Evaluation of the Effects of Azithromycin on the Kidney of Adult Albino Rats and the Possible Protective Role of Vitamin C Using Histological and Immuno-Histochemical Studies

Background: Azithromycin (AZ) is a part of the azalide subclass of macrolides, it has a potential antiviral and anti-inflammatory effects and it has been used to treat COVID-19.Vitamin C (VIT. C); L-Ascorbic acid is an antioxidant that can combat free radicals in the body, thereby decreases inflammation. It is also required for collagen complex and speed wound healing. Objectives: This work aimed to study the histopathological changes in the kidney of adult albino rats induced by AZ and the possible protective role of VIT. C. Material and Methods: Forty five adult albino rats were used in this study. They were divided into equal 3 groups; group I(Control),group II (AZ) and group III(AZ + VIT. C). Drugs were administrated via intragastric route by stomach tube daily for successive two weeks. Rats were sacrificed and tissue samples were collected and processed for histopathological and immunohistochemical (IHC) examination. Results: Histological evaluation of AZ group showed abnormal structure of the renal cortex, some renal corpuscles revealed dilatation of renal spaces, cells of the proximal and distal convoluted tubules showed marked vacuolations in their cytoplasm and shrinkage of nuclei, some empty spaces, hemorrhages and mononuclear cellular infiltration. IHC examination showed significant increase in both Caspase 3 and tumor necrosis factor-α(TNF-α) immune stain. Group III showed restoration of kidney structure in H&E and IHC stained sections. Conclusion: Azithromycin induced renal adverse side effect, VIT.C can reduce this nephrotoxicity, due to its antioxidant, anti-inflammatory, and anti- fibrotic properties.