Effects of N-acetyl-L-cysteine against apical periodontitis in rats with adriamycin-induced cardiomyopathy and nephropathy

Int Endod J. 2024 Feb;57(2):195-207. doi: 10.1111/iej.14010. Epub 2023 Dec 9.

Abstract

Aim: This study aimed to investigate the potential protective effects of N-acetyl-L-cysteine (NAC) against apical periodontitis (AP) in rats with adriamycin (ADR)-induced kidney and heart diseases.

Methodology: Fourty-eight Wistar albino rats were divided into six groups: (1) Control group, (2) ADR group (1 mg/kg/day ip for 10 days), (3) AP Group (1st mandibular molar tooth), (4) AP + ADR Group, (5) AP + NAC group (150 mg/kg/day ip), and (6) AP + ADR + NAC group. After 3 weeks, the rats were decapitated and blood and tissue samples (heart, kidney, and jaw) were collected. Tissue samples were evaluated by biochemical (inflammatory cytokines and hemodynamic parameters) and radiological analyses. One-way anova with Tukey post hoc tests was used to compare data, considering p < .05 as statistically significant.

Results: The serum levels of TNF-α, IL-1β, BUN, Creatinine, CK, and LDH were elevated in the test groups compared with the control group, and treatment with NAC reduced these levels (p < .05). Heart and kidney tissue analysis showed a higher heart-to-body weight ratio (HW/BW) and kidney-to-body weight ratio (KW/BW) in the test groups compared with the control group (p < .05). No significant differences in HW/BW and KW/BW were found between the control and AP + NAC groups. Volumetric apical bone resorption analysis showed an increase in periapical radiolucencies in AP-induced groups indicating apical periodontitis. NAC treatment reduced the total area and volume of resorption cavities (p < .05).

Conclusions: The results suggest that NAC's antioxidant and anti-inflammatory effects can reduce adriamycin-mediated heart and kidney damage and may have a positive effect on apical periodontitis in individuals with nephropathy and cardiomyopathy.

Keywords: adriamycin; animal model; apical periodontitis; cytokines; n-acetyl-L-cysteine.

MeSH terms

  • Acetylcysteine / pharmacology
  • Acetylcysteine / therapeutic use
  • Animals
  • Body Weight
  • Cardiomyopathies* / chemically induced
  • Cardiomyopathies* / drug therapy
  • Doxorubicin
  • Periapical Periodontitis* / chemically induced
  • Periapical Periodontitis* / drug therapy
  • Rats
  • Rats, Wistar

Substances

  • Acetylcysteine
  • Doxorubicin