Authors

  • Ziyaviddin Khakimov
    Tashkent State Medical University
  • Alisher Rakhmanov
    Tashkent State Medical University
  • Fatima Khalmuratova
    Karakalpak Medical Institute

DOI:

https://doi.org/10.71337/inlibrary.uz.ijms.129318

Abstract

 Considering the increasing incidence of toxic liver damage—the primary organ for xenobiotic detoxification—the insufficient effectiveness of currently used pharmacological treatments necessitates the search for and implementation of new effective drugs for treating hepatobiliary system pathology in prepubertal patients. In this context, the authors studied the effects of Rutan and Karsil on the levels of lipid peroxidation products (Acylhydroperoxides [AcGP], malondialdehyde [MDA]) and the activity of antioxidant enzyme systems (catalase [CAT], superoxide dismutase [SOD]) in the liver during acute hepatitis induced by carbon tetrachloride in one-month-old rats. Results showed that Rutan, similarly to Karsil, reduces elevated levels of AcGP and MDA in the microsomal-cytosolic liver fraction significantly increased by acute toxic hepatitis induced by carbon tetrachloride. Notably, this effect is accompanied by increased activity of antioxidant enzyme systems. It was concluded that Rutan may be used in the treatment of acute liver diseases in the prepubertal period.

 

 

background image

w

w

w

.a

ca

de

m

icp

ub

lis

he

rs

.o

rg

Vo

lu

m

e

5,

Ju

ly

,2

02

5

,

M

ED

IC

AL

SC

IE

N

CE

S.

IM

PA

CT

FA

CT

OR

:7

,8

9

EFFECTIVENESS OF RUTAN IN CORRECTING DISORDERS OF LIPID

PEROXIDATION IN PREPUBERTAL RATS WITH ACUTE TOXIC HEPATITIS

Ziyaviddin Z. Khakimov¹, Alisher H. Rakhmanov², Fatima A. Khalmuratova³

¹Doctor of Medical Sciences, Professor, Department of Pharmacology, Tashkent State

Medical University

²Doctor of Medical Sciences, Professor, Researcher, Biomedical Center, Tashkent State

Medical University

³Assistant, Department of Pharmacology and Pharmaceutical Technology, Karakalpak

Medical Institute, Uzbekistan

Abstract:

Considering the increasing incidence of toxic liver damage—the primary organ

for xenobiotic detoxification—the insufficient effectiveness of currently used

pharmacological treatments necessitates the search for and implementation of new effective

drugs for treating hepatobiliary system pathology in prepubertal patients. In this context, the

authors studied the effects of Rutan and Karsil on the levels of lipid peroxidation products

(Acylhydroperoxides [AcGP], malondialdehyde [MDA]) and the activity of antioxidant

enzyme systems (catalase [CAT], superoxide dismutase [SOD]) in the liver during acute

hepatitis induced by carbon tetrachloride in one-month-old rats. Results showed that Rutan,

similarly to Karsil, reduces elevated levels of AcGP and MDA in the microsomal-cytosolic

liver fraction significantly increased by acute toxic hepatitis induced by carbon tetrachloride.

Notably, this effect is accompanied by increased activity of antioxidant enzyme systems. It

was concluded that Rutan may be used in the treatment of acute liver diseases in the

prepubertal period.

Keywords:

acute toxic hepatitis, rats, prepubertal period, liver, free radical oxidation,

antioxidant defense enzymes.

Conflict of interest.

The authors declare no actual or potential conflicts of interest related to

the publication of this article.

Introduction

The widespread prevalence and high incidence of hepatitis present a serious medico-social

problem for healthcare systems. The use of many effective hepatoprotectors—derivatives of

amino acids and other organic acids, vitamin preparations, and compounds from various

chemical groups—is widely discussed globally [1]. In the development of toxic liver

pathology, free radical processes play a significant role [2]. One of the current problems in

hepatology remains the development and implementation of new highly effective

hepatoprotectors, as toxic liver disease incidence has increased in recent years [3,4]. At the

same time, the use of known therapeutic agents does not always yield the desired results. It

is believed that improving the effectiveness of pharmacotherapy for hepatobiliary system

pathologies requires a comprehensive approach using safe multifunctional hepatoprotectors

that protect hepatocytes from damage and restore their function. The most promising in this

regard is the use of phytopreparations, characterized by a broad spectrum of

pharmacological activity, high effectiveness at early stages of diseases, during slow-

progressing and chronic diseases, as well as in remission and rehabilitation periods [1,5,6].


background image

w

w

w

.a

ca

de

m

icp

ub

lis

he

rs

.o

rg

Vo

lu

m

e

5,

Ju

ly

,2

02

5

,

M

ED

IC

AL

SC

IE

N

CE

S.

