Abstract: The effect of artesunate on the hematological indices, hepatotoxicity and histology of liver was investigated in 20 adult male wistar rats. The animals were divided into 4 groups of 5 each and group 1 which served as control were administered normal saline while groups 2, 3 and 4 were administered 1, 2 and 5 mg/kg/day respectively for a period of 5 days. The animals were humanely sacrificed on the sixth day and blood samples were obtained for hematological indices and serum enzyme analysis. The liver were excised and processed for light microscopy using the H &amp; E stain. Hematological indices indicated insignificant difference in the RBC, WBC and DC counts, while a significant dose dependent increase in PCV and hemoglobin were observed (p&lt;0.05). No changes were observed in the serum levels of Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Alkaline Phosphatase (ALP) among the groups. Histological examination of the liver revealed points of focal necrosis among the treated groups. The mild liver tissue damage was more evident among the over dosed group. Artesunate is thus safe, when administered within the therapeutic range

Andrew J Nok

Fareha Muzaffar

James A Timbuak

Sabdat O Sani

Samuel A Ojo

Sunday A Musa

Uduak E Umana

Wilson O Hamman

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Asian Journal of Medical Sciences 3(4): 176-179, 2011
ISSN: 2040-8773
© Maxwell Scientific Organization, 2011
Received: June 27, 2011 Accepted: August 27, 2011 Published: August 30, 2011
Corresponding Author: Wilson O. Hamman, Department of Human Anatomy, Faculty of Medicine, Ahmadu Bello University
Zaria-Nigeria, Tel.: 234-08062303007
176
Acute Exposure to Artesunate and its Effect on the Hematological Indices,
Hepatotoxicity and Histology of the Liver of Adult Wistar Rats
1Wilson O. Hamman, 1Sunday A. Musa, 1Fareha Muzaffar, 1Sabdat O. Sani, 1Uduak E. Umana,
1James A. Timbuak, 2Andrew J. Nok and 3Samuel A. Ojo
1Department of Human Anatomy, Faculty of Medicine, Ahmadu Bello University Zaria-Nigeria
2Department of Biochemistry, Faculty of Science, Ahmadu Bello University Zaria-Nigeria
3Department of Veterinary Anatomy, Ahmadu Bello University Zaria-Nigeria
Abstract: The effect of artesunate on the hematological indices, hepatotoxicity and histology of liver was
investigated in 20 adult male wistar rats.  The animals were divided into 4 groups of 5 each and group 1 which
served as control were administered normal saline while groups 2, 3 and 4 were administered 1, 2 and 5
mg/kg/day respectively for a period of 5 days. The animals were humanely sacrificed on the sixth day and blood
samples were obtained for hematological indices and serum enzyme analysis.  The liver were excised and
processed for light microscopy using the H & E stain. Hematological indices indicated insignificant difference
in the RBC, WBC and DC counts, while a significant dose dependent increase in PCV and hemoglobin were
observed (p<0.05). No changes were observed in the serum levels of Aspartate Aminotransferase (AST),
Alanine Aminotransferase (ALT) and Alkaline Phosphatase (ALP) among the groups. Histological examination
of the liver revealed points of focal necrosis among the treated groups.  The mild liver tissue damage was more
evident among the over dosed group. Artesunate is thus safe, when administered within the therapeutic range.
Key words: Artesunate, hepatotoxicity, hematological indices, histology, liver
INTRODUCTION
Artesunate is a potent blood schizoriticide agent for
Plasmodium falciparum. It is effectively used against P.
falciparum resistant to all other malaria drugs (Larinate,
2006). It is a water-soluble hemi-succinate derivative of
dihydroartemisinin. Artemisinin is sequiterpene lactone
isolated from Artemisia  annua, a herb traditionally used
in China for the treatment of malaria (Hien and White,
1993). Artesunate is the most widely available
Artemisinin related compound and may be given
intravenously, intramuscularly, orally or rectally (Nasten
et al., 1994)   
The underlying mechanism for the parasiticidal
activity of this drug is free radical reaction.  This may
include free radical production in the parasite’s food
vacuole (Eckstein-Ludwig et al., 2003) and inhibition of
parasitic calcium ATPase (Artemisinin derivative, 2006).
The target tissue for Artesunate are red blood cells, with
