Silybum marianum reduces acute kidneys injury by modifying biochemical changes and oxidative stress levels in glycerol-induced CRUSH syndrome
Authors:   Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria, Karamalakova Y. D. , Georgieva E. D. ,   Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria, Petkova-Parlapanska K. V. ,   Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria, Slavova V. B. ,   Department of Social medicine, Health Management and Disaster Medicine, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria, Ivanova K.V. ,   General and Clinical Pathology, Forensic Medicine and Deontology, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria, Ivanov V. A. ,   Department of Social medicine, Health Management and Disaster Medicine, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria, Nikolova G. D. ,   Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria
Published: August 2024

Crush syndrome (CS), also known as traumatic rhabdomyolysis, is a condition that can occur as a result of various incidents such as traffic accidents, earthquakes, and long-term crushing of muscle-rich parts. This condition arises due to the destruction of striated muscle cells. When the compressive pressure is suddenly removed, the damaged cells and myoglobin (Mb), which is nephrotoxic, are carried by oxygenated blood, leading to myoglobinuria, acute kidney injury (AKI), metabolic disorders, hypovolemic shock, and multiple organ dysfunction syndrome (MODS). This study aims to investigate the protective effects of Silybum marianum (S. marianum, SM) against induced toxicity resulting from glycerol (Gly) intramuscular injection (50 % glycerol: 0.9 % saline), which can lead to CS. The study involved 24 rats, which were randomly divided into four groups: (1) controls; (2) S. marianum treated (oral, 5 g/1 kg per day, 18 days); (3) Gly (8 mg/kg b.wt.: 50 % saline, intramuscular (i.m.), once, only on day 16); and (4) S. marianum (oral, 5 g/1 kg per day, 18 days) administered for 18 days, once per day, and Gly (8 mg/kg body weight: 50% saline, i.m., once, only on day 16). By the end of the 19 experimental days of Gly administration, no mortality was observed in rats. After euthanasia, histopathological, biochemical and oxidative stress studies were performed on right kidney tissues and blood samples. All parameters of groups 1 and 2 were similar. The Gly-administered group showed significant weight loss (p < 0.003) compared to the control and S. marianum groups. On the other hand, the combined treatment Gly + S. marianum demonstrated a significant increase in antioxidant defense (p < 0.005). This can be attributed to the suppression of oxidative stress and reduced reactive oxygen/nitrogen production observed in the kidney and blood. Additionally, treatment with S. marianum provided protection against acute tubular necrosis, medullary congestion, and apoptotic indices recorded in the Gly group. Combination therapy of Gly and S. marianum improves tubular necrosis, activates antioxidant enzyme defense, and reduces free radicals. Longer treatment with this therapy can prevent CS (rhabdomyolysis).