Topamax® and Ginger Oil Potential Neurotoxicity And Their Interaction in Mice Thru Oxidative Stress and Inflammatory Markers, Neurotransmitters Expression and Immunohistochemical Measurements

Abstract

Background: Topamax® ® has multiple pharmacological mechanisms that are efficient to treat epilepsy and migraine. Ginger has been demonstrated to have gingerols and shogaols compounds that proven to cross the blood-brain barrier causing migraine relief, implying that it is useful in the treatment of migraines. Moreover, Topamax has many off-label uses. So it was necessary to explore the possible neurotoxicity of Topamax®, Ginger oil and their interaction in the mice brain. Methods and Results: Male mice were orally gavage with Topamax®, ginger oil (400mg/kg), and Topamax® plus ginger oil with the same pattern for one month. Oxidative stress markers, acetylcholinesterase (AchE) and gamma aminobutyric acid (GABA) and tumor necrosis factor-alpha (TNF- α), were analyzed in brain tissue. Histopathological examination by hematoxylin and eosin, immunohistochemical glial fibrillary acidic protein (GFAP), and Bax expression analysis were done. The mRNA levels of GABAAR subunits, Gabra1, Gabra3, and Gabra5 were evaluated by RT qPCR. The analysis of data revealed that Topamax® elevated the levels of oxidative stress markers, neurotransmitters, TNF-α, and diminished the level of glutathione reduced (GSH). Topamax® exhibited various neuropathological alterations, strong Bax expression, and GFAP immune-reactivity in the cerebral cortex. The interaction effect of Topamax® plus ginger oil attenuated the changes induced by Topamax® in the abovementioned parameters. Both Topamax® and ginger oil upregulated the mRNA expression of gabra1 and gabra3 while their interaction markedly downregulated them. Conclusion: We can conclude that the Topamax® overdose could possibly cause neurotoxicity, but the interaction with ginger oil can reduce Topamax® -induced neurotoxicity and should be taken in parallel.