preferential accumulation in P. falciparum infected
erythrocytes (Campbell et al., 1968).  This study was
carried out to evaluate the effect of oral administration of
Artesunate on the hematological indices, hepatotoxicity
and the histology of the liver of adult wistar rats.
MATERIALS AND METHODS
Xenobiotic: Fifty (50) mg tablets Artesunate®
(Greenfield Pharmaceuticals Co. Ltd. China), packed in
aluminium foil and plastic blister packs were purchased in
Zaria-Nigeria. Artesunate solution was made by
dissolving the tablets in normal saline.
Animal treatment: 20 apparently healthy male wistar
rats weighing between 180 and 200 g were obtained from
the animal house of the department of Human Anatomy,
Ahmadu Bello University Zaria-Nigeria. The animals
were kept in a cross-ventilated room (temperature
30.0±2.00ºC, 12 h light/12 h dark cycle) and fed with
livestock growers mash, mixed with groundnut cake
powder and maize chaff. Clean drinking water was
liberally provided. 
Experimental design: The 20 male Wistar rats were
obtained from the animal house of the Department of
Human Anatomy, Ahmadu Bello University Zaria-Nigeria
in June, 2010 and randomly divided into 4 group of 5 rats
each. Group 1 which served as a control were orally
administered     normal    saline.   Groups   2,   3  and   4
Asian J. Med. Sci., 3(4): 176-179, 2011
177
Table 1: Effect of acute exposure to Artesunate on the hematological indices of adult male Wistar rats
Hematological indices Group 1  Group 2  Group 3 Group 4 p-value
RBC (1012/L) 5.10±0.31 4.56±0.12 5.12±0.45 5.48±0.21 0.236
PCV (%) 43.40±0.51 30.20±1.99* 37.80±1.16* 42.60±0.75* 0.001
Hemoglobin (g/dL) 14.40±0.25 10.10±0.73* 12.60±0.51* 14.20±0.37* 0.001
WBC (109/L) 11.36±0.40 13.66±1.08 12.82±0.61 12.42±0.81 0.245
p<0.05; Mean±SEM
Table 2: Effect of acute exposure to Artesunate on the differential white blood cell counts of adult male Wistar rats
Variable (%) Group 1 Group 2  Group 3 Group 4 p-value
Neutrophils 29.00±0.90 25.60±3.50 24.80±1.74 21.60±2.16 0.192
Lympocytes 67.00±1.52 69.80±2.49 72.80±2.49 75.40±2.27 0.081
Eosinophils 1.80±0.66 2.00±0.32 1.00±0.45 1.60±0.25 0.447
Monocytes 2.20±0.49 2.80±0.74 1.40±0.51 1.40±0.75 0.356
Basophils 0.00±0.00 0.00±0.00 0.00±0.00 0.00±0.00 0.000
Mean±SEM
Table 3: Effect of acute exposure to Artesunate on the serum level of AST, ALT and ALP in adult Wistar rats
Serum enzyme Group 1 Group 2 Group 3 Group 4
AST (9/L) 27.00±1.594 28.80±2.154 25.00±1.000 28.80±1.463
ALT (:/L) 38.00±2.223 39.00±1.732 40.00±1.517 41.80±1.530
ALP (:/L 10.28±0.576 10.44±0.982 11.42±0.922 11.40±1 068
Mean±SEM
respectively received  2, 4 and 10 mg/kg/day of
Artesunate in normal saline on the first day (normal start
dose) and 1, 2 and 5 mg/kg/day (subnormal, normal and
overdose, respectively) for 4 days. On the sixth day, the
animals were humanely sacrificed and blood samples
collected through cardiac puncture from the base of the
heart. For hematological indices, blood samples were
placed in EDTA containers, while those for serum
enzyme analysis were placed in plain serum bottles.
Liver tissues were excised, fixed in 10% formalin,
paraffin sections prepared and processed for light
microscopy using the H & E staining technique.
Statistical analysis: One way analysis of variance
(ANOVA) was use to compare the data obtained within
groups and Student’s t-test was used to compare data
obtained between groups. Differences were considered
significant with p<0.05.
RESULTS
A significant decrease in the Packed Cell Volume
(PCV) and hemoglobin concentration was observed
(p<0.05) among the Artesunate treated groups as
compared to the control, while the other hematological
indices measured were not significantly affected by the 5-
day  oral  administration  of  Artesunate  as  shown in
Table 1 and 2.
Serum concentration of ALT showed a slight dose
dependent increase among the Artesunate treated groups.
However, the observed increase in concentration of ALT
is  not  significant as compared to the control group. The
Fig. 1a: Light micrograph of the liver of male Wistar rat of the
control group showing normal portal triad (PT),
hepatocytes (H) and sinusoids (S). H&E, X 100
Fig.  1b: Light micrograph of the liver of male Wistar rat treated
with 1 mg/kg Artesunate showing an area of Focal
Necroses (FN). H&E, X100
Asian J. Med. Sci., 3(4): 176-179, 2011
178
 
