O Abdel Salam, S Nofal, S El-Shenawy, N Shaffie
bile duct ligation, bone, liver, piperine, rat
O Abdel Salam, S Nofal, S El-Shenawy, N Shaffie. Effect Of Piperine On Liver Damage And Bone Changes Caused By Bile Duct Ligation In Rats. The Internet Journal of Pharmacology. 2007 Volume 5 Number 2.
Thirty five rats with biliary obstruction induced by double ligation and section of the common bile duct were randomly and blindly assigned to receive piperine (20, 40 or 80 mg/kg), silymarin (25 mg/kg) or saline once a day orally, starting one day after surgery and continued for one month. At the end of the treatment period, rats were killed and analyzed for blood biochemistry, liver and bone histopathology. Piperine administered at 20, 40 or 80 mg/kg to bile duct-ligated (BDL) rats reduced elevated plasma ALT by 16.2-37.5%, AST by 15.4-26.8%, ALP by 60.5-72.7% and bilirubin by 28.4-46.3%, respectively. On histology, liver fibrosis was reduced by piperine in a dose-dependent manner. Piperine also increased the amount of collagenous fibers in the matrix of bone tissue and areas of regeneration. It is concluded that in the model of bile duct ligation, piperine protects against hepatocellular injury and fibrosis and improves bone alterations.
Spices are widely used in human food due to their taste and burning sensations caused by their pungent principles. Black pepper (family Piperaceae) alone accounts for about 35% of the world's total spice trade. Piperine is the active principle of black pepper (
Piperine also exerts antidepressant like effects in mice.(14) Contradictory data, however, has been reported as regards the effect of piperine in models of hepatic injury. Piperine pretreatment has been reported to inhibit(15) or potentiate(16) the hepatotoxicity of CCl4 in rodents. The present study was therefore designed to examine the effect of piperine treatment on liver damage caused in rats by ligation of the common bile duct. This model closely mimics the situation of surgical obstruction of the common bile duct in man such as that occurring due to stricture or malignant growth etc... The effect of piperine was compared with that of silymarin, a standardized extract, derived from the milk thistle plant and is used as a hepatoprotective agent worldwide(17). We also aimed to bone changes and the possible effect of piperine in this model of obstructive jaundice.
Materials and methods
The following drugs were used: Piperine (Sigma, USA), silymarin (SEDICO, ARE).
Sprague–Dawley rats of either sex, weighing 130–150 g of body weight were used. They were housed under standard laboratory conditions with free access to standard laboratory chow and water. Seven rats were used in each group. Animal procedures were performed in accordance with the Ethics Committee of the National Research Centre and followed the recommendations of the National Institutes of Health Guide for Care and Use of Laboratory Animals (Publication No. 85-23, revised 1985).
Under light ether anaesthesia, midline laparotomy was performed, the common bile duct isolated and ligated with 4-0 silk suture in two places just above the duodenum anterior to the pancreas and posterior to the hilum of the liver. The bile duct was then cut between the two ligatures and the abdominal wall was closed in two layers by continuous suturing. Animals were given topical betadine as an antiseptic and 0.2 ml gentamicin intramuscularly to control post-surgical infection. The rats were then allowed to recover with free access to food and water after the surgery.
Design of experiments
Rats with ligation-section of the common bile duct were randomly and blindly assigned to daily oral silymarin administration of piperine at 20, 40 or 80 mg/kg, silymarin at 25 mg/kg or saline, starting 1 day after surgery and continued for 4 weeks. In sham-ligated animals, the duct was located, manipulated, and replaced. At the end of the treatment period, rats were killed and analyzed for blood biochemistry and liver pathology. The doses were selected on the basis of previous published work(18).
At the end of the experiments, blood samples were obtained from the retro-orbital vein plexuses, under ether anaesthesia. ALT and AST activities in serum were measured according to Reitman-Frankel colorimetric transaminase procedure(19), whereas colorimetric determination of ALP activity was done according to the method of Belfield and Goldberg(20), using commercially available kits (BioMérieux, France). Calcium and bilirubin were determined using commercially available kits (Roche Diagnostics GmbH, USA).
