Publications by authors named "Amany Mohamed Shalaby"

13 Publications

  • Page 1 of 1

Combined lead and zinc oxide-nanoparticles induced thyroid toxicity through 8-OHdG oxidative stress-mediated inflammation, apoptosis, and Nrf2 activation in rats.

Environ Toxicol 2021 Dec 23;36(12):2589-2604. Epub 2021 Sep 23.

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

A human is exposed to a chemical mixture rather than a single chemical, particularly with the wide spread of nanomaterials. Therefore, the present study evaluated the combined exposure of lead acetate (Pb) and zinc oxide-nanoparticles (ZnO-NPs) compared to each metal alone on the thyroid gland of adult rats. A total of 30 adult male albino rats were divided into four groups, group I (control), group II received Pb (10 mg/kg), group III received ZnO-NPs (85 mg/kg) and group IV co-administrated the two metals in the same previous doses. The materials were gavaged for 8 weeks. The toxicity was assessed through several biochemical parameters. Our results revealed significant body weight reduction relative to increased thyroid weights, decreased both of serum-free triiodothyronine (FT3), tetra-iodothyronine (FT4), increased thyroid-stimulating hormone (TSH), increased serum and thyroid levels of Pb and zinc, significant elevation in tumor necrosis factor-α (TNF-α), reduction in interleukin 4 (IL4), upregulation of Bax, and downregulation of Bcl-2 genes. Additionally, there was significant overexpression of nuclear factor erythroid 2-related factor 2(Nrf2), 8-Hydroxydeoxyguanosine(8-OHdG), the elevation of tissues malondialdehyde (MDA), reduction of tissues total antioxidant capacity (TAC), and disruptive thyroid structural alterations in all metals groups with marked changes in the combined metals group. In conclusion, the combined exposure of Pb and ZnO-NPs induced pronounced toxic thyroid injury, pointing to additive effects in rats than the individual metal effects through different significant changes of disruptive thyroid structural alterations related to the loading of thyroid tissues with Pb and zinc metals producing oxidative stress that mediated inflammation and apoptosis.
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http://dx.doi.org/10.1002/tox.23373DOI Listing
December 2021

Metanil yellow promotes oxidative stress, astrogliosis, and apoptosis in the cerebellar cortex of adult male rat with possible protective effect of scutellarin: A histological and immunohistochemical study.

Tissue Cell 2021 Dec 17;73:101624. Epub 2021 Aug 17.

Histology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.

Metanil yellow is a food dye that has harmful impacts on different body systems. Scutellarin has antioxidant, antiapoptotic, and anti-inflammatory activities. The aim of the current research was to study the effect of chronic administration of metanil yellow on the cerebellar cortex of rats and to evaluate the protective effect of scutellarin. Forty adult male rats were allocated into four groups: group I acted as control, group II was administrated scutellarin (100 mg/kg/day), group III was administrated metanil yellow (200 mg/kg/day), and group IV was administrated scutellarin and metanil yellow as in group II and group III. The agents were administered via oral gavage for 8 weeks. Metanil yellow induced a significant rise in the malondialdehyde coupled with a significant reduction in the superoxide dismutase and glutathione peroxidase. The Purkinje cells were irregular and shrunken with condensed nuclei. A significant elevation in glial fibrillary acidic protein (GFAP) and cleaved caspase-3 as well as a significant reduction of synaptophysin expression were revealed in comparison with the control group. Interestingly, few changes were noticed in rats given metanil yellow concomitant with scutellarin. In conclusion, scutellarin could protect against metanil yellow-induced alterations in the cerebellar cortex by reducing oxidative stress and minimizing gliosis.
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http://dx.doi.org/10.1016/j.tice.2021.101624DOI Listing
December 2021

Prognostic and clinicopathological significance of TMEFF2, SMOC-2, and SOX17 expression in endometrial carcinoma.

Exp Mol Pathol 2021 10 31;122:104670. Epub 2021 Jul 31.

