https://doi.org/10.52973/rcfcv-e34322
Received: 18/09/2023 Accepted: 05/11/2023 Published: 06/02/2024
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Revista Científica, FCV-LUZ / Vol. XXXIV, rcfcv-e34322
ABSTRACT
The Pomegranate (Punica granatum) is a commonly found fruit in
the Mediterranean and Iran, which has a variety of uses including
medicinal purposes, cosmetics, and as a spice in culinary
applications. Pharmacological functions of Pomegranate include
antioxidation, anti–tumor, anti–hepatotoxicity, anti–lipoperoxidation
and antibacterial properties. The aim of this study was to evaluate the
therapeutic ecacy of Pomegranate extract by utilizing its antioxidant
activity in an experimental rat model of gastritis induced by ethanol.
In the study, 24 female Wistar albino rats (180–200 g) were used.
Gastritis in rats was induced using Ethanol. In experimental groups,
Tumor necrosis factor–alpha, Myloperoxidase, Superoxide Dismutase
and Malondialdehyde were examined for biochemical analyzes.
Streptavidin peroxidase immunohistochemistry method was applied
to gastric tissues with gastritis. A statistically signicant difference
was observed between Superoxide Dismutase and Meloperoxidase
levels. CD8 and CD68 immunoreactivity was higher in the Ethanol
group compared to the other groups. A decrease was observed in
CD8 and CD68 positive immunoreactivity in Ethanol+Pomegranate
extract group compared to Ethanol group. The study found that the
immunoreactivity of MHC–I and MHC–II was found in specic locations,
namely intraepithelial lymphocytes located in the epithelium, some
capillary vessel endothelium, and connective tissue. Changes in
anti–oxidative stress markers such as Superoxide Dismutase and
Myloperoxidase contributed to the mucosal protective effect of
Pomegranate extract in Ethanol–induced gastritis.
Key words: Gastritis; immunohistochemistry; MHC class molecules;
pomegranate extract; rat
RESUMEN
La granada (Punica granatum) es una fruta que se encuentra
comúnmente en el Mediterráneo e Irán, y que tiene una variedad de
usos que incluyen nes medicinales, cosméticos y como especia
en aplicaciones culinarias. Las funciones farmacológicas de la
granada incluyen propiedades antioxidantes, antitumorales, anti
hepatotoxicidad, anti lipoperoxidación y antibacterianas. El objetivo
de este estudio fue evaluar la ecacia terapéutica del extracto de
granada mediante la utilización de su actividad antioxidante en un
modelo experimental de gastritis inducida por etanol en ratas. En
el estudio se utilizaron 24 ratas albinas Wistar hembra (de 180 a
200g). La gastritis en ratas se indujo utilizando etanol. En los grupos
experimentales, se examinaron el factor de necrosis tumoral alfa, la
mieloperoxidasa, la superóxido dismutasa y el malondialdehído para
análisis bioquímicos. Se aplicó el método de inmunohistoquímica de
estreptavidina peroxidasa a tejidos gástricos con gastritis. Se observó
una diferencia estadísticamente signicativa entre los niveles de
superóxido dismutasa y mieloperoxidasa. La inmunorreactividad de
CD8 y CD68 fue mayor en el grupo de etanol en comparación con los
otros grupos. Se observó una disminución en la inmunorreactividad
positiva para CD8 y CD68 en el grupo de etanol + extracto de granada
en comparación con el grupo de etanol. El estudio encontró que la
inmunorreactividad de MHC–I y MHC–II se encontró en ubicaciones
especícas, a saber, linfocitos intraepiteliales ubicados en el epitelio,
algunos endoteliales de vasos capilares y tejido conectivo. Los
cambios en los marcadores de estrés antioxidante, como la superóxido
dismutasa y la mieloperoxidasa, contribuyeron al efecto protector de
la mucosa del extracto de granada en la gastritis inducida por etanol.
Palabras clave: Gastritis; inmunohistoquímica; moléculas de clase
MHC; extracto de granada; rata
The protective effect of Pomegranate extract against the experimental
gastric ulcer induced by ethanol in rats
El efecto protector del extracto de Granada contra la úlcera
gástrica experimental inducida por etanol en ratas
Zelal Karakoç
1
* , İdris Oruç
2
, Bircan Çeken–Toptancı
3
, Nazan Baksi
1
, Muzaffer Aydın Ketani
4
1
Dicle University, Faculty of Veterinary Medicine, Department of Laboratory Animals. Diyarbakır, Türkiye.
