title: Ribavirin induced anaemia: the effect of vitamin D supplementation on erythropoietin and erythrocyte indices in normal Wistar rat.
abstract: OBJECTIVE
  To measure the effect of vitamin D3 (VitD) supplementation on erythrocyte indices, serum and kidney erythropoietin (EPO) in normal rats treated with Pegylated interferon-α (Peg-INF-α) and ribavirin (RBV).
  
  
  METHODS
  Eighty male Wistar rats were divided equally into 8 groups. 'Control'; 'P': only received Peg-INF-α; 'PD': Peg-INF-α/VitD; 'PR': Peg-INF-α/RBV; 'PRD': Peg-INF-α/RBV/VitD; 'R': only received RBV; 'RD': RBV/VitD and 'VitD': only received vitamin D3. Peg-INF-α-2a was injected subcutaneously (6 µg/rat/week) for 4 weeks. RBV (4 mg/rat/day) and VitD (500 IU/rat/day) were given orally for 5 weeks. Blood samples were collected to measure erythrocyte indices and serum 25(OH) vitamin D. EPO was measured in serum samples and kidney specimens by ELISA.
  
  
  RESULTS
  Peg-INF-α alone did not affect the RBCs count, haemoglobin, serum and kidney EPO compared to control (P > 0.05). RBV significantly decreased (P < 0.05) the erythrocyte count, haemoglobin and EPO levels in kidney and serum, either individually (R group) or combined with Peg-INF-α (PR group), compared to 'Control' and 'P' groups. VitD prevented the development of anaemia and significantly increased the concentrations of EPO at serum and kidney levels in the 'RD' and 'PRD' groups compared to 'R' and 'PR' groups. There was a significant positive correlation between blood levels of VitD with serum and kidney EPO, Red cell count and haemoglobin concentrations.
  
  
  CONCLUSIONS
  VitD could have a potential beneficial role in the prevention of ribavirin-induced anaemia by promoting endogenous EPO. Further studies are needed to explore the role of vitamin D in the prevention of ribavirin associated anaemia.
authors.affiliation: Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University Al-Abdeyah, Makkah, PO Box 7607, KSA.
authors.forename: Bassem
authors.initials: B
authors.lastname: Refaat
authors.affiliation: Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University Al-Abdeyah, Makkah, PO Box 7607, KSA.
authors.forename: Tariq Helal
authors.initials: TH
authors.lastname: Ashour
authors.affiliation: Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University Al-Abdeyah, Makkah, PO Box 7607, KSA ; Department of Pharmacology, Faculty of Medicine, Assiut University Egypt.
authors.forename: Adel Galal
authors.initials: AG
authors.lastname: El-Shemi
keywords: Anaemia; erythropoietin hormone; pegylated interferon-α; ribavirin and vitamin D