IM

PA

CT

FA

CT

OR

:7

,8

9

Furthermore, hepatoprotective agents of plant origin used in complex pharmacotherapy

potentiate the effects of basic medications and correct metabolic disturbances in the

damaged organ [7,8]. This problem is particularly relevant in pediatric practice, as the

incidence of acute hepatobiliary diseases in children tends to increase [9]. Previously, we

demonstrated the effectiveness of Rutan—an interferon inducer—in treating acute and

chronic inflammation in experimental models [10,11]. Considering that liver damage of

toxic etiology involves aseptic inflammation in its pathogenesis, it was hypothesized that

Rutan might exert hepatoprotective effects. Studies in adult animals confirmed the

hepatoprotective properties of Rutan [12]. However, the potential use of Rutan as a

treatment for hepatitis in prepubertal subjects remained unexplored. It was also assumed that

the antioxidant properties of Rutan’s polyphenols underlie its beneficial effects [13].

Aim of the Study

To evaluate the effectiveness of Rutan compared to Karsil on the intensity of lipid

peroxidation processes and the activity of antioxidant enzymes in acute toxic hepatitis in the

prepubertal period.

Materials and Methods

The study was conducted on 30 white growing rats of both sexes, one month old, born under

vivarium conditions. The experiments were carried out in accordance with the rules adopted

by the International Convention for the Protection of Vertebrate Animals used for

Experimental and other Scientific Purposes (Strasbourg, 1986). The conduct of experimental

research on laboratory animals was approved by the Ethics Committee of the Tashkent

Medical Academy under the Ministry of Health of the Republic of Uzbekistan (protocol No.

9 dated May 26, 2025).

Acute toxic hepatitis (ATH) was induced in the rats by intragastric administration of a 50%

oil solution of carbon tetrachloride (CCl₄) at a dose of 0.2 ml/100 g once daily for 4 days.

Twenty-four hours after the last administration of CCl₄, the animals were divided into four

groups. Rats in the first and second groups received Rutan at doses of 25 mg/kg and 50

mg/kg, respectively; the third group received Karsil at a dose of 40 mg/kg; and the fourth

group was left untreated (control relative to all other groups). The drugs were administered

once daily for six days.

The effects of Rutan and Karsil on the intensity of lipid peroxidation (LPO) processes and

the activity of antioxidant enzyme systems (AOS) in rats were studied. Twenty-four hours

after the last procedure, under light ether anesthesia, the rats were sacrificed in a cold room

at a temperature of 0–2°C by instantaneous decapitation. The liver was homogenized in a

glass homogenizer with a Teflon pestle in an isolation medium consisting of 0.25 M sucrose,

0.05 M KCl in a 0.05 M Tris-HCl buffer solution, pH 7.4.

To precipitate nuclei, mitochondria, and particles of damaged cells, the homogenates were

centrifuged at 9000 g for 20 minutes. In the microsomal-cytosolic fraction of the liver, the

content of acylhydroperoxides (AcGP) was determined by the method of Gavrilov V.V. and

Mishkorudnaya M.M., and the content of malondialdehyde (MDA) by the method of


background image

w

w

w

.a

ca

de

m

icp

ub

lis

he

rs

.o

rg

Vo

lu

m

e

5,

Ju

ly

,2

02

5

,

M

ED

IC

AL

SC

IE

N

CE

S.

IM

PA

CT

FA

CT

OR

:7

,8

9

Andreeva L.I. [14]. The state of antioxidant enzyme systems (AOS) was assessed by the

activity of catalase (CAT) [14] and superoxide dismutase (SOD) [14].

The obtained data were statistically processed using the standard software package Statistica

for Windows by the well-known method of variation statistics with evaluation of

significance of the indicators (M±m) and differences between samples by Student’s t-test.

