Abstract
Purpose
To assess the effects of levamisole on experimental endometriosis in rats through the histopathology of the implants, the blood leukocyte and lymphocyte counts and the concentrations of interleukin-6, vascular endothelial growth factor-A and tumor necrosis factor-alpha in the peritoneal environment at the three healthy, endometriotic and post-treatment milestones.
Methods
Twenty-two 8-week-old Sprague–Dawley rats with normal estrus cycles were recruited in a prospective, parallel-group, placebo-controlled, double-blind, stratified-randomized animal trial with the equal allocation ratio of 1:1 challenging the efficacy of levamisole. Endometriosis was induced. After 6 weeks, laparotomy was performed to randomly excise one implant for histopathology assessment. Based on the results, they were stratified randomized and allocated (by software) to two groups of nine: levamisole (5 mg/rat/day) or placebo. After 6 weeks, necropsy was done. Two days before each laparotomy, blood samples and during the procedure, peritoneal wash were collected for ELISA.
Results
Seven rats showed success in treatment in the levamisole group, while three did in the other group. The histopathology results descriptively revealed a drop in the levamisole group, which was not meaningful statistically (0.66 ± 1.32 vs. 2.00 ± 1.50, p = 0.065). The comparisons of the post-treatment leukocytes and lymphocytes in the groups showed significant differences (11088.88 ± 5869.50 vs. 4677.77 ± 3476.98, p = 0.008, and 8588.88 ± 5721.32 vs. 3511.11 ± 2835.24, p = 0.014, respectively). The results of the cytokines were mostly, but not completely, in favor of the efficacy of levamisole.
Conclusion
This study indicates a possible successful role for levamisole in the treatment of experimental endometriosis. Further studies to assess the effects of high dose levamisole on endometriosis are recommended.
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Acknowledgments
The authors would like to express their gratitude to Dr. Behzad Haddad for his help in the editing of images, Dr. Zahra Nikoo for her assistance in the surgical procedures and the funders of this study. Budget was received for this research from Laparoscopy Research Center, Infertility Research Center and Administration of Research of Shiraz University of Medical Sciences. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Azimirad, A., Alborzi, S., Kumar, P.V. et al. The effects of levamisole on experimental endometriosis: a randomized controlled trial in a rat model. Arch Gynecol Obstet 288, 1301–1308 (2013). https://doi.org/10.1007/s00404-013-2895-8
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DOI: https://doi.org/10.1007/s00404-013-2895-8