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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Radioprotective Effects of Amifostine, L-Carnitine and Vitamin E in Preventing Early Salivary Gland Injury due to Radioactive Iodine Treatment

Author(s): Nese Torun*, Asli Muratli, Burcu Dirlik Serim, Alev Ergulen and Gulay Durmus Altun

Volume 15, Issue 4, 2019

Page: [395 - 404] Pages: 10

DOI: 10.2174/1573405614666180314150808

Price: $65

Abstract

Objective: Standard treatment of differentiated thyroid cancer includes total thyroidectomy and high-dose Radioactive Iodine Therapy (RIT) for ablation of remnant thyroid tissue. When administered systemically, RIT can cause radiation-induced damage in non-targeted normal tissues. The aim of the present study was to compare the protective effects of amifostine (AMI), LCarnitine (LC), and Vitamin E (EVIT) against high dose radioactive iodine treatment induced Salivary Gland (SG) damage using SG scintigraphy and histopathological examination.

Methods: Forty adult guinea pigs were studied. Twenty guinea pigs receive 555-660 MBq 131Iodine intraperitoneally (IP) to ablate the thyroid and impair the parenchymal function of the SGs. The animals were divided into eight groups as follows: (1) Group 1 (control): 1 mL IP PS (physiological saline); (2) Group 2: single dose of 200 mg/kg IP AMI one hour prior to 1 mL IP PS; (3) Group 3: 200 mg/kg IP LC and 1 mL IP PS for 10 days; (4) Group 4: 40 mg/kg intramuscular (IM) EVITand 1 mL IP PS for 10 days; (5) Group 5: IP RIT after premedication; (6) Group 6: Single dose of 200 mg/kg IP AMI one hour prior to RIT and IP RIT after premedication; (7) Group 7: IP RIT after premedication and 200 mg/kg IP LC for 10 days starting one day before RIT; and (8) Group 8: IP RIT after premedication and 40 mg/kg IM EVIT for 10 days starting one day before RIT. Scintigraphy was performed 1 month after treatment. SGs were examined by light microscopy and a histopathological scoring system was used to assess the degree of SG damage.

Results: There were significant differences in the body weight and thyroid hormone levels between the groups after treatment.

Conclusion: The individual use of AMI, LC and EVIT for radioprotection yield different levels of protection against radioactive iodine treatment injury in SGs; however, none of the agents could provide absolute protection at the doses administered in this experimental model.

Keywords: Radioactive iodine therapy, salivary gland, amifostine, L-Carnitine, Vitamin E, thyroid cancer.

