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Tramadol is a synthetic opioid analgesic commonly prescribed for moderate to severe pain. This study was designed to evaluate the effects of silymarin supplementation on Tramadol induce injury, oxidative stress and PCNA expression alterations on liver in rats. For this purpose 40 male albino rats were divided into four groups and treated for 4 weeks (group 1 was control, group 2 was silymarin, group 3 was Tramadol and group 4 was Tramadol plus silymarin). The obtained results revealed that; serum GPT, GOT, ALP, GGT activities and MDA levels in liver tissues were significantly increase in rats treated with Tramadol as compared to control group while, total protein, albumin, globulin levels in serum, GSH, SOD and catalase levels in liver tissues levels were significantly decrease in Tramadol group when compared with control rats. Liver sections in rats treated with Tramadol exhibited mild positive reactions were detected for PCNA-ir, marked dilation or congestion in central veins, marked cellular infiltrations, atrophied and vacuolated hepatocytes. Treated rats with Tramadol plus silymarin succeeded to modulate these observed abnormalities resulting from Tramadol as indicated by the reduction of enzymes activity and the pronounced improvement of the investigated biochemical, antioxidant parameters, oxidative stress, hepatic injury and PCNA alterations. Further studies are needed to investigate the impacts of tramadol on human health.

Silymarin extract modulates toxicity, injury, oxidative stress, and PCNA alternations induced by tramadol in rat liver