Evaluation of the impact of platelet rich plasma and hyaluronic acid on ketamine-induced cystitis in albino rats : A histological and immunohistochemical study.

Abstract

Background: ketamine induced cystitis (KIC) is commonly occurred in ketamine abusing individuals. It is associated with damage in the lining of the bladder and lower urinary tract symptoms. Platelets rich plasma (PRP) is attractive therapeutic line in regenerative medicine. Hyaluronic acid (HA) has many beneficial therapeutic effects in treatment of different types of cystitis. Objective: to evaluate the effect of PRP and HA on ketamine induced cystitis in adult male rats. Materials and Methods: Forty-four adult male rats were divided into five groups: Group I: control rats. Group II: Ketamine group. Group III: Recovery group. Group IV: Ketamine and PRP treated group. Group V: Ketamine and HA treated group. Specimens from the body of the urinary bladder were processed and examined histologically and immunohistochemically. Morphometrical studies and statistical analysis were conducted. Results: Groups II and III showed focal areas of degeneration and ulceration with apparently decreased thickness of the urothelium. Cellular infiltration and dilated congested blood vessels of the lamina propria were also observed. A significant increase of the collagen fibers in the lamina propria and between the muscle bundles. Nuclear factor kappa B (NF-κB) immunoreaction was significantly increased but there was a non-significant increase of antiproliferating cell nuclear antigen (PCNA) immunopositive nuclei among urothelium and a significant decrease of desmin, compared to group I. Groups III and IV showed improvement of most of the histological and immunohistochemical changes described before. Conclusion:The intravesical injection of PRP and HA provide a positive impact on treatment of KIC. HA therapy is a more efficient mean as it provides a better improvement in healing of urothelium and promotes more rapid tissue regeneration.

Platelet-rich plasma attenuates the UPEC-induced cystitis via inhibiting MMP-2,9 activities and downregulation of NGF and VEGF in Canis Lupus Familiaris model

“…The active form of NF-κB is a crucial player in the process of inflammation 20 . Its expression was mainly observed in the urothelium and the lamina propria of PRP-treated cystitis 151 ; likewise to our study which showed expression of NF-KB in the urothelium and inflammatory cells of the PRP-treated groups. However, the decreased expression of NF-κB in the group treated with PRP and antibiotics was not reflected in the histopathology of the bladder mucosa as there were still erosions in the urothelium.…”

“…However, PRP treated group was remarkably improved in which the normal thickness of urothelium was maintained and edema was regressed. Similarly, An earlier investigation revealed that PRP had a positive effect on ketamine-induced cystitis in rats in which the urothelium thickness was increased but congestion and inflammatory cell infiltration were still observed in the urinary bladder 151 . In the present study, all groups treated with PRP showed urothelium proliferation which is critical in maintaining a functional barrier against urinary toxic substances and bacteria 60 .…”