Differences between groups were considered significant at a 95% confidence level (p <

0.05).

Results and Discussion

It is well known that the formation of free radicals, which have a destructive effect on the

structure of biological membranes of cells, including hepatocytes, is one of the important

pathogenetic mechanisms of the damaging action of hepatotoxins [15–17]. This especially

applies to carbon tetrachloride [15–17]. The latter is widely used in experimental hepatology

in the study and introduction of new hepatoprotectors. Many researchers use the

determination of initial products — acylhydroperoxides (AcGP) and intermediate products

— malondialdehyde (MDA) of lipid peroxidation to assess the intensity of free radical

processes [6,14,18].

In this regard, we investigated the content of AcGP and MDA in prepubertal animals with

acute toxic hepatitis treated with Rutan and Karsil. The results of biochemical studies

showed a significant increase in LPO products in animals with acute toxic hepatitis.

Compared to intact animals, the AcGP content increased more than 4.5 times, and MDA —

3.7 times. These results confirm the high prooxidant activity of carbon tetrachloride [19,20].

In contrast, administration of Rutan at a dose of 25 mg/kg resulted in a decrease of AcGP

levels by 68.6% and MDA by 64.0% compared to untreated animals. Doubling the dose of

the drug did not lead to a noticeable change in this effect. Experimental pharmacotherapy

with Karsil, as seen from the data in Table 1, had a similar effect, i.e., the drug significantly

reduced the levels of AcGP and MDA to a degree not significantly different from the results

of Rutan.

Table 1.

The effect of Rutan and Karsil on the intensity of lipid peroxidation processes in the

liver of rats with acute toxic hepatitis, (M±m, n=6).

Animal groups

Doses,

mg/kg

Acyl hydroperoxide

rel. units / mg protein

Malondialdehyde nmol/mg

protein

Intact

-

0,75 ± 0,04

0,69 ± 0,06

OTG+H

2

O

-

3,41 ± 0,23

а

2,56 ± 0,28

а

OTG+Rutan

25

1,07 ± 0,08

а,б

0,92 ± 0,09

б

OTG+Rutan

50

1,28 ± 0,12

а,б

1,17 ± 0,11

а,б

OTG+Karsil

40

1,19 ± 0,13

а,б

1,08 ± 0,09

а,б

Note: a – P <0.05 compared to the intact group, b – P <0.05 compared to the control group.


background image

w

w

w

.a

ca

de

m

icp

ub

lis

he

rs

.o

rg

Vo

lu

m

e

5,

Ju

ly

,2

02

5

,

M

ED

IC

AL

SC

IE

N

CE

S.

IM

PA

CT

FA

CT

OR

:7

,8

9

Therefore, the results of the conducted studies indicate that in acute toxic hepatitis (ATH),

there is a significant and persistent increase in the content of lipid peroxidation (LPO)

products in the microsomal-cytosolic fraction of the liver. Experimental therapy with Rutan

and Karsil led to a substantial decrease in the levels of Acylhydroperoxides (AcGP) and

Malondialdehyde (MDA), indicating suppression of LPO intensity.

It is known that the content of lipid peroxidation products depends on the activity of

antioxidant enzyme systems (AOS). Taking this into account, we studied the effect of Rutan

and Karsil on the activity of antioxidant enzymes in the liver of animals with hepatitis.

The results showed that six days after the induction of the hepatitis model, the activities of

catalase (CAT) and superoxide dismutase (SOD) decreased by 64.9% and 60.7%,

respectively, compared to the values of healthy animals (Table 2). In the experimental

therapy with Rutan at doses of 25 and 50 mg/kg in rats with ATH, a statistically significant

increase in CAT activity was observed at 131.9% and 97.9%, and SOD activity at 122.1%

and 103.2%, respectively, compared to untreated animals. A similar increase in the activity

of the studied enzymes was observed with Karsil therapy, with CAT activity increasing by

140.4% and SOD by 111.6% compared to untreated animals.

It should be noted that with treatment by both drugs, the activity of the studied enzymes did

not differ statistically significantly from the corresponding values of healthy animals.

Table 2.

Effect of Rutan and Karsil on the activity of antioxidant enzyme systems in the liver of

rats with acute toxic hepatitis (M±m, n=6).

