ABSTRACT
Aim: The primary aim of this study is to investigate the histopathologic
effects of acute pioglitazone intoxication and the effects of intralipid
emulsion treatment in reversing these possible unwanted effects in a rat
model.Methods: For the study, 32 Spraque-Dawley rats weighing between 250-300 g were
randomly divided into 4 groups. The first group was the control group
and 12.4 ml/kg normal saline was given by intravenously (IV). 12.4 ml/kg
intralipid emulsion was given to the second group by IV route. ½ LD50
pioglitazone (1000 mg/kg) per oral (PO) followed by 12.4 ml/kg normal
saline IV was given to the third group. ½ LD50 pioglitazone (1000 mg /
kg) PO followed by 12.4 ml / kg intralipid emulsion IV was then given to
the fourth group. After 24 hours, rats were decapitated and tissue
samples were taken for histopathological examination.Results:The histopathological scores of liver tissue in the third and fourth
groups were significantly higher than the other groups. The
histopathological scores of the kidney tissue were significantly higher
in the second, third and fourth groups compared to the control group.
The histopathological scores of the heart tissue were examined, no
statistically significant difference was found in our model. intralipid
emulsion itself were found toxic to kidney cells.Conclusion:Although toxic effects can be observed in the liver and kidney tissues
due to pioglitazone usage, intralipid emulsion treatment is insufficient
to reverse these toxic effects. Toxic effects can be seen in the kidney
tissue due to intralipid treatment and studies on different doses and
timing are needed.Keywords: Pioglitazone, intravenous lipid emulsion,
intoxication, animal modelWhat’s already known about this topic?
In the literature there are no studies about the reversibility and
treatability of the toxic effects of pioglitazone. Only supportive
treatment modalities are advised to use in the management of
pioglitazone overdose cases. Effectiveness of intralipid emulsion
treatment in lipophilic drug toxicities have been studied in literature.
What does this article add?
Our study found that intralipid emulsion is not effective in reversing
effects of pioglitazone toxicity. Also, that intralipid emulsion itself
may be toxic for renal tissues.