2
Dicle University, Faculty of Medicine, Department of Nephrology–Internal Medicine. Diyarbakır, Türkiye.
3
Dicle University, Atatürk Vocational School of Health Services, Department of Medical Services and Techniques. Diyarbakir, Türkiye.
4
Dicle University, Faculty of Veterinary Medicine, Department of Histology and Embryology. Diyarbakır, Türkiye.
*Corresponding Author: zelal.karakoc@dicle.edu.tr
Gastroprotective effect of Pomegranate in rats / Karaket al. _____________________________________________________________________
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INTRODUCTION
Gastrointestinal hemostasis, which is crucial for human well–
being and a long life, is one of several pathways that play a vital role.
Gastritis can be caused by various factors including non–steroidal
anti–inammatory drugs, burns, brain injury, autoimmunity, and
Helicobacter pylori infections. However, contributing factors such as
obesity, smoking, heavy alcohol intake, and fast food consumption
originated from modern lifestyle and dietary habits also play a
significant role in the development of gastric diseases [1]. The
pathogenesis of gastritis involves inammation, gastric mucosal
cell changes (degeneration, apoptosis and necrosis), barrier damage
and bleeding. Furthermore, oxidative–induced gastric disorders
are signicantly inuential in the development of pathogenesis [1].
The Pomegranate (Punica granatum) is a commonly found fruit
in the Mediterranean and Iran, which has a variety of uses including
medicinal purposes, cosmetics, and as a spice in culinary applications.
Pharmacological functions of Pomegranate include antioxidation, anti–
tumor, anti–hepatotoxicity, anti–lipoperoxidation and antibacterial
properties [2, 3]. It has been shown that Pomegranate juice has much
higher antioxidant activity than red wine and green tea (Camellia sinensis)
[4]. Extracts from Pomegranate are used as potential therapeutics in
inammation, bacterial infections, healing wounds, neurodegenerative
disorders, obesity, diabetes mellitus and also protect against cancer [5].
Living organisms have enzymatic and non–enzymatic antioxidant
defense systems to regulate the levels of free radicals [5]. When
reactive oxygen species (ROS) are not eliminated by antioxidant
systems, it results in a state of oxidative stress. Previous studies
have shown that oxidative stress causes several diseases, including
neurodegenerative disorders, multiple sclerosis, rheumatoid arthritis
and cancer, as well as the natural aging process [6, 7, 8].
For the immune system to generate a targeted response against
a protein antigen, it is essential that antigen–presenting cells
process the antigen and display specic peptides through major
histocompatibility complex (MHC) molecules on their surface, which
can then be recognized by T cells. MHC class I (MHC–I) molecules
activate CD8
+
cytotoxic T cells, which are responsible for eliminating
intracellular pathogens. On the other hand, MHC class II (MHC–II)
molecules activate CD4
+
helper T cells, which can target both
intracellular and extracellular pathogens. Hence, certain functions,
such as cytokine production and antibody synthesis required for
leukocyte activation occurs [9]. CD68 is a protein highly expressed
by circulating macrophages and tissue macrophages that contain
specialized elements called lysosomes [10]. It is commonly used as a
macrophage marker. CD8 is expressed on the cell surface membranes
of functionally different T cell populations and is a cytotoxic T
lymphocyte cell surface receptor [11].
The aim of this study was to evaluate the therapeutic efficacy
of Pomegranate extract by utilizing its antioxidant activity in an
experimental rat model of gastritis induced by Ethanol. In the
presedent study, it was aimed to
determine the possible changes in
the expressions of critical molecules such as CD8, CD68, MHC–I and
MHC–II during the healing process by beneting from the antioxidant
activity of Pomegranate extract in gastritis experimentally induced
in Wistar albino rats (Rattus norvegicus). Additionally, it was aimed
to reveal changes in the serum levels of Tumor necrosis factor–alpha
(TNF–α), Myeloperoxidase (MPO), Superoxide Dismutase (SOD) and
Malondialdehyde (MDA), which are components of the enzymatic
antioxidant system.
MATERIALS AND METHODS
Herbal extract
The Pomegranates used in the study were obtained from Pomegranate
producers registered in Siirt in Turkey. After the Pomegranates were
thoroughly washed and dried, they were cut in half and Pomegranate
juice was extracted with a juicer. The resulting Pomegranate juice was
ltered and lyophilized (Christ, 0.21 mm Hg, -80°C [Panasonic–MDF–
U53865–PE/Japon]) until dry. The extract obtained was stored in a dark
bottle at +4°
C
(TSX series/Thermo Fisher Scientic/USA).