Department of Gynecology and Obstetrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Background there is a need for novel biomarkers and targeting therapies for predicting Endometrial carcinoma (EC) progression and recurrence. TMEFF2 is a gene that was found to play a role in EMT. SMOC-2 is expressed in embryogenesis and it was identified as a recent stem cell-related gene that has a role in cancer progression. SRY-box 17 (SOX17) is a member of the SRY-related HMG-box (SOX) family of transcription factors. Dysregulation or downregulation of SOX17 expression was found in many cancer tissues.

Aim: In the present study, we aimed to assess the tissue protein expressions of TMEFF2, SMOC-2, and SOX17 in EC using immunohistochemistry to evaluate their clinicopathological values and prognostic roles in EC patients.

Patients And Methods: This is prospective cohort study included 120 patients with EC. Sections from 120 paraffin blocks were retrieved and stained with TMEFF2, SMOC-2, and SOX17 using immunohistochemistry, the expression of markers in all tissue samples was assessed, analyzed and correlation of pathological parameters with the levels of expression was done. All patients were followed up till death or till the last known alive data for about 50 months (range from 25 to 60).

Results: TMEFF2, SMOC-2 expression was correlated with the presence of lymph node metastases (p = 0.023), distant metastasis (p = 0.039) recurrence of the tumor after successful therapy, overall survival, and disease-free survival (p < 0.001). SOX17 positive expression was positively correlated with low grade (p = 0.019), absence of lymph node metastasis (p = 0.001), absence of distant metastasis (p = 0.013), low stage (p = 0.03), and its negative expression was positively correlated with recurrence of the tumor after successful therapy, overall survival and disease-free survival (p = 0.001). In conclusion, we demonstrated that both TMEFF2 and SMOC-2 were highly expressed in EC and were associated with a shortened survival rate, dismal outcome, and poor prognosis in EC patients. While SOX17 expression was related to a favorable outcome and its down-regulation was associated with dismal EC patient's survival.
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http://dx.doi.org/10.1016/j.yexmp.2021.104670DOI Listing
October 2021

The Effect of Induced Diabetes Mellitus on the Cerebellar Cortex of Adult Male Rat and the Possible Protective Role of Oxymatrine: A Histological, Immunohistochemical and Biochemical Study.

Ultrastruct Pathol 2021 May 18;45(3):182-196. Epub 2021 May 18.

Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Diabetes mellitus (DM) represents a widespread metabolic disease with a well-known neurotoxicity in both central and peripheral nervous systems. Oxymatrine is a traditional Chinese herbal medicine that has various pharmacological activities including: anti-oxidant, anti-apoptotic and anti-inflammatory potentials. The present work aimed o study the impact of diabetes mellitus on the cerebellar cortex of adult male albino rat and to evaluate the potential protective role of oxymatrine. Fifty-five adult male rats were randomly divided into three groups: group I served as control, group II was given oxymatrine (80 mg/kg/day) orally for 8 weeks and group III was given a single dose of streptozotocin (50 mg/kg) intaperitoneally to induce diabetes. Then diabetic rats were subdivided into two subgroups: subgroup IIIa that received no additional treatment and subgroup IIIb that received oxymatrine similar to group II. The diabetic group revealed numerous changes in the Purkinje cell layer in the form of multilayer arrangement of Purkinje cells, shrunken cells with deeply stained nuclei as well as focal loss of the Purkinje cells. A significant increment in glial fibrillary acidic protein (GFAP) and synaptophysin expression were reported in immunohistochemistry compared with the control group. Transmission electron microscopy showed irregularity and splitting of myelin sheaths in the molecular layer, dark shrunken Purkinje cells with ill-defined nuclei, dilated Golgi saccules and dense granule cells with irregular nuclear outlines in the granular layer. In contrast, these changes were less evident in diabetic rats that received oxymatrine. In conclusion, Oxymatrine could protect the cerebellar cortex against changes induced by DM.
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http://dx.doi.org/10.1080/01913123.2021.1926610DOI Listing
May 2021

The Diagnostic and Prognostic Roles of Combined Expression of Novel Biomarkers in Lung Adenocarcinoma and Lung Squamous Cell Carcinoma: An Immunohistochemical Study.

Iran J Pathol 2021 21;16(2):162-173. Epub 2020 Dec 21.

Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta, Egyp t.

