Anti-apoptotic pro-survival effect of clotrimazole in a normothermic ischemia reperfusion injury animal model.

Background: Increasing evidence suggests that apoptosis plays a critical role in ischemia reperfusion (IR)-mediated liver injury. Clotrimazole (CTZ) is a potent antimycotic drug that also has a free radical scavenger activity. This study investigated the possible anti-apoptotic, pro-survival role of CTZ in hepatic IR injury in rats.

Methods: Male Sprague-Dawley rats were divided into three groups: sham, control, and CTZ-treated (n = 10 each). Control and CTZ-treated animals were subjected to 60 min of normothermic ischemia of the left lateral lobe of the liver followed by 6 h of reperfusion. Animals were then sacrificed, the liver excised, and blood samples collected.

Results: CTZ induced a significant increase in expression of anti-apoptotic Bcl-xL protein. Serum levels of aspartate transaminase and alanine transaminase were significantly lower in CTZ-treated animals than in controls. Histopathologically, tissue damage in the form of apoptosis was significantly lower in CTZ-treated animals than in controls. Expression of the activated form of caspase-3 and the cleaved form of its substrate, poly-ADP-ribose polymerase, decreased significantly in the CTZ-treated group compared with controls. CTZ increased the expression of phospho-p 44/42 ERK1/2 and decreased the phosphorylated form of JNK, without affecting p38 MAPK.

Conclusion: CTZ protects the liver against IR apoptosis in rats through overexpression of the anti-apoptotic protein Bcl-xL. Other pro-survival pathways such as phospho-p 44/42 ERK1/2 kinase are also activated while JNK is down-regulated.