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J Res Clin Med. 2020;8(1): 25.
doi: 10.34172/jrcm.2020.025
  Abstract View: 21
  PDF Download: 27

Original Article

Blood-Brain Barrier Destructive Effect of Overdose Digitalis in Rats: Experimental Study

Mehmet Nuri Kocak ORCID logo, Ozgur Caglar * ORCID logo, Dilek Destegul, Kemal Alp Nalci, Sevilay Ozmen, Mehmet Dumlu Aydin

Abstract

Introduction Cardiac glycosides are widely used in critical cardiac diseases despite their unexplained mechanisms cardio-respiratory and other autonomic complications within both intra-uterine or post-natal life. The aim of this study is to investigate if overdose digitalis could cause a result in such complications by blood-brain barrier (BBB) destructive effect. Methods Twenty-five male Sprague Dawley rats weighing 300–350 g were divided into the following groups: control (n=5), sham (isotonic) (n=5), therapeutic dose (n=5), arrhythmogenic dose (n=5), and lethal dose (n=5). The animals were euthanized, and their brains were extracted. The brains were histopathologically and immunohistochemically examined to evaluate BBB morphology in the superior temporal cortex. Results One animal died because of experimental procedures on the first day. Macroscopic examination of brains revealed brain edema, subarachnoid hemorrhage, and narrowed cisterns in toxic doses of digitalis-treated animals. Brain histopathological examination of these groups revealed bloody subarachnoid and cisternal spaces, cortical arteriolar vasospasm, neurodegeneration, and even peri-arteriolar neuroglial component fragmentation; these changes induced BBB destruction in the high-dose digitalis-treated animals. Conclusion Digitalis should not be used with overdoses if the cardio-respiratory arrhythmia is unexpectedly appearing in low doses against the possibility of defected or disrupted BBB.
Keywords: Digitalis toxicity, blood–brain barrier, rat brain, digoxin
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Submitted: 01 May 2020
Revision: 02 Jun 2020
Accepted: 07 Jun 2020
ePublished: 08 Jun 2020
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