Ulus Travma Acil Cerrahi Derg. 2017; 23(3): 181-187 | DOI: 10.5505/tjtes.2016.64509

Beneficial effects of garlic (Allium sativum) oil in experimental corrosive esophageal burns effects of garlic oil in esophageal burns

Ceren Þen Tanrýkulu¹, Yusuf Tanrikulu², Fahriye Kýlýnç³, Burak Bahadýr⁴, Murat Can⁵, Füruzan Köktürk^6
1Department of Emergency Medicine, Bülent Ecevit University Faculty of Medicine, Zonguldak-Turkey
²Department of General Surgery, Zonguldak Atatürk State Hospital, Zonguldak-Turkey
³Department of Pathology, Konya Numune Hospital, Konya-Turkey
⁴Department of Pathology, Bülent Ecevit University Faculty of Medicine, Zonguldak-Turkey
⁵Department of Biochemistry, Bülent Ecevit University Faculty of Medicine, Zonguldak-Turkey
⁶Department of Biostatistics, Bülent Ecevit University Faculty of Medicine, Zonguldak-Turkey

BACKGROUND: Corrosive esophageal burns, particularly common in developing countries, lead to different problems in different age groups. The ingestion of corrosive substances can cause such problems as stricture of the esophagus, to acute perforation, and even death. Because stricture formation is related to the severity of the initial injury, the prevention of stricture constitutes a main goal of treatment. The aim of this study was to investigate the protective and anti-inflammatory effects of garlic (Allium sativum) oil in corrosive esophageal burn.
METHODS: Twenty-eight rats were randomly divided into 4 equal groups: group 1 (sham), group 2 (control), group 3 (topical treatment), and group 4 (topical and systemic treatment). In groups 2, 3, and 4, corrosive esophageal burns were generated by applying sodium hydroxide to a 1.5-cm segment of the abdominal esophagus. Normal saline was applied to group 2, topical garlic oil to group 3, and topical and systemic garlic oil were used in group 4.
RESULTS: The level of hydroxyproline was lower in the topical treatment groups than in the control group (p=0.023). There was difference in tumor necrosis factor alpha level between the systemic treatment groups and the control group (p=0.044). Treatment with garlic oil decreased stenosis index (SI) and histopathological damage score (HDS) in corrosive esophageal burn rats. The SI in the topical treatment group was significantly lower than that of the control group (p=0.016). The HDS was significantly lower in group 4 when compared with the control group (p=0.019).
CONCLUSION: Garlic oil is an effective agent in promoting the regression of esophageal stenosis and tissue damage caused by corrosive burns. While the protective effect of garlic oil on tissue damage is more significant when applied topically, the anti-inflammatory effect is more pronounced when applied systemically. Therefore, we believe that the application of garlic oil in patients with corrosive esophageal burns can reduce complication rates.

Keywords: Corrosive esophageal burn, garlic oil, hydroxyproline, stenosis index, tumor necrosis factor alpha.

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Deneysel korozif özefagus yanýklarýnda sarýmsak yaðýnýn (Allium Sativum) yararlý etkileri

Ceren Þen Tanrýkulu¹, Yusuf Tanrikulu², Fahriye Kýlýnç³, Burak Bahadýr⁴, Murat Can⁵, Füruzan Köktürk^6
1Bülent Ecevit Üniversitesi Týp Fakültesi, Acil Týp Ana Bilim Dalý, Zonguldak
²Zonguldak Atatürk Devlet Hastanesi, Genel Cerrahi Kliniði, Zonguldak
³Mevlana Üniversitesi, Patoloji Ana Bilim Dalý, Konya
⁴Bülent Ecevit Üniversitesi Týp Fakültesi, Patoloji Ana Bilim Dalý, Zonguldak
⁵Bülent Ecevit Üniversitesi Týp Fakültesi, Biyokimya Ana Bilim Dalý, Zonguldak
⁶Bülent Ecevit Üniversitesi Týp Fakültesi, Bioistatistik Ana Bilim Dalý, Zonguldak

AMAÇ: Özellikle geliþmekte olan ülkelerde daha yaygýn görülen korozif özefagus yanýklarý farklý yaþ gruplarýnda farklý problemlere yol açarlar. Korozif maddelerin yutulmasý özefagus striktürlerinden perforasyona hatta ölüme kadar birçok problem neden olabilir. Striktür oluþmasý ilk hasarýn þiddeti ile iliþkili olduðundan striktür geliþiminin önlenmesi tedavinin asýl amacýdýr. Bu çalýþmada, korozif özefagus yanýðýnda sarýmsak yaðýnýn (Allium Sativum) koruyucu ve antienflamatuvar etkisi araþtýrýldý.
GEREÇ VE YÖNTEM: Yirmi sekiz sýçan rastgele dört eþit gruba ayrýldý; 1. grup (Sham), 2. grup (kontrol), 3. grup (topikal tedavi) ve 4. grup (topikal ve sistemik tedavi). Sham grubu hariç diðer gruplarda abdominal özefagusun 1.5 cm’lik distal kýsmýna NaOH uygulanarak korozif özefagus yanýðý oluþturuldu. Ýkinci gruba normal salin, 3. gruba topikal sarýmsak yaðý ve 4. gruba topikal ve sistemik sarýmsak yaðý verildi.
BULGULAR: Hidroksiprolin seviyeleri topikal tedavi grubunda kontrol grubundan daha düþüktü (p=0.023). Sistemik tedavi grubu ile kontrol grubu arasýnda tümör nekrozis faktör alfa (TNF-α) seviyelerine göre farklýlýk mevcuttu (p=0.044). Sarýmsak yaðý ile tedavinin stenoz indeksini (SI) ve histopatolojik hasar skorunu (HDS) azalttýðý görüldü. Kontrol grubu ile karþýlaþtýrýldýðýnda topikal tedavi grubunda SI belirgin olarak daha düþüktü (p=0.016). Histopatolojik hasar skoru kontrol grubuna göre sistemik tedavi grubunda anlamlý olarak düþüktü (p=0.019).
TARTIÞMA: Sarýmsak yaðý korozif özefagus yanýðýna baðlý oluþan doku hasarýnýn ve özefagial stenozun azaltýlmasýnda etkili bir ajandýr. Sarýmsak yaðý topikal uygulandýðýnda doku hasarý üzerine koruyucu etkisi daha belirgin iken, sistemik uygulandýðýnda antienflamatuvar etkilerinin daha ön plandaydý. Bundan dolayý, korozif özefagus yanýðý olan hastalarda sarýmsak yaðý uygulamasýnýn komplikasyon oranlarýný azaltacaðýna inanýyoruz.
Anahtar sözcükler: Hidroksiprolin; korozif özefagus yanýðý; sarýmsak yaðý; stenoz indeksi; TNF-α.

Anahtar Kelimeler: Hidroksiprolin, korozif özefagus yanýðý, sarýmsak yaðý, stenoz indeksi, TNF-α.

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