Ethical statement
The research was carried out in compliance with the animal
experimentation regulations set by the Local Ethics Committee of
Dicle University Health Sciences Application and Research Center
Animal Experiments (Protocol no: 2022–08).
Experimental design
In the study, 24 female Wistar albino rats (Rattus norvegicus)
(180–200 g) were used. Animals were housed under conditions of
constant temperature (22 ± 3°C) and humidity (50–55%), a 12 h light/
dark cycle and free access to food and water. In order to create the
experimental gastritis model, the rats were deprived of food for a
period of 24 h prior to the experiment, with unrestricted access to
water during this time. Gastritis in rats was induced using ethanol.
The animals were randomly divided into 4 groups.
»
Group 1 (control): healthy rats were given 1 mL saline by oral
gavage during the study period.
»
Group 2 (Pomegranate extract): healthy rats were given 0.5mL
(100 mg·kg
-1
) by oral gavage during the study period [12].
»
Group 3 (Ethanol): healthy rats were given 2 mL Ethanol by
oral gavage on the rst day.
»
Group 4 (Ethanol+Pomegranate extract): healthy rats were
given 2 mL Ethanol on the rst day and then 0.5 mL (100mg·kg
-1
)
Pomegranate extract by oral gavage during the study period [12].
At the end of the study period (6 days), blood sample was obtained
from the heart under Xylazine–Ketamine (10–90 mg·kg
-1
) anesthesia
and the animals were sacriced.
Tissue harvesting
Gastric tissue sample were obtained from the euthanized rats. The
tissue samples taken were xed in formalin–alcohol solution for 18 h
and were embedded in paran after undergoing routine histological
processing [13].
Five–micron–thick serial sections were cut from
(Leica RM2235 Rotary microtome/Germany) the paran blocks at
100–lm intervals. The slides were stained with Crossmans triple stain
for the determination of the histopathologic changes.
Immunohistochemical procedure
Sections from paran blocks were placed on adhesive slides
coated with Aminopropyltriethoxysilane and were then deparanized,
rehydrated, and washed in distilled water. The sections were
treated with 3% H
2
O
2
prepared in Methanol for 20 min to remove
endogenous peroxidase activity. The sections were washed using
0.01 M phosphate buffer saline (PBS, 4×5). Next, citrate buffer
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(0.01 M, pH 6.0) was prepared for retrieving antigens by boiling
the sample at 95°C and allowed to cool. Slides were incubated in
protein blocking solution (Ultra V Block, Thermo Fisher Scientic
Lab Vision Corporation, Fremont, CA, USA; TA–125UB) for 15 min
at room temperature (25°C) to prevent nonspecic staining. Next,
sections were immediately incubated (Arçelik 5223 NHEY Fridge/
Turkey) 4°C overnight with mouse monoclonal CD8 [CD8 (UCH–T4),
sc–1181; Santa Cruz Biotechnology], CD68 (CD68, Clone KP1; cat.no:
CM 033 A,B,C; Biocare Medical), MHC–I [HLA class I (B–D11), sc–65319;
Santa Cruz Biotechnology], and MHC–II [MHC–II (HLA–DR) Ab–1 (Clone
LN3); Thermo Fisher Scientic Lab Vision Corporation), and primary
antibodies were diluted at 1/200 ratios. After incubation, sections
were washed using 0.01 M PBS (4×5). To visualize the colored reaction,
slides were immersed in 3,3'–diaminobenzidine (DAB) (Thermo
Fisher Scientific Lab Vision Corporation, Fremont, CA, USA), a
chromogen, for 4–10 min. The sections were counterstained using
Gill’s Hematoxylin for 1 min and then washed in tap water until they
turned blue. Sections were passed through graded alcohol series
and xylol and then covered with entellan [13, 14].
Negative and positive controls were used to exhibit specicity
of immunohistochemical staining. Human tonsil tissue retrieved
from tissue archives of Dicle University Department of Pathology
with cells with known possession of CD8, CD68, MHC–I, and MHC–II
surface receptors was used as positive control (FIG. 1). As for negative
controls, normal mouse IgG (Santa Cruz sc–2025) was used. As a
result, nonspecic staining was not detected in negative controls.