Animal groups

Doses,

mg/kg

Catalase, nmol

H

2

O

2

/min ∙ mg protein

Superoxide

dismutase

conventional units/min ∙ mg

protein

Intact

-

1,34 ± 0,12

2,42 ± 0,14

OTG+H

2

O

-

0,47 ± 0,04

а

0,95 ± 0,04

а

OTG+Rutan

25

1,09 ± 0,11

б

2,11 ± 0,19

б

OTG+Rutan

50

0,93 ± 0,19

б

1,93 ± 0,19

б

OTG+Karsil

40

1,13 ± 0,10

б

2,01 ± 0,16

б

Note: a – P <0.05 compared to the intact group, b – P <0.05 compared to the control group.

Analysis of the results studying the effects of Rutan and Karsil on the activity of antioxidant

enzyme systems (AOS) allows concluding that the tested drugs restore the enzymatic

activity of catalase (CAT) and superoxide dismutase (SOD), resulting in a clear reduction of

lipid peroxidation (LPO) intensity. The obtained results correspond with data from other

researchers [10,11]. At the same time, the pharmacological efficacy of Rutan does not

significantly differ from that of Karsil.


background image

w

w

w

.a

ca

de

m

icp

ub

lis

he

rs

.o

rg

Vo

lu

m

e

5,

Ju

ly

,2

02

5

,

M

ED

IC

AL

SC

IE

N

CE

S.

IM

PA

CT

FA

CT

OR

:7

,8

9

Thus, the results of experimental studies on the efficacy of Rutan in correcting disorders of

free radical lipid oxidation in prepubertal rats with acute toxic hepatitis (ATH) show that the

studied polyphenol-containing compounds suppress the intensity of free radical lipid

peroxidation in biological membranes by increasing the activity of AOS enzymes,

confirming the hepatoprotective activity of these compounds. Therefore, like Karsil, Rutan

can be recommended as a pathogenetic treatment option for toxic liver injuries of various

etiologies in pediatric practice.

Conclusions

1.

In prepubertal animals, ATH is accompanied by a significant enhancement of LPO

processes in hepatocyte biological membranes, which is manifested by an increased content

of LPO products in the microsomal-cytosolic liver fraction.

2.

The increased intensity of free radical lipid oxidation in ATH in growing animals is

accompanied by a decrease in the activity of AOS enzymes in liver cells.

3.

Experimental therapy of ATH with Rutan more effectively reduces the intensity of

free radical lipid oxidation in the liver compared to Karsil.

4.

The positive influence on the activity of antioxidant enzymes allows recommending

Rutan for complex treatment of many pathological conditions and diseases in whose

pathogenesis enhanced free radical oxidation during the prepubertal period may be a

contributing factor.

References:

1.

Blinova E.V., Khalzova M.A., Blinov D.S., Yakhya M.Kh.S., Meleshkin A.I.,

Kurganov N.A., Geroeva O.I. Hepatoprotective activity of an organic magnesium compound

in pregnant rats with experimental hepatitis. Experimental and Clinical Pharmacology. 2018;

81(4):18-21.

2.

Simonova N.V., Dorovskikh V.A., Bondarenko D.A., Nosal L.A., Shtarberg M.A.

Comparative efficacy of Remaxol and Reamberin in liver damage by carbon tetrachloride in

experiment. Experimental and Clinical Pharmacology. 2018; 81(7):29-33.

3.

Molochkova O.V., Kovalev O.B., Konev V.A., Uchaykin V.F., Snetkova Y.S. Drug-

induced hepatitis in children. Pediatric Infections. 2017; 16(1):42-50.

4.

Molostvova A.F., Khabirova G.I., Kharisova Yu.I., Salimova L.M. Drug-induced

liver damage - modern view on the topical problem. Bulletin of Modern Clinical Medicine.

2022; 15(5):107-115.

5.

Lupanova I.A., Ferubko E.V., Kurmanova E.N., Shishkanov D.V., Saibel O.L. Study

of hepatoprotective activity of dry extract of Jerusalem artichoke herb in a toxic hepatitis

model in rats. Pathological Physiology and Experimental Therapy. 2022; 66(4):138-142.

6.

Hakimov Z.Z., Rakhmanov A.Kh., Mavlanov Sh.R. Effectiveness of medicinal plant

extract mixtures in correcting liver functional status disorders of various etiologies. Tashkent,

TMA Publishing, 2021. – 156 p.

