Abstract

Cladribine is a useful immunosuppressive drug for the treatment of autoimmune diseases, leukemias and multiple sclerosis (MS). Despite the drug having low toxicity, side effects have been reported connected with myelosuppression, neutropenia and severe anemia. The objective of this study was to investigate the influence of cladribine on lung pathomorphology and the expression of caspase 1 using immunohistochemistry method. The study was conducted on Wistar rats, which were divided into a control group (C) and an experimental group (E). In group C, the rats were given a 0.9% NaCl solution by a subcutaneous injection, at the same dose as the dose of drug used in the experiment. In group E, the animals received cladribine at a dose of 0.07 mg/kg/24 h by a subcutaneous injection. The animals were decapitated 24 h following the last dose. To detect collagen deposition, we utilized Masson's trichrome staining. To evaluate the intensity of the inflammatory process in the lung, an immunohistochemistry reaction was carried out with the use of caspase 1. In group E, we observed an increase in the thickness of space between the alveoli. A statistically significant (p < 0.017243) difference between the thicknesses of the interalveolar septum was seen between the research groups. In E group, we observed regions with collagen deposition, alveolar epithelial cell hyperplasia, hyperemia and inflammatory cell infiltration. Caspase 1 activity was higher in group E. The immunohistochemical reaction with caspase 1 was positive in 49% of all the interalveolar cells in group E; however, in group C about 13% of the interalveolar cell showed positive immunohistochemistry (IHC) response. Cladribine-based therapy might have negative influence on lung morphology. The interstitial changes in the lung tissue suggest that cladribine is a drug that may be the cause of drug-induced lung disease and may lead to several respiratory disorders.

Highlights

  • Lungs are composed of very sensitive tissue

  • Despite the drug having low toxicity, side effects have been reported connected with myelosuppression, neutropenia and severe anemia

  • A statistically significant (p < 0.017243) difference between the thicknesses of the interalveolar septum was seen between the research groups

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Summary

Introduction

Lungs are composed of very sensitive tissue. Their large surface has contact with many substances from the environment and with substances that are used incorporeally. Cladribine (2-CdA), a purine analog which acts as antineoplastic and immunosuppressive agent, has been used in the treatment of malignances, autoimmune and degenerative diseases. Reported side-effects are connected with myelosuppression, neutropenia and severe anemia, and with the complications that come about as a result of opportunistic infections. Patients have complained about general disorders such as fever, lack of appetite, tiredness, chills and general weakness. These clinical symptoms can be brought about by mucosa damage.[2,4,6]. Cladribine is a useful immunosuppressive drug for the treatment of autoimmune diseases, leukemias and multiple sclerosis (MS). Despite the drug having low toxicity, side effects have been reported connected with myelosuppression, neutropenia and severe anemia

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