Role of dexamethasone alone and in combination with quercetin in the urinary bladder after administration of ifosfamide

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Background Ifosfamide (IFO) is a broad-spectrum antineoplastic agent. Dexamethasone inhibits the activity of a variety of cytokines. Quercetin is a flavonoid with an antioxidant effect. Aim This work aimed to study the possible protective role of dexamethasone alone and in combination with quercetin on the IFO-treated urinary bladder. Materials and methods Sixty adult albino rats were used in this study and were divided into six groups: group I was the control group; group II was the dexamethasone-treated group; group III was the dexamethasone and quercetin-treated group; group IV was the IFO-treated group in which each rat was injected with IFO; group V was the IFO and dexamethasone-treated group, in which each rat was injected with IFO and three doses of dexamethasone; and group VI was the IFO, dexamethasone and quercetin-treated group, in which each rat was injected with IFO and three doses of dexamethasone and quercetin. Urinary bladder specimens were processed for histological and immunohistochemical staining for inducible nitric oxide synthase and nuclear factor-κB (NF-κB), followed by different morphometric examinations. Results Group IV revealed areas of epithelial denudation and vacuolated cells. Group V revealed partially restored thickness of the urothelium with vacuolated cells. Group VI showed restored epithelial integrity with reduced cytoplasmic vacuoles. Electron microscopic examination of the urothelium revealed indented nuclei and dilated intercellular spaces in group IV. After administration of dexamethasone, indented nuclei and partially dilated intercellular space were seen. In group IV, the urothelium revealed apparently normal nuclei with almost intact intercellular junctions. Highly significant increase in mast cell count in group IV but nonsignificant increase after administration of both dexamethasone and quercetin were noticed. Optical density of inducible nitric oxide synthase and NF-κB immunoreaction was highly significantly increased in group IV. Significant increase was detected in group V for NF-κB but nonsignificant increase in group VI for both immunohistochemical stains was observed. Conclusion It could be concluded that combined dexamethasone and quercetin exerted better protective roles against the toxic effects induced by IFO rather than dexamethasone alone.