Methotrexate (MTX) is one of the medicines on the World Health Organization's list of essential medicines. The MTX chronic administration even at very low doses is toxic to the liver, kidney, respiratory, reproductive, and hematopoietic systems. The liver is the organ, which is affected most by this drug (
1). Using natural products for treating diseases is now increasing due to lifestyle changes. People all around the world have become more alert about health and nutrition and prefer to take natural products instead of synthetic drugs, due to their fewer side effects (
11). In this study, we evaluated the role of zingerone (one of the main constituents of the natural substance, ginger) on MTX-induced liver injury in a rat model, from diverse points of view, including redox system, inflammation, and liver enzymes. Finally, we did histopathological examinations to see if they confirm our results.
Injury to the liver (acute or chronic) results in an increment in serum concentrations of liver aminotransferases (AST and ALT). Besides, Alkaline Phosphatase (ALP) levels can mostly be elevated by liver and bone diseases (
33). The present study showed that the administration of zingerone could decrease ALT, AST, and ALP by at least one dose of zingerone significantly. Amin et al. and Mir et al. confirm our study by showing the protective effect of zingerone on lead- (
8) and cyclophosphamide (
34)-induced hepatoxicity, respectively, regarding liver function markers.
The imbalance between reactive oxygen and nitrogen species (RONS) production and antioxidant defense systems can result in oxidative stress. Besides, RONS is the result of many endogenous and exogenous processes (
35). Enzymes such as catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) are the main cellular antioxidant defensive systems that can protect cells against ROS-induced damage (
36).
Lipids are the most important targets of oxidative stress. Lipid oxidation gives rise to the production of malondialdehyde (MDA), which has potentially mutagenic effects (
37). This study demonstrated that zingerone (50 and 100 mg) could decrease the main product of lipid peroxidation (MDA), showing its ability to defeat oxidative damage in MTX-induced hepatotoxicity. Mir et al. also showed that zingerone could attenuate MDA elevation induced by cyclophosphamide-induced liver injury, which confirms our results (
34).
Although nitric oxide (NO) plays an important role in several vital physiological functions (
38), it is also a poisonous, highly reactive, short-lived, and unstable free radical gas (
39), which can induce apoptotic cell death in neuronal cells (
7,
34). When NO reacts with superoxide radicals, it yields peroxynitrite, which can cause membrane peroxidation, DNA damage, and GSH content depletion (
34). The current study showed that zingerone (100 mg/kg) could significantly decrease the level of liver tissue NO in MTX-induced hepatic injury. Wei et al. declared that ROS is probably involved in a series of events that result in cell injury by NO (
7). Therefore, we can conclude that zingerone shows a protective effect against cell apoptosis and possibly performs this protection via decreasing ROS in the liver. Mir et al. also showed a result parallel to our results; they showed the protective effects of zingerone regarding reduced nitrite production in cyclophosphamide-induced hepatic injury (
34).
Moreover, RONS can oxidize proteins and give rise to the production of reactive molecules known as protein carbonyl (PC). A reliable indicator of protein oxidation is the quantity of PC in blood and tissues (
40). This study showed that zingerone with all doses used could decrease the elevated tissue levels of PC in the liver of MTX-treated rats. In another study, Hosseinzadeh et al. showed that zingerone could decrease the content of PC in renal tissue in gentamicin-induced nephrotoxicity in rats (
41). As protein carbonyl is an indicator of the existence of free radicals (
42), it can be concluded that zingerone has an antioxidant property.
Superoxide dismutase (SOD) is an important antioxidant defense system in nearly all living cells exposed to oxygen (
43). Besides, SOD can halt the damaging potential of the superoxide onion. Also, SOD catalyzes the dismutation of superoxide to oxygen plus hydrogen peroxide (H
2O
2) (
44). Hydrogen peroxide is also detrimental and can be degraded by catalase (
43). In the current study, we proved that zingerone (100 mg/kg) could increase the activity of both SOD and CAT in the liver of MTX-affected rates. Amin et al. and Mir et al. confirmed our results about the increasing activity of CAT and SOD by using zingerone (
8,
34).
Reduced glutathione (GSH) is at the center of one of the most important antioxidant systems. It is capable of scavenging RONS and acting as a cofactor for an antioxidant enzyme, glutathione peroxidases (GPX) (
45). In this study, we proved that these two important agents in the redox system could be increased by using zingerone (50 and 100 mg/kg) in rats with MTX-induced hepatic injury. Mir et al. showed results parallel to our study results regarding the increments of both GPX activity and GSH liver content by zingerone (
34). Amin et al.’s study, parallel with our study, showed the increased activity of GPX in hepatic injury by administering zingerone (
8).
This study showed that zingerone could decrease pro-inflammatory cytokines (IL-1β and TNF-α). As known, ROS production leads to neutrophil infiltration and proinflammatory cytokine release, and this can result in apoptosis, cell damage, and death (
6). Thus, it is concluded that zingerone can protect hepatic injury via decreasing inflammation and ROS features. Kucukler et al. also showed similar results; they declared that zingerone could decrease these cytokines that are responsible for inflammation and apoptosis in vancomycin-induced hepatoxicity (
46).
The current study showed a great improvement in MTX-induced histopathological changes in liver tissue after zingerone administration. Zingerone, at least at two doses, could reduce all features assessed for hepatic cell damage. Amin et al. (
8) also stated a significant positive change in hepatic and renal histopathology by zingerone, which confirms this study.
5.1. Conclusion
Zingerone can improve hepatic injury induced by methotrexate in rats regarding the redox system features, inflammation, and histological changes. This can make humans hopeful for using Ginger in the future for attenuating the hepatic side effects of MTX when used chronically.