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Speculation of the Cytotoxic Effect of Cisplatin Either Necrosis or Apoptosis and the Possible Antagonist Protective Role of Acetyl L-Carnitine, In vitro Study

Background: Cisplatin is one of mostly used chemotherapeutic drugs. Eventhough, cisplatin drawbacks limit its use. Acetyl L- Carnitine is a neuro-protective and anti-oxidant agents as well as it has anti-apoptotic properties.Aim of the study: this study was designed to evaluate the mechanism of Cisplatin to influence tissue in the pathway of apoptosis or the pathway of necrosis and the protective role of Acetyl-L-Carnitine against cytotoxicity induced by Cisplatin in the dental pulp. Material and methods: Total of 30 male albino rats (250-300 grams) were divided equally into three groups where saline was given to the control group (Group I), Cisplatin was injected into group II the (Cisplatin Group), and L- Carnitine was given to the Group III (L- Carnitine group + Cisplatin) before the injection of Cisplatin. After sacrificing the rats one week later, the extraction and preparation of their jaws were carried out in order to examine their dental pulp histologically histologically and immunohistochemically. Results: The light microscopic results showed degeneration in the dental pulp tissue of group II animals represented by cytoplasmic vacuolization, idiopathic calcification, hyaline and fatty degeneration. While group III showed normal dental pulp tissues with dilated blood vessels. Immunohistochemical examination showed significant differences in group II when compared to control group for both Bax (p=0.0002) and TNF-α (p=0.0029). No significant differences appeared in group III when compared to control group for both Bax and TNF-α. Significant differences were evident in comparison between group II and group III for both Bax (p=0.0015) and TNF-α (p=0.000001).Conclusion: Cisplatin has a devastating effect on dental pulp tissues via both the apoptosis and necrosis pathways. L-Carnitine had a protective effect against the cytotoxicity of Cisplatin.