Effect of jujube fruit on cyclophosphamide-induced cystitis in rats

The main side effect of cyclophosphamide, an alkylating agent used in antineoplastic treatment, is sterile hemorrhagic cystitis. Hemorrhagic cystitis is characterized by a decrease in bladder capacity and significant increase in urination reflex. It causes serious pathological disorder called "overactive bladder". Treatment of cystitis is important due to hyperactive bladder and developing inflammation. Jujube has been frequently used in traditional Chinese medicine and recent studies prove it's anti-inflammatory and antioxidant activities. In the literature review, it was determined that the effect of jujube fruit on hemorrhagic cystitis was not investigated. Therefore, we examined the effect of jujube fruit extract on hemorrhagic cystitis model. In our study, it was observed that cyclophosphamide injection increased rat bladder activity. Bladder pressure, amplitude of basal spontaneous contractions and AUC (area under curve) values of hemorrhagic cystitis group, were significantly higher than the control group. In addition, amplitude and AUC values of basal spontaneous contractions decreased significantly with HE application. Similarly, a significant increase was observed in phasic contractions imposed on tonic contractions induced by carbachol. CAT and SOD ELISA values, which were decreased in the hemorrhagic cystitis group, increased close to the control values. On the other hand, the increased MDA ELISA values were found close to the control values. Liver histopathology was also evaluated, and our findings show that jujube extract does not have a significant toxic effect on the liver at the doses used. The in vitro isolated whole bladder experiment results and ELISA results show that jujube extract can partially treat cystitis. These results may provide another option for the development of new treatment agents in the prevention of hemorrhagic cystitis.