Healing effect of trimetazidine on damaged tissue in an experimental corrosive esophageal burn model

Objective: Esophageal burns caused by exposure to corrosive substances are common in childhood and adult age groups. However, there is no standardized treatment method to prevent mortality and morbidity. This study was conducted to investigate the therapeutic effect of Trimetazidine (TMZ), which has strong antioxidant and cytoprotective effects, on esophageal corrosive burns caused by sodium hydroxide (NaOH). Materials and methods: The 24 Sprague Dawley rats used in this study were divided into 4 groups of 6 rats in each group. In the experiment, 0.1 ml of 25% NaOH, an alkaline substance, was administered by gavage to create a corrosive esophageal burn. Group 1 (no burn was induced, sham group), Group 2 (burned with NaOH, no treatment was given), Group 3 (burned with NaOH, 10mg/kg TMZ was given intraperitoneally), Group 4 (burned with NaOH, 20mg/kg TMZ was given intraperitoneally). During the 4-day study period, rats were fed with standard food and water. At the end of the 4th day, the esophagus of the rats were removed for histopathologic evaluation. In histopathologic evaluation; inflammation, epithelial loss, vascular congestion, muscularis mucosa damage, increased collagen deposition in submucosa, collagen deposition in tunica muscularis were evaluated. Results: According to the findings obtained in the study, when group 2 and group 4 were compared in terms of epithelial loss, epithelial loss was less in group 4 and this result was statistically significant (P2-4= 0.025). This significant difference shows that 20 mg/kg dose TMZ treatment is effective on healing. The lack of statistically significant difference between group 1 and group 4 suggests that 20 mg/kg dose of TMZ can completely normalize epithelial loss. When collagen deposition in the tunica muscularis was compared, there was a statistically significant difference between the groups (P= 0.002). The significant statistical difference between group 1 and group 3 (P1-3 = 0.021) suggests that TMZ at a dose of 10 mg/kg was not effective on healing. The absence of a significant statistical difference between group 1 and group 4 suggests that TMZ at 20 mg/kg dose has a healing effect. There was no statistically significant difference in inflammation scores and muscularis mucosa damage between the groups (p = 0.241 and 0.117, respectively). Conclusion: In an experimental corrosive esophageal burn model induced by 25% NAOH in rats, 20 mg/kg dose of TMZ caused an increase in collagen deposition in the esophageal submucosa and prevented epithelial loss. In the light of histopathologic data, 20 mg/kg dose TMZ treatment was more effective than 10 mg/kg dose TMZ treatment. As a result of our findings and analyses; TMZ was found to have ameliorative effect on the histopathologic damage seen as a result of corrosive esophageal burn. Key Words: Esophagus, trimetazidine, corrosive substance, NaOH