Background & Objective: Diagnosis and discrimination of lung adenocarcinoma (LUAD) from lung squamous cell carcinoma (LUSC) is critical to select the appropriate treatment regimen as recently targeted therapies require accurate subtyping of nonsmall-cell lung carcinoma (NSCLCs). There are currently several biomarkers that could be used for differentiation between LUAD and LUSC, but they have less sensitivity, specificity, and clinical applicability. The aim of this study was to assess the diagnostic and prognostic values of CLCA2, SPATS2, ST6GALNAC1, and Adipophilin tissue expression in the tissues retrieved from LUAD and LUSC patients using immunohistochemistry.

Methods: The current study was performed on the samples retrieved from sixty primary lung masses that were diagnosed as LUAD and LUSC. Immunohistochemistry was performed by using a panel of CLCA2, SPATS2, and ST6GALNAC1. We assessed the diagnostic roles of the studied markers in the discrimination between LUAD and LUSC and their prognostic values.

Results: SPATS2 and CLCA2 were expressed higher in LUSC than LUAD. ST6GALNAC1 and Adipophilin showed higher expression in LUAD than LUSC ( 0.001). The sensitivity and specificity of CLCA2, SPATS2, ST6GALNAC1 and Adipophilin in adequate subtyping and reaching the accurate diagnosis was 100%. We found only significant difference in survival rate between the patients with negative and positive CLCA2 expression (=0.038 and =0.019, respectively).

Conclusion: The combination of biomarkers of CLCA2, SPATS2, ST6GALNAC1, and Adipophilin may lead to an appropriate subtyping of lung cancer and reaching accurate diagnosis with the highest sensitivity and specificity.
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http://dx.doi.org/10.30699/IJP.2020.130944.2452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085294PMC
December 2020

The Usefulness of 4 Immunoperoxidase Stains Applied to Urinary Cytology Samples in the Pathologic Stage of Urothelial Carcinoma: A Study With Histologic Correlation.

Appl Immunohistochem Mol Morphol 2021 07;29(6):422-432

Pathology Department.

Background: Currently, the golden rule for the diagnosis of urothelial carcinoma is biopsy and cystoscopy, unfortionally both are costly, invasive, and uncomfortable. While most urothelial cancers are noninvasive at presentation, it is necessary to find a highly sensitive, noninvasive way to diagnose in its earlier stages, Cytology with immunostaining is a noninvasive, reliable method that might play a role in detecting the earlier stages before its progression and accurate correlation with different stages of these tumors.

Aim: This study aimed to reach an accurate level in the staging of urothelial carcinoma using CD44, ProExC, Laminin, and Fascin on urinary cytology.

Design: We include a total of 180 urinary cytology specimens with their surgical biopsies' counterparts, the staging of the surgical specimens were done according to AJCC2017TNM classification, while their counterpart urinary samples were centrifuged and the sediment was used for H&E and immunocytochemical staining with CD44, ProExC, Laminin, and Fascin.

Results: The diagnosis of Ta-stage tumors was done according to the following immunohistochemical (IHC) profile [positive (+ve) CD44, negative (-ve) proExC, -ve Laminin, and -ve Fascin] with 100% sensitivity, 100% specificity. The diagnosis of Tis stage tumors was done according to IHC profile [-ve CD44, +ve proExC, -ve Laminin, and -ve Fascin] with 100% sensitivity, 93% specificity. The diagnosis of T1 stage tumors according to IHC profile [-ve CD44, +ve proExC, +ve Laminin, and -ve Fascin] with 100% sensitivity, 97% specificity, The diagnosis of T2 and T3 stage tumors was done according to IHC profile [-ve CD44, +ve proExC, +ve Laminin and weak to moderate +ve Fascin] with 100% sensitivity, 92% specificity, while the diagnosis of T4 stage tumors according to the IHC profile [-ve CD44, +ve proExC, +ve Laminin, and intense +ve Fascin] with 100% sensitivity, 100% specificity.

Conclusion: Using (CD44, ProExC, Laminin, and Fascin) on urinary cytology is a simple, reliable, and noninvasive method for the staging of urothelial carcinoma with 99% total accuracy.
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http://dx.doi.org/10.1097/PAI.0000000000000905DOI Listing
July 2021

Resveratrol Ameliorates the Seminiferous Tubules Damages Induced by Finasteride in Adult Male Rats.