Tissue sections were examined by conventional light microscopy
(Nikon Eclipse E400; Nikon, Tokyo, Japan) and were photographed
with a digital camera (Nikon Coolpix 4500).
Biochemical analysis
Before the animals were sacriced, blood samples were collected
from the heart into serum tubes under general anesthesia. TNF–α
(tumor necrosis factor–alpha), MPO (myeloperoxidase), SOD
(Superoxide Dismutase) and MDA (Malondialdehyde) values were
determined using Eliza kit from the blood which was transported to
the laboratory in accordance with the cold chain procedure.
All blood samples were analyzed in duplicate, the obtained values
were displayed on a BS–400 automated spectrophotometer (Mindray,
Shenzhen, China).
Statistical analysis
SPSS software version 24.0 (IBM, Armonk, NY, USA) was used for
statistical analysis. Kolmogorov Smirnow test was used to test the
homogeneity of the data. Differences between groups were evaluated
by one–way analysis of variance (ANOVA) test and Kruskal Wallis was used
as a post hoc test. P<0.05 value was considered statistically signicant.
RESULTS AND DISCUSSIONS
Histopathologic ndings
The results showed that both the control group and the group
treated with Pomegranate extract had mucosa layers that were
consistent with the typical histological structure. The gastric mucosa
consisted of a single layer of prismatic epithelium, the lamina propria
was lled with gastric glands, and the mucosal layer was covered
with a thin lamina muscularis (FIG. 2).
In the Ethanol group, most of the single layer prismatic epithelial
cells were degenerated and epithelial integrity was disrupted. The
disrupted epithelial cells were found to form extensions towards
the lumen. Gastric glands located under the mucosa were found to
have dilatations. The glandular cells exhibited disorganization, and
there were areas of hemorrhage interspersed between them. Intense
inammatory cell inltration was found in the lamina propria. The
level of cell inltration was higher in the cutaneous mucosa. When
the Ethanol+Pomegranate extract group was examined, It has been
observed that damage to the apical part of the mucosa is signicantly
reduced by treatment with Pomegranate extract compared with
the ethanol–only group. Damage to single–layer prismatic epithelial
cells was also signicantly reduced. There was a marked decrease in
dilatation of the gastric glands with mild hemorrhagic areas. It was
determined that mitotic activity was higher in the glands located in
the basal part of the lamina propria compared to the other groups.
The distribution of inammatory cells within the lamina propria was
noted to decrease, scattering towards the epithelial tissue (FIG. 2).
Immunohistochemical ndings
Immunohistochemical ndings of CD8, CD68, MHC I and MHC II in
the stomach are given in TABLE I.
CD8 and CD68 immunoreactivity was positive in numerous
inflammatory cells localized in connective tissue where cell
inltrations were intense. CD8 and CD68 immunoreactivity was
higher in the Ethanol group compared to the other groups. A
decrease was observed in CD8 and CD68 positive immunoreactivity
in Ethanol+Pomegranate extract group compared to Ethanol
group (FIG. 3).
FIGURE 1. Positive control for CD8, CD68, MHC–I and MHC–II in the stomach
in rats. Bar: CD8 and MHC–I gures 50 µm, CD68 and MHC–II gures 100 µm
FIGURE 2. Sections of gastric mucosa of controls and treatment groups
(Crossman’s triple stain). Group 1 and Group 2, black arrow: normal mucosa.
Group 3, black arrow: impaired mucosal integrity, yellow arrow: intraepithelial
cell inltration, yellow head arrow: hemorrhagic area. Group 4, yellow arrow:
subepithelial cell inltration. Group 2: gure 25 µm, Group 1, 3, 4: gures 50 µm
FIGURE 3. Immunohistochemical staining of CD8 and CD68 in the stomach.
Black arrow: positive immunoreactivity in glands cell, red arrow: mitotic activity
in cells, E: epithelium, S: stroma, G: glands. All gures 100 µm
CD–8
CD–68
Group–1
Group–1
Group–3
Group–3
Group–4
Group–4
Group–2
Group–2
Gastroprotective effect of Pomegranate in rats / Karaket al. _____________________________________________________________________
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TABLE I
Immunohistochemical expression intensities of
CD8, CD68, MHC I and MHC II in stomach
Groups CD8 CD68 MHC I MHC II
1 (control) ++ ++ ++ ++
2 (
P. granatum extract) ++ ++ ++ ++
3 (Ethanol) +++ +++ + +
4 (Ethanol +
P. granatum extract) + + + +
Staining intensity; (–) no staining, (+) weak, (++) moderate, (+++) strong
The study found that the immunoreactivity of MHC–I and MHC–II was
found in specic locations, namely intraepithelial lymphocytes located
in the epithelium, some capillary vessel endothelium, and connective
tissue. When Ethanol and Ethanol+Pomegranate extract groups
were examined, it was observed that positive immunoreactivity was
distributed throughout the lamina propria (FIG. 4).
