Vitamin C and Ferric Gluconate Modulatory Effects on Methotrexate-Induced Cytotoxicity and Oxidative Stress

Abstract

Methotrexate (MTX) is a common drug for inflammatory disorders, such as rheumatoid arthritis, although it has been associated with cytogenetic abnormalities, which suggest genotoxicity. This research evaluated the impact of vitamin C and ferric gluconate on micronucleus (MN) frequency and oxidative stress in patients receiving MTX. One hundred subjects were divided into four groups: MTX alone, MTX + vitamin C, MTX + ferric gluconate and combination adjunct therapy. Blood samples were taken at baseline and 8 weeks to measure MN and oxidative stress. Following treatment, the MTX group had increased MN, while the adjunct therapy groups, particularly the combined group had decreased MN. Oxidative stress analyses showed decreased MDA and increased GSH, SOD and CAT in the adjunct groups, especially the combined group (p < 0.001). Correlation studies suggested that the improved oxidative status was correlated with genomic stability. These findings suggest that vitamin C and ferric gluconate, particularly the combination, are associated with improved oxidative status and reduced chromosomal damage in patients receiving MTX.