After the end of the treatment period, rats were killed, livers and right tibia were excised and fixed in 10% formalin saline. Sections were prepared and stained with hematoxylin and eosin (H & E) for the histological investigations.
All results are expressed as means ± SE. Multiple group comparisons were performed by ANOVA followed by Duncan test. P< 0.05 was considered statistically significant.
Effect of piperine on serum transaminases, alkaline phosphatase and biliruin
Results are presented in table 1. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and bilirubin levels were significantly higher in bile duct ligated rats compared with their Sham-treated counterparts. Serum ALT increased by 78.1%(31.0 ± 2.7 vs 56.2 ± 4.7 U/l), serum AST by 403.6% (78.2 ± 6.4 vs 393.8 ± 31.3 U/l), serum ALP by 850% (326.0 ± 26.3 vs 3098.8 ± 121.6 U/l), respectively. Serum total bilirubin increased markedly in BDL compared to sham operated rats (6.7 ± 0.5 mg/dl
The administration of piperine at 20, 40 or 80 mg/kg to bile duct ligated rats reduced elevated plasma ALT by 16.2, 23.3, 37.5%, AST by 15.4, 19,26.8%, ALP by 60.5, 72.4, 72.7% and bilirubin by 28.4, 44.8,46.3%, respectively. In comparison, the elevated serum ALT, AST, ALP and bilirubin levels decreased to 28.3%, 20%, 62.8 and 31.3% of controls, respectively by 22 mg kg of silymarin. ALT by 16.2, 23.3, 37.5%, respectively.
Effect of piperine on serum calcium
Calcium levels in plasma of BDL rats were not significantly altered by piperine, however calcium level values in BDL-rats plus 40 or 80 mg/kg piperine were significantly less than normal (Sham) rats (table 2).
Effect of piperine on liver injury
Examination of sections of liver tissue from a BDL-control rats showed severe fibrosis accompanied with obvious lymphocytic infiltration at the portal areas (Fig. 1A). Sections of liver tissue from rats treated with piperine 20 mg/kg still showed fibrosis at the portal areas with slight lymphocytic infiltration (Fig. 1B). Fibrosis was markedly reduced in sections of liver tissue from rats treated with piperine 40 mg/kg (Fig. 1C), while sections of liver tissue from rats treated with piperine 80 mg/kg showed nearly normal architecture of liver tissue (Fig. 1D).
Effect of piperine on bone changes
Section of bone tissue from a BDL-control rats showed some small gaps in the matrix of the tissue with widening of the canals normaly present. The osteocytes appeared small in size with dense flattened nuclei. The internal surface of the bone showed irregularities and invasion at some points (Fig. 2A). In rats treated with piperine 20 mg/kg, there were increased number and size of the gaps in the matrix of bone (Fig. 2B), but with the higher dose of 40 mg/kg, decrease in number of the gaps in the bone matrix was seen together with an increase in the amount of collagenous fibers in the matrix of bone tissue. Areas of basophilic cartilaginous tissue appear within the bone tissue representing areas of regeneration (Fig. 2C). Sections of bone tissue from rats treated piperine 80 mg/kg showed increased density of the bone matrix as a result of increased amount of collagenous fibers that become more regularly arranged. No gaps appeared in the bone tissue matrix, but areas of basophilic cartilaginous tissue are still present (Fig. 2D).