7.

Demidov V.N., Nazarenko O.A., Egorova E.Yu. et al. Efficacy of Progepar in

experimental liver damage caused by alcohol and paracetamol. Pharmateka, 2011; 2: 85–90.

8.

Nikolaev S.M. Phyto-pharmacotherapy and phytoprophylaxis of diseases. Ulan-Ude:

2012; 286 p.


background image

w

w

w

.a

ca

de

m

icp

ub

lis

he

rs

.o

rg

Vo

lu

m

e

5,

Ju

ly

,2

02

5

,

M

ED

IC

AL

SC

IE

N

CE

S.

IM

PA

CT

FA

CT

OR

:7

,8

9

9.

Sema Mandal, Ruth Simmons, Georgina Ireland, et al. Pediatric acute hepatitis of

unknown etiology: a national investigation and adenoviraemia case-control study in the UK.

The Lancet Child & Adolescent Health. 2023; 7(11):786-796.

10.

Abzalov Sh.R., Khakimov Z.Z., Rakhmanov A.Kh. The Effect of Dry Extract

Obtained from Rhus Cariaria in Experimental Models of Edema and Inflammation.

American Journal of Medicine and Medical Sciences. 2020; 10(7):503-508.

11.

Khakimov Z.Z., Rakhmanov A.Kh., Abzalov Sh.R. Influence of RHUS Coriaria L.

leaf extract on chronic arthritis progression. Medical Journal of Uzbekistan. 2024; 2:182-188.

12.

Mavlonov A.A., Boboeva R.R. Study of the hepatoprotective action of Rutan.

Academicia: an International Multidisciplinary Research Journal. 2020; 10(5):117-120.

13.

Aripov T.F., Ghaibov U.G., Ghaibova S.N., Abdullaev A.A., Abduazimova D.Sh.,

Oschepkova Yu.I., Salikhov Sh.I. Antioxidant and antiradical activity in vitro of polyphenol

mixture (active substance of antiviral drug Rutan) from RHUS CORIARIA L. leaves.

Chemistry of Plant Raw Materials. 2024; 4:138-147.

14.

Mavlanov Sh.R., Khakimov Z.Z., Rakhmanov A.Kh. Experimental methods for

studying the effects of new pharmacologically active compounds on hepatobiliary system

function. Methodological Guide, Tashkent, 2017. – 63 p.

15.

Rakitskii V.N., Skupnevskii S.V. Seasonal variations of carbon tetrachloride toxicity.

Hygiene and Sanitation. 2019; 98(3):324-327.

16.

Timasheva G.V., Repina E.F., Karimov D.O., et al. Peculiarities of metabolic

changes in experimental animals at early terms of pharmacological correction of toxic liver

diseases. Toxicological Review. 2020;(1):13-19.

17.

Hsu Y-W, Chen Y-Y, Tsai C-F. Protective Effects of Chlorogenic Acid against

Carbon Tetrachloride-Induced Hepatotoxicity in Mice. Processes. 2022; 10(1):31.

18.

Gildikov D.I. Oxidative stress in animals: a pathophysiologist's perspective. Russian

Veterinary Journal. 2020; 4:10–18.

19.

Averyanova E.V., Shkolnikova M.N., Chugunova O.V., Mazko O.N. Effects of

triterpenoids in fatty products on liver condition of laboratory animals with acute toxic

hepatitis. Problems of Nutrition. 2023; 92(4):81-91.

20.

Unsal V., Cicek M., Sabancilar İ. Toxicity of carbon tetrachloride, free radicals and

role of antioxidants. Rev Environ Health. 2020 Sep 25;36(2):279-295.

References

Blinova E.V., Khalzova M.A., Blinov D.S., Yakhya M.Kh.S., Meleshkin A.I., Kurganov N.A., Geroeva O.I. Hepatoprotective activity of an organic magnesium compound in pregnant rats with experimental hepatitis. Experimental and Clinical Pharmacology. 2018; 81(4):18-21.

Simonova N.V., Dorovskikh V.A., Bondarenko D.A., Nosal L.A., Shtarberg M.A. Comparative efficacy of Remaxol and Reamberin in liver damage by carbon tetrachloride in experiment. Experimental and Clinical Pharmacology. 2018; 81(7):29-33.

