Introduction: Azithromycin (AZ) is a broad-spectrum macrolide that is incorporated in the treatment of various infectious diseases, and recently enlisted in the protocol of Covid-19 management. Allicin is a classical garlic extraction with cardioprotective, antioxidant, anti-inflammatory, and anti-apoptotic properties.
Aim of the Work: To evaluate the cardiotoxic effect of AZ and evaluate the possible protective effect of Allicin against AZ cardiotoxicity using various histological and immunohistochemical techniques.
Materials and Methods: Forty adult male albino rats were randomly divided into four main groups: group-I acted as a control group, group-II was given Allicin (20 mg/kg/day) orally for consecutive 14 days, group-III was given AZ (30 mg/kg/day) orally for consecutive 14 days and group-IV was given both AZ and Allicin in the same doses for consecutive 14 days. The cardiac specimens were processed for different histological and immunohistochemical techniques. Morphometrical and statistical studies were also done.
Results: Azithromycin induced several myocardial changes in the form of focal areas of destruction of cardiac muscle fibers, darkly stained pyknotic nuclei and cytoplasmic vacuoles. Wavy muscle fibers, widening of the intercellular spaces, mononuclear cellular infiltration, fatty infiltration and hemorrhage were obvious. Dilated and congested blood vessels were also noticed. A significant increase in the mean area percentage of both Masson and α-SMA immunoreactivity was detected while a significant decrease in the mean area percentage of Bcl-2 was demonstrated. In contrast, most of the histological changes disappeared by Allicin co-treatment except in few localized areas.
Conclusion: Azithromycin induced several destructive changes in cardiac muscle fibers. Allicin had a potent ameliorative role in prevention of cardiotoxicity induced by AZ.