The Effects of N-Acetylcysteine and Ozone Therapy on Oxidative Stress and Inflammation in Acetaminophen-Induced Nephrotoxicity Model

Figures & data

Table 1.  Biochemical findings in the all experimental groups.

	Groups
Parameters	Sham (I)	Control (II)	NAC (III)	NAC + Ozone (IV)	p^a (overall)	p^b (I vs. II)	p^b (I vs. III)	p^b (I vs. IV)	p^b (II vs. III)	p^b (II vs. IV)	p^b (III vs. IV)
Renal MDA (nmol/mg protein)	6 (0–24)	214 (99–250)	50.5 (20–86)	6 (0–24)	<0.001	<0.001	0.007	1.000	0.005	0.005	0.007
Renal GPx (U/g protein)	207 (84–364)	105.5 (59–168)	142 (81–358)	200 (102–426)	0.047	0.090	1.000	1.000	0.691	0.070	1.000
Serum neopterin (nmol/L)	5.7 (5.3–6.9)	6.0 (5.1–7.3)	5.8 (5.5–6.5)	5.85 (4.8–6.2)	0.451	1.000	1.000	1.000	1.000	1.000	1.000
Serum IL-10 (pg/mL)	22.3 (21.0–25.6)	28.1 (24.1–31.7)	33.6 (29.4–38.6)	48.5 (33.6–102.1)	<0.001	<0.001	0.005	0.005	0.011	0.005	0.092
Serum TNF-α (pg/mL)	88 (84–99)	159 (142–172)	125.5 (120–199)	104.5 (92–176)	<0.001	<0.001	0.004	0.037	0.068	0.069	0.273
Serum IL-6 (pg/mL)	1435.5 (1158–1761)	1620 (1211–1769)	1424 (1226–1961)	1407.5 (1258–1946)	0.747	1.000	1.000	1.000	1.000	1.000	1.000
Serum creatinine (mg/dL)	0.46 (0.40–0.52)	0.47 (0.38–0.70)	0.45 (0.40–0.50)	0.46 (0.40–0.47)	0.779	1.000	1.000	1.000	1.000	1.000	1.000
Serum urea (mg/dL)	51.5 (30–66)	50.5 (42–103)	55.5 (46–63)	50.5 (40–62)	0.647	1.000	1.000	1.000	1.000	1.000	1.000

Notes: All data were expressed as median (minimum–maximum). MDA, malondialdehyde; GPx, glutathione peroxidase; IL-10, interleukine-10; TNF-α, tumor necrosis factor-alpha; IL-6, interleukine-6.

^aKruskal Wallis Test.

^bBonferroni-corrected Mann–Whitney U-Test.

Figure 1.  (A) A case in the control (APAP) group demonstrates severely injured tubular and interstitial structures (epithelial necrosis, attenuated epithelium with necrotic luminal debris, diminished brush border) and mild to moderate interstitial edema (H&E, ×200). (B) All structures of kidney show histopathologically normal kidney tissue in the sham group (H&E, ×200). (C) A case in the NAC group shows mild tubular injury (epithelial vacuolization) and minimal interstitial edema (H&E, ×200). (D) In the NAC + OT group, most of tubular and interstitial areas are normal (H&E, ×200).

Table 2. Mean scores of histopathologic changes in all animal groups.

	Glomerular changes			Tubular changes			Interstitial changes				Vascular changes
Groups	Congestion	Hemorrhage	Necrosis (mesangiolisis)	Vacuolar degeneration	Necrosis	Regeneration	Edema	Tubular congestion	Hemorrhage	Inflammation	Fibrinoid necrosis	Fibrointimal thickening	Total scores
Sham	1	0	0	1	0	0	0	1	0	0	0	0	2
Control	4	0	0	3	2	2	3	4	0	2	0	0	20
NAC	1	0	0	2	1	1	1	1	0	0	0	0	7
NAC + OT	1	0	0	1	1	0	1	1	0	0	0	0	5
	0: Normal/no pathologic changes			0: Normal/no pathologic changes			0: Normal/no pathologic changes				0: Normal/no pathologic changes
	1: Focal^a and segmental			1: Focal and mild			1: Focal and mild				1: Minimal
	2: Focal and global			2: Focal and severe			2: Focal and severe				2: Mild
	3: Diffuse^b and segmental			3: Diffuse and mild			3: Diffuse and mild				3: Moderate
	4: Diffuse and global			4: Diffuse and severe			4: Diffuse and severe				4: Severe

Notes: ^aThe involvement restricted in less than 50 % of glomeruli.

^bThe involvement restricted in less than 50% of glomeruli.