Graphical Abstract

[1]
Caron NR, Clark OH. Well differentiated thyroid cancer. Scand J Surg 2004; 93: 261-71.
[2]
Nostrand DV, Ed. Thyroid Cancer A Comprehensive Guide to Clinical Management. 2nd edition. New Jersey: Humana Press 2006; pp. 459-85.
[3]
Caglar M, Tuncel M, Alpar R. Scintigraphic evaluation of salivary gland dysfunction in patients with thyroid cancer after radioiodine treatment. Clin Nucl Med 2002; 27: 767-71.
[4]
An YS, Yoon JK, Lee SJ, Song HS, Yoon SH, Jo KS. Symptomatic late-onset sialadenitis after radioiodine therapy in thyroid cancer. Ann Nucl Med 2013; 27: 386-91.
[5]
Jentzen W, Schneider E, Freudenberg L, et al. Relationship between cumulative radiation dose and salivary gland uptake associated with radioiodine therapy of thyroid cancer. Nucl Med Commun 2006; 27: 669-76.
[6]
Kita T, Yokoyama K, Higuchi T, et al. Multifactorial analysis on the short-term side effects occurring within 96 hours after radioiodine-31 therapy for differentiated thyroid carcinoma. Ann Nucl Med 2004; 18: 345-9.
[7]
Mansour HH. Protective role of carnitine ester against radiation-induced oxidative stress in rats. Pharmacol Res 2006; 54: 165-71.
[8]
Sezen O, Ertekin MV, Demircan B, et al. Vitamin E and L-carnitine, separately or in combination, in the prevention of radiation-induced brain and retinal damages. Neurosurg Rev 2008; 31: 205-13.
[9]
Weiss JF, Landauer MR. Protection against ionizing radiation by antioxidant nutrients and phytochemicals. Toxicology 2003; 189: 1-20.
[10]
Bohuslavizki KH, Brenner W, Klutmann S, et al. Radioprotection of salivary glands by amifostine in high-dose radioiodine therapy. J Nucl Med 1998; 39: 1237-42.
[11]
Uzal C, Durmus-Altun G, Caloglu M, Ergülen A, Altaner S, Yigitbasi NO. The protective effect of amifostine on radiation-induced acute pulmonary toxicity: Detection by (99m)Tc-DTPA transalveolar clearances. Int J Radiat Oncol Biol Phys 2004; 60: 564-9.
[12]
Wasserman T. Radioprotective effects of amifostine. Semin Oncol 1999; 26: 89-94.
[13]
Hakim SG, Kosmehl H, Lauer I, Nadrowitz R, Wedel T, Sieg P. A comparative study on the protection profile of lidocaine, amifostine, and pilocarpin on the parotid gland during radiotherapy. Cancer Res 2005; 65: 10486-93.
[14]
Uçüncü H, Ertekin MV, Yörük O, et al. Vitamin E and L-carnitine, separately or in combination, in the prevention of radiation-induced oral mucositis and myelosuppression: A controlled study in a rat model. J Radiat Res 2006; 47: 91-102.
[15]
Caloglu M, Yurut-Caloglu V, Durmus-Altun G, et al. Histopathological and scintigraphic comparisons of the protective effects of L-carnitine and amifostine against radiation-induced late renal toxicity in rats. Clin Exp Pharmacol Physiol 2009; 36: 523-30.
[16]
Ramos FM, Pontual ML, de Almeida SM, Bóscolo FN, Tabchoury CP, Novaes PD. Evaluation of radioprotective effect of vitamin E in salivary dysfunction in irradiated rats. Arch Oral Biol 2006; 51: 96-101.
[17]
Torun N, Ergulen A, Dirlik B, Durmus-Altun G. Experimental high dose radioactive I-131 ablation model in guinea pig. Eur J Nucl Med Mol Imaging 2009; 36: 432.
[18]
Aung W, Murata Y, Ishida R, Takahashi Y, Okada N, Shibuya H. Study of quantitative oral radioactivity in salivary gland scintigraphy and determination of the clinical stage of Sjögren’s syndrome. J Nucl Med 2001; 42: 38-43.
[19]
Umehara I, Yamada I, Murata Y, Takahashi Y, Okada N, Shibuya H. Quantitative evaluation of salivary gland scintigraphy in Sjörgen’s syndrome. J Nucl Med 1999; 40: 64-9.
[20]
Bohuslavizki KH, Klutmann S, Jenicke L, et al. Radioprotection of salivary glands by S-2-(3-aminopropylamino)- ethylphosphorothioic (amifostine) obtained in a rabbit animal model. Int J Radiat Oncol Biol Phys 1999; 45: 181-6.
[21]
Kutta H, Kampen U, Sagowski C, Brenner W, Bohuslavizki KH, Paulsen F. Amifostine is a potent radioprotector of salivary glands in radioiodine therapy. Structural and ultrastructural findings. Strahlenther Onkol 2005; 181: 237-45.
[22]
Bhartiya US, Raut YS, Joseph LJ, Hawaldar RW, Rao BS. Evaluation of the radioprotective effect of turmeric extract and vitamin E in mice exposed to therapeutic dose of radioiodine. Indian J Clin Biochem 2008; 23: 382-6.

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