Microsc Microanal 2020 12;26(6):1176-1186

Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta31527, Egypt.

Finasteride is commonly used in the management of alopecia and nodular prostatic hyperplasia. It was reported to have a harmful effect on spermatogenesis with subsequent infertility. Thus, this research was to determine the ameliorative effect of resveratrol against testicular damage caused by finasteride. Forty adult male rats were randomly divided into four main groups: group I acted as the control, group II was administrated resveratrol 20 mg/kg/day, group III was administrated finasteride 5 mg/kg/day, and group IV was administrated finasteride and resveratrol as in the previous groups. Finasteride induced a significant decrement in the testosterone and dihydrotestosterone levels. The level of malondialdehyde significantly increased, while the levels of glutathione peroxidase, superoxide dismutase, and catalase significantly decreased in the finasteride-administrated rats. Variable histopathological alterations in the testes were revealed in the form of irregular seminiferous tubules. Some seminiferous tubules appeared with degenerated germinal epithelium. Others showed detachment of their germinal epithelium. Congested blood vessels and homogeneous acidophilic substance in-between tubules were also detected. A significant decrement in PCNA positive cells and a significant increment in Bax expression were demonstrated. Ultrastructural examination showed Sertoli cells with rarefied cytoplasm. Vacuolated cytoplasm, shrunken nuclei, and dilated perinuclear spaces were also revealed in the spermatogonia, primary spermatocytes, and early spermatids. On the contrary, few changes were noticed in rats received resveratrol concomitant with finasteride. This study indicated that resveratrol exerted a potent ameliorative effect against testicular injury caused by finasteride.
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http://dx.doi.org/10.1017/S1431927620024514DOI Listing
December 2020

Tramadol Promotes Oxidative Stress, Fibrosis, Apoptosis, Ultrastructural and Biochemical alterations in the Adrenal Cortex of Adult Male Rat with Possible Reversibility after Withdrawal.

Microsc Microanal 2020 06;26(3):509-523

Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta31527, Egypt.

Tramadol is a centrally acting analgesic drug, used for the management of moderate to severe pain in a variety of diseases. The long-term use of tramadol can induce endocrinopathy. This study aimed to evaluate the effect of tramadol dependence on the adrenal cortex and the effect of its withdrawal. Thirty adult male rats were divided into three experimental groups: the control group, the tramadol-dependent group that received increasing therapeutic doses of tramadol orally for 1 month, and the recovery group that received tramadol in a dose and duration similar to the previous group followed by a withdrawal period for another month. Specimens from the adrenal cortex were processed for histological, immunohistochemical, enzyme assay, and quantitative real-time PCR (RT-qPCR) studies. Tramadol induced a significant increase in malondialdehyde level and a significant decrease in the levels of glutathione peroxidase and superoxide dismutase. A significant decrease in the levels of adrenocorticotrophic hormones, aldosterone, cortisol, corticosterone, and dehydroepiandrosterone sulfate was also detected. Severe histopathological changes in the adrenal cortex were demonstrated in the form of disturbed architecture, swollen cells, and shrunken cells with pyknotic nuclei. Inflammatory cellular infiltration and variable-sized homogenized areas were also detected. A significant increase in P53 and Bax immunoreaction was detected and confirmed by RT-qPCR. The ultrastructural examination showed irregular, shrunken adrenocorticocytes with dense nuclei. Dilated smooth endoplasmic reticulum, mitochondria with disrupted cristae, and numerous coalesced lipid droplets were also demonstrated. All these changes started to return to normal after the withdrawal of tramadol. Thus, it was confirmed that the long-term use of tramadol can induce severe adrenal changes with subsequent insufficiency.
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http://dx.doi.org/10.1017/S1431927620001397DOI Listing
June 2020

Edaravone attenuates lung injury in a hind limb ischemia-reperfusion rat model: A histological, immunohistochemical and biochemical study.

Ann Anat 2020 Mar 31;228:151433. Epub 2019 Oct 31.

Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt. Electronic address:

Edaravone is a potent free radical scavenger that has a promising role in combating many acute lung injuries. Ischemia/reperfusion process is a serious condition that may lead to multiple organ dysfunctions. This work was designed to investigate novel mechanisms underlying ischemia/reperfusion-induced lung injury and to evaluate the protective role of edaravone. Thirty adult male rats were divided into three experimental groups; operated with no ischemia (Sham-group), ischemia/reperfusion (I/R) group and edaravone-I/R group. Hind limb ischemia was carried out by clamping the femoral artery. After two hours of ischemia for the hind limb, the rat underwent 24h of reperfusion. Rats in the edaravone-I/R group received edaravone (3mg/kg), 30min before induction of ischemia. At the end of the I/R trial, specimens from the lungs were processed for histological, immunohistochemical, enzyme assay, and RT-qPCR studies. Specimens from I/R group showed focal disruption of the alveolar architecture. Extensive mononuclear cellular infiltration particularly with neutrophils and dilated congested blood capillaries were observed. A significant increase in iNOS, NF-κB, and COX-2 immunoreaction was detected and confirmed by RT-qPCR. Ultrastructural examination showed RBCs and fluid inside alveoli, cellular infiltration, and vacuolations of the inter-alveolar septum. In addition to the presence of extravasated neutrophils and RBCs within the inter-alveolar septum. In contrast, minimal changes were observed in rats which received edaravone before the onset of the ischemia. It could be concluded that edaravone exerted a potent protective effect against lung injury induced by a hind limb I/R in rats through its antioxidant and anti-inflammatory activities.
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http://dx.doi.org/10.1016/j.aanat.2019.151433DOI Listing
March 2020

Lycopene protects against renal cortical damage induced by nandrolone decanoate in adult male rats.

Ann Anat 2019 Jul 17;224:142-152. Epub 2019 May 17.

Histology and Cell Biology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt.

Nandrolone decanoate is an anabolic androgenic steroid that is abused worldwide by young athletes and bodybuilders to enhance their physical performance. Many clinical reports among those abusers demonstrated a variety of renal disorders. Lycopene is one of the dietary carotenoids found in fruits like tomato, watermelon, and grapefruit and has attracted considerable attention as an antioxidant. Therefore, the present study was designed to evaluate the protective effect of lycopene against nandrolone decanoate induced renal cortical damage. Forty adult male rats were equally divided into four main groups: group I served as the control, group II received lycopene 4 mg/kg/day, group III received nandrolone 10 mg/kg/week, and group IV received nandrolone and lycopene at a dose similar to the previous groups. At the end of the experiment, urea, creatinine and oxidative stress indicators were measured, then the kidneys were sampled for histopathological and immunohistochemical studies. Sections of the group (ПI) showed variable histopathological alterations in the form of distorted shrunken glomeruli and almost complete loss of the glomerular capillaries, in addition to vacuolation and shedding of the tubular epithelium. In conclusion, these results showed that nandrolone decanoate induced toxic effects in the kidney of rats and lycopene had protective effects versus such evoked renal damage.
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http://dx.doi.org/10.1016/j.aanat.2019.05.003DOI Listing
July 2019

Effect of aspartame on the placenta of adult albino rat. A histological and immunohistochemical study.

Ann Anat 2019 Jul 18;224:133-141. Epub 2019 May 18.

Human Anatomy and Embryology Department, Faculty of Medicine, Zagazig University, Egypt. Electronic address:

Aspartame is an artificial sweetener usually consumed by hundreds of millions of persons all over the world. Its metabolites can be toxic to many organs and there are only a few studies on the use of aspartame during gestation. The present study was designed to fully evaluate the effect of aspartame on the histological structure of the placenta in the adult albino rat. Twenty pregnant female rats were equally divided into group I that served as control, and group II that received aspartame at a dose 14 mg/kg by gavage on the 9th, 10th and 11th day of pregnancy. Placental specimens were processed for histological and immunohistochemical staining against vascular endothelial growth factor (VEGF). Aspartame induced a significant decrease in the mean placental weight and the mean thickness of both labyrinth and basal zones. Damage in the placenta was detected in the form of rupture of the interhemal membrane, lysis of glycogen trophoblast cells, spongiotrophoblast cells with vacuolated cytoplasm and darkly stained nuclei. A significant increase in vascular endothelial growth factor expression in both labyrinth and basal zones was detected. Ultrastructural examination showed fetal capillaries with condensed nuclei of endothelial cells, cytotrophoblasts with condensed fragmented nuclei and vacuolated cytoplasm, and syncytiotrophoblasts with irregular condensed fragmented nuclei. It could be concluded that aspartame has deeply impacted the normal structure and presumably the function of the placenta, therefore, restrictions are to be imposed on the consumption of aspartame especially during pregnancy.
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http://dx.doi.org/10.1016/j.aanat.2019.04.007DOI Listing
July 2019

