Effect of Ciprofloxacin on the Articular Cartilage and Epiphyseal Growth Plate Cartilage in the Growing Albino Rats and the Possible Protective Role of Vitamin E (α –Tocopherol): A Histological and Morphometric Study

Introduction: Ciprofloxacin is one of fluoroquinolone derivatives, which has a broad spectrum bactericidal activity. It is contraindicated in children and adolescents because of its potential chondrotoxicity in juveniles. However, fluoroquinolones continue to be prescribed as a drug of choice for treatment of some life threatening diseases in pediatrics. Aim of the Work: To asses ciprofloxacin juvenile chondrotoxicity and evaluate the possible protective role of vitamin E (α-tocopherol). Materials and Methods: Thirty three growing rats (5 weeks old) were divided into: Group (1) as a control, Group (2) received ciprofloxacin (20mg/kg/day) for 15 consecutive days, Group (3) received the same dose of ciprofloxacin for 15 consecutive days, then sacrificed after another 30 days of ciprofloxacin stoppage and Group (4) received the same dose of ciprofloxacin, in addition to vitamin E (100mg/kg/day) for 15 consecutive days. The knee joints were extracted and prepared for histological examination by light microscopy. Morphometric study and statistical analysis of the results were also performed. Results: Ciprofloxacin induced damage of the articular cartilage of knee joint with cavity formation in the intermediate zone bounded by shrunken chondrocytes and some collagen fibers in addition to the absence of the deep zone. The epiphyseal growth plate cartilage revealed wide clefts and marked diminution of the hypertrophic zone. Both articular and epiphyseal growth plate cartilages showed a statistically significant decrease in their thickness as well as the number of articular cartilage chondrocytes. Moreover, these histo-pathological changes did not disappear after 30 days of ciprofloxacin stoppage. On the other hand, addition of vitamin E ameliorated these deleterious effects. Conclusion: It could be concluded that ciprofloxacin induced damage of the articular and epiphyseal growth plate cartilages of the knee joint in growing albino rats. This damage was irreversible after 30 days of drug stoppage, while addition of vitamin E could alleviate these deleterious effects. Thus α-tocopherol could be used as a novel chondroprotective agent against ciprofloxacin-induced chondrotoxicity in pediatrics