FIGURE 4. Immunohistochemical staining of MHC–I and MHC–II in the stomach.
Black arrow: positive immunoreactivity in glands cell, red arrow: mitotic activity
in cells, E: epithelium, S: stroma, G: glands, b: blood vessel, m: musculer layer.
All gures 100 µm
MHC–I
MHC–II
Group–1
Group–1
Group–3
Group–3
Group–4
Group–4
Group–2
Group–2
 













FIGURE 5. TNF–α (pg·mL
-1
), MPO (IU·L
-1
), SOD (IU·mL
-1
) and MDA (mmol·L
-1
) of
ethanol–induced gastritis in rats
TABLE II
Comparison of tumor necrosis factor–α, myeloperoxidase, superoxide
dismutase and malondialdehyde levels in blood samples from all groups
a
Groups TNF–α MPO SOD MDA
1 (control) 65,805 ± 26,33 91,500 ± 105,62 387,950 ± 124,13 46,320 ± 16,31
2 (
P. granatum extract) 49,505 ± 4,57 38,850 ± 28,42 190,900 ± 44,68 16,640 ± 13,47
3 (Ethanol) 69,020 ± 16,69 80,300 ± 83,79 143,500 ± 125,77 40,520 ± 17,91
4 (Ethanol+extract) 61,790 ± 34,30 19,900 ± 7,39 410,150 ± 91,26 41,265 ± 13,27
P 0,540 0,019 0,013 0,061
TNF–α: Tumor necrosis factor–α, MPO: Myeloperoxidase, SOD: Superoxide Dismutase, MDA:
Malondialdehyde.
a
P–values are for ANOVA tests, ranging from P=0.05 to P<0.001. Values are expressed
as the mean standard deviation
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Biochemical ndings
Serum TNF–α, MPO, SOD and MDA values of the groups are shown
in TABLE II. There was no statistically signicant difference between
TNF–α and MDA levels between the groups. However, a statistically
signicant difference was observed between SOD and MPO levels
(P<0.05). The highest SOD level was found in the Ethanol+Pomegranate
extract group and the lowest in the Ethanol group. MPO levels were
highest in the Ethanol group and lowest in the Ethanol+pomegranate
extract group (FIG. 5).
The Pomegranate fruit is recognized for its antimicrobial and
antiviral properties. It has also been a focus of interest in cancer
research. According to the evaluation of ability of fruit juices to reduce
of iron capacity and clearance of free radicals, Pomegranate juice
has been shown to contain higher levels of antioxidants than red
wine and green tea [4]. Commercial Pomegranate juice, obtained by
pressing the whole Pomegranate fruit and peels, contains signicant
amounts of antioxidants. Pomegranate fruit has been proven to lower
blood pressure, affect enzyme activity, reverse vascular damage,
contribute to healing of prostate cancer and arthritis, ameliorate
diarrhea, protect phagocyte cells against autooxidative damage
Gastroprotective effect of Pomegranate in rats / Karaket al. _____________________________________________________________________
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through β–carotene, stimulate T cell functions, and support cytokine
formation [15]. It was reported that Pomegranate peel extract used
against experimental gastric ulcer in rats showed protective effect in
gastric ulcer [16]. Signicant reductions in the secretion of markers
of vascular inammation, thrombo spondinin (TSP) and cytokine
transforming growth factor–b1 (TGF–b1) have been reported in obese
rats fed an atherogenic diet supplemented with Pomegranate juice
or Pomegranate extract. Pomegranate juice has also been shown to
prevent oxidative degradation of nitric oxide [4].