Reversal of the hepatic damage induced by the supraphysiological dose of nandrolone decanoate after its withdrawal in the adult male rat.

Tissue Cell 2018 Aug 28;53:44-52. Epub 2018 May 28.

Department of Histology and Cell Biology, Faculty of Medicine, Tanta University, Tanta, 31527, Egypt. Electronic address:

Nandrolone decanoate is an anabolic-androgenic steroid that is frequently used at a very high dose to improve the physical performance. Recently, this drug has been abused by athletes to augment their muscle mass and improve their physical performance. However, this could have an impact on other body systems with the potential increase in its harmful effect. Therefore, the aim of this study was to evaluate the effect of administering a supraphysiological dose of nandrolone decanoate on the hepatic functions and structure of the adult rat and to test the potential reversibility after nandrolone withdrawal. Thirty adult male rats were equally divided into; control group, nandrolone-treated group (10 mg/kg/IM/weekly) for four weeks and recovery group (received nandrolone for four weeks followed by four weeks recovery). The results showed that nandrolone treatment led to a significant increase in the body weight gain and in the levels of serum alanine and aspartate transaminases. Moreover, the liver sections from nandrolone-treated rat showed; dilatation and congestion in the blood vessels, inflammatory cellular infiltration with hepatic fibrosis, severe vacuolar cytoplasmic degeneration, apoptotic hyperchromatic nuclei and partial loss of mitochondrial cristae in the hepatocytes. In addition, nandrolone treatment resulted in significant increase in the apoptotic index and the area percentage of GFAP positive stellate cells in the liver tissues. Importantly, withdrawal of nandrolone for 4 weeks rescued these biochemical and histological changes. In conclusion, our results showed that supraphysiological dose of nandrolone has hepatotoxic effects in the adult rat and showed that these toxic effects are reversible after treatment withdrawal.
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http://dx.doi.org/10.1016/j.tice.2018.05.013DOI Listing
August 2018

Effect of rolipram, a phosphodiesterase enzyme type-4 inhibitor, on γ-amino butyric acid content of the frontal cortex in mice exposed to chronic mild stress.

J Pharmacol Pharmacother 2012 Apr;3(2):132-7

Clinical Pharmacology, Department Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Objectives: To investigate the alterations in GABA levels by rolipram in the model of depression.

Materials And Methods: The alteration of GABA content by rolipram as a phosphodiesterase enzyme type-4 inhibitor in the frontal cortex (FCx; as a brain region crucial for the control of emotion and cognition) obtained from male mice exposed to chronic mild stress (CMS)-induced anhedonia (the loss of pleasure or lack of sensitivity to pleasure stimuli) was recorded.

Results: The results demonstrated the reversal of CMS-induced anhedonia after 3 weeks per os of rolipram in a dose of 0.1 mg/kg/day dissolved in distilled water. Furthermore, rolipram showed a significant reduction in duration of immobility in long-term behavioral changes recorded by the FST. Additionally, there was a significant increase in the GABA content of the FCx of rolipram-treated mice exposed to CMS-induced anhedonia.

Conclusions: The present study suggested that GABA levels may be decreased in an animal model of depression and its reversal together with the behaviour improvement by rolipram could support the hypothesis that modification in GABAergic activity has a role in mood disorders. These effects may complement the antidepressant effect of rolipram that is originally mediated via inhibition of phosphodiesterase enzyme type-4 [PDE4] that increases cyclic adenosine monophosphate signalling the pharmacotherapy of depression.
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http://dx.doi.org/10.4103/0976-500X.95509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356953PMC
April 2012
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