in septic shock patients, as shown by
magnetic resonance spectroscopy (2004). Extended case report Vol 8 No
2.
[20] M. Tepel and W. Zidek, N-Acetylcysteine in nephrology; contrast
nephropathy and beyond, Curr. Opin. NephrolHypertens. 13 (2004) 649-
654.
[21] R. Safirstein, L. Andrade, J.M. Vieira, Acetylcysteine and nephrotoxic
effects of radiographic contrast agents: A new use for an old drug, N.
Engl. J. Med. 343 (2000) 210-212.
[22] M.J. Smilkstein, G.L. Knapp, K.W. Kulig, B.H. Rumack, Efficacy of
oral N-acetylcysteine in the treatment of acetaminophen overdose.
Analysis of the national multicenter study (1976 to 1985), N. Engl. J.
Med. 319 (1988) 2557-2562.
[23] S.R. Powell, The antioxidant properties of zinc. J. Nutr. 130 (2000)
1447-1454.
[24] L. Allegra, M. Dal Sasso, C. Bovio, C. Massoni, E. Fonti, P.C. Braga,
Human neutrophil oxidative bursts and their in vitro modulation by
different N-acetylcysteine concentrations, Arzneimittelforschung 52
(2002) 669-676.
[25] F. Candan, F. Gultekin, F. Dandau, Effect of vitamin C and zinc on
osmotic fragility and lipid peroxidation in zinc deficient hemodialysis
patients. Cell Biochem. Funct. 20 (2002) 95-98.
[1] L. Von Konow, C.E. Nord, A. Nordenram, Anaerobic bacteria in dentoalveolar
infections, Int. J. Oral Surg. 10 (1981) 313-322.
[2] A.W. Chow, S.M. Rose, F.A. Brady, Orofacialodontogenic infections,
Ann Intern. Med. 88 (1978) 392-402.
[3] L. Winter Jr., E. Bass, B. Recant, J.F. Cahaly, Analgesic activity of
ibuprofen (Motrin) in postoperative oral surgery pain, Oral Surg. Oral
Med. Oral Pathol. 45 (1978) 159-166.
[4] S. Sevillano, A.M. De la Mano, I. De Dios et al., Major pathological
mechanisms of acute pancreatitis are prevented by N-acetylcysteine,
Digestion 68 (2003) 34–40.
[5] I. Dalle-Donne, R. Rossi, R.D. Colombo et al., Biomarkers of oxidative
damage in human disease, Clin. Chem. 52 (2006) 601–623.
[6] F. Santangelo, Intracellular thiol concentration modulating inflammatory
response: influence on the regulation of cell functions through cysteine
pro-drug approach, Curr. Med. Chem. 10 (2003) 2599-2610.
[7] E. Ristoff and A. Larsson, Inborn errors in the metabolism of
glutathione, Orphanet, J. Rare Dis. 2 (2007) 16.
[8] M. Battino, M.S. Ferreiro, I. Gallardo, H.N. Newma, P. Bullon, The
antioxidant capacity of saliva, J. Clin. Periodontol. 29 (2002) 189-194.
[9] E.M. Bulger and R.V. Maier, Antioxidants in critical illness, Arch. Surg.
136 (2001) 1201-1207.
[10] G.E. Sklar and M. Subramaniam, Acetylcysteine treatment for nonacetaminophen-
induced acute liver failure, Ann Pharmacother. 38
(2004) 498-500.
[11] S. Holt, D. Goodier, R. Marley, D. Patch, A. Burroughs et al.,
Improvement in renal function in hepatorenal syndrome with Nacetylcysteine,
Lancet 353 (1999) 294-295.
[12] L. Castro and B.A. Freeman, Reactive oxygen species in human health
and disease, Nutrition 17 (2001) 161-165.
[13] M. Hatakeyama, M. Tsudo, S. Minamoto, T. Kono, T. Doi et al.,
Interleukin-2 receptor β chain gene: generation of three receptor forms
by cloned human α and β chains cDNA's, Science 244 (1989) 551-556.
[14] K.I. Plaisance, G.L. Drusano, A. Forrest, R.J. Townsend, H.C.
Standiford, Pharmacokinetic evaluation of two dosage regimens of
clindamycin phosphate, Antimicrob. Agents Chemother. 33 (1989) 618-
620.
[15] D.C. Brater, C. Harris, J.S. Redfern, B.J. Gertz, Renal effects of COX-2-
selective inhibitors, Am. J. Nephrol. 21 (2001) 1-15.
