مجله دانشکده پزشکی اصفهان
پیاپی 747 (هفته سوم بهمن 1402)

Oligodendrocyte apoptosis is one of the principal mechanisms in progressive myelin destruction and the development of neurological disabilities. The oligodendrocyte cell death is usually caused by local inflammation and the toxic effects of some environmental factors. Valproic acid can increase cell survival and differentiation due to its diverse antioxidant, anti-apoptotic, anti-inflammatory, and neuroprotective effects. In the present study, the effects of this compound were investigated in preventing oligodendrocyte cell death in the mouse brain corpus callosum.

In this study, 40 mice were randomly divided into four groups: control, sham, cuprizone, and valproic acid/cuprizone. To kill oligodendrocyte cells, 0.2% caprizone compound was used. In addition, the combination of valproic acid was used intraperitoneally, daily with a dose of 300 mg/kg, and for three weeks. immunohistochemical and real-time methods were used to investigate the specific markers of oligodendrocyte cells.

The results showed that the percentage of cells expressing Oligodendrocyte transcription factor (Olig2) and Myelin oligodendrocyte glycoprotein (Mog) markers increased significantly in the group that received valproic acid compared to the groups that received cuprisone (P < 0.05). Also, an increase in the expression of oligodendrocytes-specific genes was reported in the Real Time-PCR method.

The results of this study showed that valproic acid can prevent oligodendrocyte cell death, therefore, the use of this compound can be a suitable solution to prevent the destruction of myelin in nerve tissue

Identifying the effective factors in the progression toward lactic acidosis and death is essential in improving the treatment of Metformin-poisoned patients. This study investigates the blood lactate level in Metformin-poisoned patients and the factors affecting it.

This was a case series study in two referral clinical toxicology centers in Iran for one year. 16 patients were included in the study. The questionnaire was filled out based on the demographic characteristics of the person, vital signs, poisoning symptoms, blood biochemistry, blood gases, blood sugar, and treatments. The lactate level was measured 6-12-24 hours later.

Three cases (18.8%) were male and 13 (81.3%) were female. The average age was 30.13 ± 16.22 years. One case of hypoglycemia, three cases of metabolic acidosis, and three cases of creatinine level above 1.2 were observed. The initial pH and bicarbonate were predictors of the lactate level. No cases of death or lactic acidosis were observed.

Blood pH and bicarbonate can be used as predictors of serum lactate increase. Also, this study showed that the probability of death and lactic acidosis with metformin is very low.