Evaluation of the impact of platelet rich plasma and hyaluronic acid on ketamine-induced cystitis in albino rats : A histological and immunohistochemical study.

Abstract

Background: ketamine induced cystitis (KIC) is commonly occurred in ketamine abusing individuals. It is associated with damage in the lining of the bladder and lower urinary tract symptoms. Platelets rich plasma (PRP) is attractive therapeutic line in regenerative medicine. Hyaluronic acid (HA) has many beneficial therapeutic effects in treatment of different types of cystitis.Objective: to evaluate the effect of PRP and HA on ketamine induced cystitis in adult male rats.Materials and methods: Forty- four adult male rats were divided into five groups: Group I: control rats. Group II: Ketamine group. Group III: Recovery group. Group IV: Ketamine and PRP treated group. Group V: Ketamine and HA treated group. Specimens from the body of the urinary bladder were processed and examined histologically and immunohistochemically. Morphometrical studies and statistical analysis were conducted.Results: Groups II and III showed focal areas of degeneration and ulceration with apparently decreased thickness of the urothelium. Cellular infiltration and dilated congested blood vessels of the lamina propria were also observed. A significant increase of the collagen fibers in the lamina propria and between the muscle bundles. Nuclear factor kappa B (NF-κB) immunoreaction was significantly increased but there was a non-significant increase of antiproliferating cell nuclear antigen (PCNA) immunopositive nuclei among urothelium and a significant decrease of desmin, compared to group I. Groups III and IV showed improvement of most of the histological and immunohistochemical changes described before. Conclusion: The intravesical injection of PRP and HA provide a positive impact on treatment of KIC. HA therapy is a more efficient mean as it provides a better improvement in healing of urothelium and promotes more rapid tissue regeneration.