[16] M.R. Griffin, A. Yared, W.A. Ray, Non-steroidal anti-inflammatory
drugs and acute renal failure in elderly persons, Am. J. Epidemiol. 151
(2000) 488-496.
[17] F.J. Taut, R. Breitkreutz, C.M. Zapletal, J.C. Thies, A. Babylon et al.,
Influence of N-acetylcysteine on hepatic amino acid metabolism in
patients undergoing orthotropic liver transplantation, Transpl. Int. 14
(2001) 329-333.
[18] P.R. Grant, A. Black, N. Garcia, J. Prieto, J.A. Garson, Combination
therapy with interferon-alpha plus N-acetyl cysteine for chronic hepatitis
C: a placebo controlled double-blind multicentre study, J. Med. Virol. 61
(2000) 439-442.
[19] O.V. Hein, R. Ohring, A. Schilling, M. Oellerich, V.W. Armstrong et
al., N-acetylcysteine decreases lactate signal intensities in liver tissue
and improves liver function in septic shock patients, as shown by
magnetic resonance spectroscopy (2004). Extended case report Vol 8 No
2.
[20] M. Tepel and W. Zidek, N-Acetylcysteine in nephrology; contrast
nephropathy and beyond, Curr. Opin. NephrolHypertens. 13 (2004) 649-
654.
[21] R. Safirstein, L. Andrade, J.M. Vieira, Acetylcysteine and nephrotoxic
effects of radiographic contrast agents: A new use for an old drug, N.
Engl. J. Med. 343 (2000) 210-212.
[22] M.J. Smilkstein, G.L. Knapp, K.W. Kulig, B.H. Rumack, Efficacy of
oral N-acetylcysteine in the treatment of acetaminophen overdose.
Analysis of the national multicenter study (1976 to 1985), N. Engl. J.
Med. 319 (1988) 2557-2562.
[23] S.R. Powell, The antioxidant properties of zinc. J. Nutr. 130 (2000)
1447-1454.
[24] L. Allegra, M. Dal Sasso, C. Bovio, C. Massoni, E. Fonti, P.C. Braga,
Human neutrophil oxidative bursts and their in vitro modulation by
different N-acetylcysteine concentrations, Arzneimittelforschung 52
(2002) 669-676.
[25] F. Candan, F. Gultekin, F. Dandau, Effect of vitamin C and zinc on
osmotic fragility and lipid peroxidation in zinc deficient hemodialysis
patients. Cell Biochem. Funct. 20 (2002) 95-98.
@article{"International Journal of Medical, Medicine and Health Sciences:60999", author = "Gouda K. Helal and Marwa I. Shabayek and Heba A. El-Ramly and Heba A. Awida", title = "Antioxidants Reveal Protection against the Biochemical Changes in Liver, Kidney and Blood Profiles after Clindamycin / Ibuprofen Administration in Dental Patients", abstract = "The adverse effects of Clindamycin (Clind.) /
Ibuprofen (Ibu.) combination on liver, kidney, blood elements and the
significances of antioxidants (N-acetylcysteine and Zinc) against
these effects were evaluated. The study includes: Group I; control
n=30, Group II; patients on Clind.300mg/Ibu.400mg twice daily for a
week n=30, Group III; patients on Clind.300mg/Ibu.400mg+Nacetylcysteine
200mg twice daily for a week n=15 and Group IV;
patients on Clind.300mg/Ibu.400mg+Zinc50mg twice daily for a
week n=15. Serum malondialdehyde (MDA), alanine transferase
(ALT), aspartate transferase (AST), γ glutamyl transferase (GGT),
creatinine, blood urea nitrogen (BUN) were measured. Applying one
way ANOVA followed by Tuckey Kramer post test, Group II showed
significant increase in ALT, AST, GGT, BUN and decrease in Hb,
RBCs, platelets than Group I. Group III showed significant decrease
in ALT, AST, GGT, BUN than Group II. Moreover, Group IV
showed significant decrease in ALT, AST, GGT and increase in Hb,
RBCs, and platelets than Group II. Conclusively, Adding Zinc or Nacetylcysteine
buffer the oxidative stress and improve the therapeutic
outcome of Clindamycin/Ibuprofen combination.
", keywords = "Clindamycin, Ibuprofen, Adverse effects,
Antioxidant, Zinc, N-acetylcysteine.", volume = "8", number = "9", pages = "587-4", }
