N-acetylcysteine enhances bone marrow activity in treating pancytopenia induced by canine hemoprotozoan diseases

Canine hemoprotozoan diseases viz. ehrlichiosis and babesiosis are mostly associated with critical anemia and thrombocytopenia with pancytopenic changes, leading to multi-organ failure. For faster recovery of patients with complicated hemoprotozoan diseases, whole blood transfusion or bone marrow stimulating agents to produce more red blood cells (RBCs) and platelets might be helpful. Unfortunately, canine specific transfusion procedures are expensive and even not available in many developing countries. Development of alternate therapeutic modality by bone marrow stimulation to augment the production of RBCs and platelets and thus, to treat the critical pancytopenic patients is and urgent necessity. N-acetylcysteine (NAC), acts as a precursor of reduced glutathione and increases the production of bone marrow B cells. It also improves viability and self-renewal capacity of stem cells and thus, boosts hematopoietic differentiation by protecting induced pluripotent stem cells. This study envisaged to develop alternate therapeutic approach to combat pancytopenia secondary to canine hemoprotozoan diseases. Bone marrow mediated aplastic pancytopenia was induced experimentally by administration of cyclophosphamide in rats. Bone marrow stimulating property of NAC was compared with desmopressin, another bone marrow stimulator, which revealed better in terms of hematobiochemical and histopathological changes. Results of rat model study were extrapolated in clinical canine hemoprotozoan cases having pancytopenia. Dogs treated with hemoprotozoan disease specific therapy along with NAC rendered favorable changes by haltering the progression of critical anemia and thrombocytopenia. Study revealed that supplementation of NAC along with canine hemoprotozoan specific therapy is beneficial to alleviate pancytopenia.