TNF–α, which is a type of cytokine, is released by macrophages
and plays a crucial role as an activator. Its cytotoxic effect plays
an important role in regulating the inflammatory reaction and
inflammation [17]. In the pathogenesis of diseases, it has been
reported that TNF–α plays a key role in cell activation and regulation
of MHC–I and MHC–II expression, and recent studies have shown an
increase in the expression of TNF–α and its receptors in chronic
inammation sites under in vivo conditions [18]. Pomegranate extract
has been reported to contribute to the healing of gastric and duodenal
mucosa by causing a decrease in TNF–α and IL–1β activities and to
show gastroprotective effect [19, 20]. According to the current study,
the analysis of serum TNF–α levels showed that the group given
Ethanol had an increase, while the groups treated with Pomegranate
extract showed a decrease. This suggests that Pomegranate extract
may have a therapeutic effect on the gastric mucosa in gastritis.
MPO is a major determinant of neutrophil inltration in gastric mucosal
tissues and is widely implicated as an indicator of neutrophil inltration
in experimental gastric injury [21]. Elevated MPO concentrations in both
tissues and serum are frequently used as markers of polymorphonuclear
leukocytes under conditions of inammation and sepsis, and MPO has
been shown to more practical and reliable marker of inammation than
IL–6 [22]. In this research, it was found that the Ethanol group showed
an increase in serum MPO level, whereas the groups treated with the
extract showed a decrease in serum MPO level. Additionally, it was
observed a reduction in inammation in the gastric mucosa based on
histopathologic evaluation. The signicant decrease observed provides
evidence that MPO serves as an inammation marker, which is in line
with previous studies.
SOD protects the gastric mucosa against ROS formation by converting
superoxide radicals containing hydroxyl peroxide and molecular oxygen
[23]. Decreased anti–oxidant levels and overproduction of free oxygen
radicals, especially super oxide and hydrogen peroxide, play a crucial
role in ethanol–induced gastric damage and also induce gastric
inammatory response [1]. Sudheesh and Vayalakshmi [24] reported
that avanoids in Pomegranate have antiperoxidative effect by causing
an increase in both SOD and Catalase and Glutathione peroxidase
activities. The results of the presedent study showed a decrease
in serum SOD level in the Ethanol group, while an increase in the
extract groups, suggesting a reduction in inammation in the gastric
mucosa. The histopathological results indicated that the reduction in
inammation observed in the groups receiving the extracts was likely
a result of an increase in the activity of SOD.
In acute gastritis, inammation, consisting mainly of mononuclear
inammatory cells and plasma cells, is supercial and mostly in the
upper layers of the mucosa [25]. Studies in human and experimental
animal models have reported that CD4 T lymphocytes are the main
component of gastritis cell inltrations, while CD8 T lymphocytes
have the ability to initiate and sustain gastric inammation [26].
This study
found that the intensity of CD8 T lymphocyte positive
immunoreaction was greater in the Ethanol group compared to the
control groups. Additionally, the positive immunoreaction decreased
in the treatment group, suggesting the involvement of mononuclear
cells in the experimentally induced acute gastritis. In this study found
evidence that CD8 T lymphocytes were present in the gastric mucosa
during gastritis, which is consistent with the ndings of Ohtani etal.
[27] who also observed the inltration of CD8 T lymphocytes in
gastritis along with CD4 T lymphocytes.
CD68 is a transmembrane glycoprotein highly expressed by tissue
macrophages [28]. The current study CD68 positive immunoreaction
was higher in the Ethanol group compared to the other groups, while
immunoreaction decreased in the treatment group. This suggests that
Pomegranate extract may reduce inammatory response–associated
protein expression to attenuate gastric mucosal injury.
MHC–I and MHC–II class gene products encode cell surface
glycoproteins involved in the binding and presentation of T
lymphocytes to T cell receptors [29, 30]. This study revealed that
positive immunoreactivity in MHC I and MHC II expressing cells
decreased in Ethanol and treatment groups compared to control
and Pomegranate extract groups. This suggests that Pomegranate's
antioxidant properties may contribute to an increase in TNF–α and
SOD levels, as well as changes in MHC class molecules that are
consistent with changes in CD8 immunoreactivity, with increased
levels during inammation and decreased levels during healing.
CONCLUSIONS
Compounds such as catechin derivatives, avonoids, phenolics
and oligomeric proanthocyanidins classied as medicinal plant active
compounds are known to have a mechanism of action related to the
reduction of free radicals against gastric mucosal lesions. In this
study, changes in anti–oxidative stress markers such as MPO and SOD
suggest that pomegranate extract has a mucosal protective effect
in ethanol–induced gastritis, but further in vivo studies are needed.
Conict of interest
The authors declare that they no conict of interest.
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