Afsheen Ahmad, Mohammad Shoaib Ayub Kazi.
Histological Effect of Methotrexate and Folinic Acid on Oral Epithelium of Albino Rats.
J Coll Physicians Surg Pak Jan ;26(6):455-8.

Objective: To determine the extent of damage to oral epithelium caused by high dose methotrexate (HDMTX) and the ameliorating role of folinic acid (FA) on damaging effect of methotrexate. Study Design: Experimental study. Place and Duration of Study: Anatomy Department of Post Graduate Medical Institute (PGMI), Lahore, from March to September 2013. Methodology: Forty-two albino rats were randomly allocated to 3 groups: Exp group-I was given HDMTX intramuscularly (I/M) on alternate days, Exp group-II was given both MTX and FA (I/M) on alternate days, and the control group received no intervention. After 16 days, buccal mucosa was excised for histological analysis under light microscope using H & E stains to see the effect of intervention. Results: Exp group-I showed marked reduction in epithelial thickness compared to Exp group-II, and the control (F = 46.44, p < 0.001) had significantly depleted basal layer (F = 6.32, p < 0.004), as well as inflammatory infiltrate with evidence of erosion and ulceration. Exp group-II showed less atrophic changes, a few inflammatory cells, no erosion and ulceration compared to the Exp group-I. Assuming epithelial thickness of control group 100% intact, the Exp group-II was found to have 78% intact and Exp group-I had only 38% thickness intact. Thus FA rescued epithelial thickness by 40%. Conclusion: Folinic acid considerably saved oral mucosa from the damaging effect of HDMTX, improving quality of life of patients.

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