ORIGINAL RESEARCH
Effect of sodium bicarbonate on the development of gastric stasis in the rat model of myeloablative chemotherapy with cyclophosphamide
1 Golikov Research Clinical Center of Toxicology of the Federal Medical and Biological Agency, Saint-Petersburg, Russia
2 State Scientific Research Test Institute of the Military Medicine of Defense Ministry of the Russian Federation, Saint-Petersburg, Russia
Correspondence should be addressed: Timur V. Schäfer
Lesoparkovaya, 4, Saint-Petersburg, 195043, Russia; ur.xednay@refahcs
Author contribution: Vakunenkova OA — experimental study; Ivnitsky JuJu — rationale, developing the experimental model, data interpretation and discussion; Gaykova ON — morphometry data interpretation; Kozlov AA — morphometry studies; Schäfer TV — experimental procedure, data processing and visualization, developing the experimental model. All authors contributed to discussion, manuscript writing and editing.
Compliance with ethical standards: the study was carried out in accordance with the principles of bioethics, approved by the European Convention for the Protection of Vertebrate Animals used for Experimental and Other Scientific Purposes.
Myeloablative cytostatic therapy is often associated with gastrointestinal (GI) stasis that is a component of pathogenesis of the bacterial overgrowth syndrome, endotoxicosis, systemic inflammation, sepsis, emetic syndrome. The study was aimed to test the hypothesis that sodium bicarbonate (NaHCO3), the alkalinizing agent administrated by gavage in the rat model of myeloablative cytostatic therapy with cyclophosphamide (CP), would have a protective effect against GI stasis. We assessed the effects of intragastric NaHCO3 administrations on the development of GI stasis, acute chemotherapy-induced mucositis of the small intestine, and urinary excretion of indican using 140 Wistar rats with the body weight of 161–190 g as a model of myeloablative cytostatic therapy with the intravenously injected CP. The CP administration in a dose of 390 mg/kg resulted in dystrophic changes in the small intestinal mucosa, the development of GI stasis with predominant gastric stasis within the first 24 h, and the increase in excretion of indican. Intragastric administration of NaHCO3 in a dose equivalent to 350 mL of the 4% NaHCO3 solution in humans to rats 30 min before and immediately after the CP administration prevented acute chemotherapy-induced mucositis of the small intestine and alleviated the symptoms of gastric stasis and excessive growth of the indole-producing gastrointestinal microbiota. The reported approach to emergency drug prevention of the myeloablative cytostatic drug therapy gastrointestinal complications holds promise for testing of the use of CP and other alkylating drugs as cytostatic agents.
Keywords: cyclophosphamide, myeloablative cytostatic therapy, rat model, acute cytostatic mucositis, gastric stasis, indican, sodium bicarbonate