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Biomedicine&pharmacotherapy
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Phenytoin-induced liver injury (PHT ILII) is a serious condition that may necessitate
discontinuation of the drug. This study investigates the mechanisms of PHT ILII and evaluates the
protective effects of Balanites Aegyptiaca (BA) fruit extracts on the liver. We focus on the
Nrf2/MAPK/NF-κB/Beclin-1 signaling pathways involved in oxidative stress and inflammation
from drug-induced liver injury. Phytochemical analyses of BA fruit extracts (Bu-F and EA-F) are
conducted. Molecular docking techniques explore the interaction between phenytoin (PHT) and the
Nrf2/MAPK/NF-κB/Beclin-1 pathways. Thirty-six male rats are divided into Control, Bu-F, EA-F,
PHT, Bu-F/PHT, and EA-F/PHT groups, and they are observed for 45 days. EA-F extract is rich in
phenolics/flavonoids, while Bu-F extract mainly contains saponins.PHT ILII causes histological
damage in liver tissues and affects Nrf- 2, MAPK, TNF-α, IL-1β, Mcp-1, Beclin-1, iNOS
expression, and liver function markers (ALT, AST, ALP). However, EA-F/Bu-F extracts effectively
improve the histological structure and significantly reduce biochemical/immunohistochemical
parameters, restoring them to near-normal levels. EA-F extract is particularly effective. in
conclusion, the Nrf2/MAPK /Beclin-1 pathways play a critical role in the development of PHT ILII.
BA fruit extracts show promise as hepato-protective agents, with the EA-F extract demonstrating
superior efficacy. These results lay the groundwork for new treatments for PHT ILII and drug-
induced liver injuries.
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