Fig. 1c: Light micrograph of the liver of male Wistar rat treated
with 2 mg/kg Artesunate showing an area of focal
necroses (FN). H&E, X100
Fig. 1d: Light micrograph of the liver of male Wistar rat treated
with 5 mg/kg Artesunate showing an area of focal
necroses (FN). H&E, X100
result obtained forthe serumconcentrations of AST and
ALP showed no significant difference between the
Artesunate treated groups and the control as shown in
Table 3.
Histology of the liver: Light microscopic examination of
the Liver sections of the control group showed a normal
histology with clearly outlined figs of anastomosing
hepatocytes along with adjacent sinusoids radiating from
the central veins towards the periphery of the liver
lobules. Present at the portal areas are connective tissues
within which are portal veins and hepatic arteries as
shown in Fig 1a. Similar histological features was
observed in the sections obtained from the subnormal,
normal and overdosed Artesunate treated groups except
for the distinctive presence of areas of focal necrosis
shown in Fig. 1b, c and d, respectively.
DISCUSSION
Packed cell volume and hemoglobin concentration
showed significant difference amongst the hematological
indices measured.  This may not be unconnected with
artesunate’s ability to accumulate in the red blood cells
being the primary site of action. The RBC counts show
statistically insignificant difference, thus the decrease in
PCV may have occurred due to increase in plasma volume
or alteration of the size and shape of the erythrocytes
(Widman, 1980). Since the hemoglobin concentration
alters in the same pattern as the PCV, the most likely
alteration may have occurred in the size and shape of the
erythrocytes.  This could be as a result of Artesunate
adding on the plasma membrane of the erythrocytes, as it
is the target site of action. Analysis of the serum level of
enzymes AST and ALT did not show any significant
difference, though a dose dependent increase in ALT was
observed.  This suggests tonicity of the liver tissue in the
treatment groups upon Aretesunate administration; since
elevation of the serum enzymes indigenous to liver is an
indicator of hepatotonicity.   Transaminases are important
useful markers of hepatocellular toxicity and damage
(Faber et al., 1981). Points of focal necrosis were
observed in the treatment groups though the extent of
tissue damage amongst the various treated groups seemed
almost the same.  This can be expected as well since the
hepato-specific markers just showed slight increases.  The
level of serum hepato-specific markers is a function of the
extent of tissue damage.  Thus, acute exposure to all doses
of Artesunate may cause hepatic damage, though the
effect of various doses may be more prominent over
chronic exposure.
CONCLUSION
The study revealed Artesunate had insignificant
effect on the hematological indices except for PCV and
Hb concentration, on acute exposure.  Since the effect on
PCV and Hb concentration was not dose-dependent, the
observed changes may have been caused by other factors,
thus its effect can be considered safe. Although mild level
of toxicity and liver tissue damage was observed, the liver
is one of the few glands with a remarkable ability to
regenerate. Artesunate can thus be said to be safe when
administered within therapeutic range.  
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Acute Exposure to Artesunate and its Effect on the Hematological Indices, Hepatotoxicity and Histology of the Liver of Adult Wistar Rats

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Acute Exposure to Artesunate and its Effect on the Hematological Indices, Hepatotoxicity and Histology of the Liver of Adult Wistar Rats

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