Molochkova O.V., Kovalev O.B., Konev V.A., Uchaykin V.F., Snetkova Y.S. Drug-induced hepatitis in children. Pediatric Infections. 2017; 16(1):42-50.

Molostvova A.F., Khabirova G.I., Kharisova Yu.I., Salimova L.M. Drug-induced liver damage - modern view on the topical problem. Bulletin of Modern Clinical Medicine. 2022; 15(5):107-115.

Lupanova I.A., Ferubko E.V., Kurmanova E.N., Shishkanov D.V., Saibel O.L. Study of hepatoprotective activity of dry extract of Jerusalem artichoke herb in a toxic hepatitis model in rats. Pathological Physiology and Experimental Therapy. 2022; 66(4):138-142.

Hakimov Z.Z., Rakhmanov A.Kh., Mavlanov Sh.R. Effectiveness of medicinal plant extract mixtures in correcting liver functional status disorders of various etiologies. Tashkent, TMA Publishing, 2021. – 156 p.

Demidov V.N., Nazarenko O.A., Egorova E.Yu. et al. Efficacy of Progepar in experimental liver damage caused by alcohol and paracetamol. Pharmateka, 2011; 2: 85–90.

Nikolaev S.M. Phyto-pharmacotherapy and phytoprophylaxis of diseases. Ulan-Ude: 2012; 286 p.

Sema Mandal, Ruth Simmons, Georgina Ireland, et al. Pediatric acute hepatitis of unknown etiology: a national investigation and adenoviraemia case-control study in the UK. The Lancet Child & Adolescent Health. 2023; 7(11):786-796.

Abzalov Sh.R., Khakimov Z.Z., Rakhmanov A.Kh. The Effect of Dry Extract Obtained from Rhus Cariaria in Experimental Models of Edema and Inflammation. American Journal of Medicine and Medical Sciences. 2020; 10(7):503-508.

Khakimov Z.Z., Rakhmanov A.Kh., Abzalov Sh.R. Influence of RHUS Coriaria L. leaf extract on chronic arthritis progression. Medical Journal of Uzbekistan. 2024; 2:182-188.

Mavlonov A.A., Boboeva R.R. Study of the hepatoprotective action of Rutan. Academicia: an International Multidisciplinary Research Journal. 2020; 10(5):117-120.

Aripov T.F., Ghaibov U.G., Ghaibova S.N., Abdullaev A.A., Abduazimova D.Sh., Oschepkova Yu.I., Salikhov Sh.I. Antioxidant and antiradical activity in vitro of polyphenol mixture (active substance of antiviral drug Rutan) from RHUS CORIARIA L. leaves. Chemistry of Plant Raw Materials. 2024; 4:138-147.

Mavlanov Sh.R., Khakimov Z.Z., Rakhmanov A.Kh. Experimental methods for studying the effects of new pharmacologically active compounds on hepatobiliary system function. Methodological Guide, Tashkent, 2017. – 63 p.

Rakitskii V.N., Skupnevskii S.V. Seasonal variations of carbon tetrachloride toxicity. Hygiene and Sanitation. 2019; 98(3):324-327.

Timasheva G.V., Repina E.F., Karimov D.O., et al. Peculiarities of metabolic changes in experimental animals at early terms of pharmacological correction of toxic liver diseases. Toxicological Review. 2020;(1):13-19.

Hsu Y-W, Chen Y-Y, Tsai C-F. Protective Effects of Chlorogenic Acid against Carbon Tetrachloride-Induced Hepatotoxicity in Mice. Processes. 2022; 10(1):31.

Gildikov D.I. Oxidative stress in animals: a pathophysiologist's perspective. Russian Veterinary Journal. 2020; 4:10–18.

Averyanova E.V., Shkolnikova M.N., Chugunova O.V., Mazko O.N. Effects of triterpenoids in fatty products on liver condition of laboratory animals with acute toxic hepatitis. Problems of Nutrition. 2023; 92(4):81-91.

Unsal V., Cicek M., Sabancilar İ. Toxicity of carbon tetrachloride, free radicals and role of antioxidants. Rev Environ Health. 2020 Sep 25;36(2):279-295.