title: Use of dexamethasone with mesna for the prevention of ifosfamide-induced hemorrhagic cystitis.
abstract: OBJECTIVE
  Hemorrhagic cystitis (HC) is a limiting side-effect of chemotherapy with ifosfamide (IFS). In the study presented here, we investigated the use of dexamethasone in combination with mesna for the prevention of IFS-induced HC.
  
  
  METHODS
  Male Wistar rats (150-200 g; 6 rats per group) were treated with saline or mesna 5 min (i.p.) before and 2 and 6 h after (v.o.) administration of IFS. One, two or three doses of mesna were replaced with dexamethasone alone or with dexamethasone plus mesna. Cystitis was evaluated 24 h after its induction by the changes in bladder wet weight and by macroscopic and microscopic analysis.
  
  
  RESULTS
  The replacement of the last dose or the last two doses of mesna with dexamethasone reduced the increase in bladder wet weight induced by IFS by 84.79% and 89.13%, respectively. In addition, it almost abolished the macroscopic and microscopic alterations induced by IFS. Moreover, the addition of dexamethasone to the last two doses of mesna was more efficient than three doses of mesna alone when evaluated microscopically.
  
  
  CONCLUSIONS
  Dexamethasone in combination with mesna was efficient in blocking IFS-induced HC. However, the replacement of last two doses of mesna with saline or all of the mesna doses with dexamethasone did not prevent HC.
authors: Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Brazil.
authors: Milena Morais
authors: MM
authors: Vieira
authors: Gerly Anne Catro
authors: GA
authors: Brito
authors: José Nelson
authors: JN
authors: Belarmino-Filho
authors: Francisco Yuri Bulcão Macedo
authors: FY
authors: Macedo
authors: Erik Aquino
authors: EA
authors: Nery
authors: Fernando Queiroz
authors: FQ
authors: Cunha
authors: Ronaldo Albuquerque
authors: RA
authors: Ribeiro
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003556:Cystitis / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control; D003907:Dexamethasone / Q000008:administration & dosage*; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D006470:Hemorrhage / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control; D007069:Ifosfamide / Q000009:adverse effects*; D008297:Male; D015080:Mesna / Q000008:administration & dosage*; D009929:Organ Size / Q000187:drug effects; D020011:Protective Agents / Q000627:therapeutic use*; D051381:Rats; D017208:Rats, Wistar; D012965:Sodium Chloride / Q000008:administration & dosage; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology
chemical_list: D000893:Anti-Inflammatory Agents; D020011:Protective Agents; D012965:Sodium Chloride; D003907:Dexamethasone; D015080:Mesna; D007069:Ifosfamide