In the present study, we have shown that piperine, the active principle of black pepper and a common dietary additive, is able to protect in a dose-dependent manner against hepatic damage caused by bile duct ligation in rats. Other researchers have shown that piperine protected against tert-butyl hydroperoxide and carbon tetrachloride hepatotoxicity(15). In a previous study, it was shown that capsaicin, the active principle of hot red and green pepper and a legend for the vanilloid receptor (TRPV1) reduced hepatic injury caused by the hepatotoxin CCl4 in rats. Liver enzymes (alanine transaminase, aspartate transaminase) in the serum and liver necrosis evaluated histologically were significantly reduced in the capsaicin-treated rats. The CCl4-related disturbances of cellular dysfunction indicated by reduced glycogen and protein content and DNA alterations were ameliorated by capsaicin(21). In the digestive tract, capsaicin-sensitive afferent innvervation participates in nocioception, gastroprotection and intestino-intestinal activation of inhibitory refexes. Sensory neuron stimulation by intragastric administration of capsaicin protects the gastric mucosa of experimental animals against a variety of injurious factors, whereas ablation of extrinsic afferent neurons with a neurotoxic dose of capsaicin impaired gastric mucosal defense with the resultant exacerbation of the chemical-induced injury.(22,23,24) Similar protective effects for sensory nerve stimulation has been demonstrated in the colon(25). In the stomach, sensory neuron-mediated protection of the mucosa involves the protective rise of gastric mucosal blood flow caused by the release of CGRP.(26,27,28) The latter is a potent vasodilator and has been shown to prevent experimental gastric and colonic injury.(29,30,31) Piperine also activates vanilloid receptors (32,33) and although piperine was a less potent agonist than capsaicin , it demonstrated a much greater efficacy (approximately two-fold) at TRPV1.(7) Piperine also showed gastric mucosal protective properties(12,34), but unlike capsaicin, the mechanism of which is not yet elucidated.
Piperine is well absorbed from the gastrointestinal tract of rat. After oral or intraperitoneal administration, about 97% was absorbed irrespective of the mode of dosing. About 1-2.5% of the intraperitoneally administered piperine was detected in the liver during 0.5-6 h after administration as contrasted with 0.1-0.25% of the orally administered dose(35). When sacs of rat intestines were incubated with piperine, about 44-63% of piperine disappeared from the mucosal side with 7-12% of the absorbed piperine being found in the serosal fluid(36).
It in this way that piperine which activates vanilloid receptors (32,33), can reach hepatobiliary tract and excite sensory nerve endings. Piperine was shown to evoke the release of substance P and CGRP, respectively, from sensory nerves (37,38). The potency ratio between piperine and capsaicin in releasing substance P, however, is 1/50 (38).
The rat hepatobiliary tract is densely innervated by CGRP-containing fibers form dense networks in the fibromuscular layer of the biliary tree and surrounding the portal vein. This suggests the involvement of these peptidergic visceral afferents in regulating hepatobiliary activities, including hemodynamic functions of the hepatic vasculature (39).
Piperine also can reduce hepatic tissue injury by virtue of its antioxidant properties. In this context, it has been shown that piperine exerted a significant protection against tert-butyl hydroperoxide and carbon tetrachloride hepatotoxicity by reducing both in vitro and in vivo lipid peroxidation, and by preventing the depletion of glutathione and total thiols in the intoxicated mice (15). In rats fed a high-fat diet Simultaneous supplementation with black pepper or piperine maintained superoxide dismutase, catalase and reduced glutathione in the liver (9).
Metabolic bone disease is common among patients with chronic liver disease with osteoporosis accounting for the majority of cases (40) (Rouillard and Lane, 2001). Osteopenia is a classic complication of chronic cholestasis related to primary biliary cirrhosis or primary sclerosing cholangitis (41,42) (Heathcote, 2000; Le Gars, 2002). Both decreased osteoblastic activity and increased osteoclastic activity contribute to the development of osteoporosis in PBC patients (43) (Hodgson et al., 1985).
The present study has in addition demonstrated that bile duct ligation for one month is associated with marked bone changes in the form of gaps in the matrix of the tissue with widening of the canals normally present. The internal surface of the bone showed irregularities and invasion at some points. These bone alterations appear to be decreased by piperine treatment with a decrease in number of the gaps in the bone matrix together with an increase in the amount of collagenous fibers in the matrix of bone tissue and increased density of the bone matrix. The mechanism by which piperine affect bone is not clear and the clinical significance of these findings is yet to be elucidated in view of the fact that piperine is a dietary constituent in humans.