Investigation of the Bioactivity of Hesperidin in an In Vivo Model of Staphylococcus Aureus -Induced Osteomyelitis

Osteomyelitis is a severe bone disease that is difficult to treat and causes serious socioeconomic problems. This study aimed to examine the bioactivity of hesperidin in an in vivo Staphylococcus aureus-induced osteomyelitis model. Total of 28 male Wistar Albino rats were randomly divided into 4 equal groups (n=7). Groups were designated as Group 1: Control group, Group 2: Sham group, Group 3: Osteomyelitis group, and Group 4: Treatment group (Hesperidin+Osteomyelitis). Unilateral tibial osteomyelitis was induced by administering arachidonic acid and 1×106 CFU-1 bacterial suspension through a hole drilled from the tibial crest. The rats in the treatment group were given hesperidin once a day by oral gavage for 28 days. At the end of the treatment, the effectiveness of the treatment was evaluated radiographically, biochemically, and histopathologically. The mean scores of intraosseous acute inflammation, intraosseous chronic inflammation, periosteal inflammation, and bone necrosis were evaluated histopathologically. The score was 0 in the control group, 0-2 in the sham group, 9-14 in the osteomyelitis group, and 2-6 in the treatment group. The median values of IAI, ICI, PI, BN, and total histopathological scores of the treatment group were significantly lower than the osteomyelitis group. Biochemically, oxidative stress increased significantly in the osteomyelitis model, however, it significantly decreased in the group treated with hesperidin. Nrf-2 translation levels increased by 0.2% in the sham group compared to the control group and decreased by 26% in the osteomyelitis group but increased by 42% in the treatment group compared to the osteomyelitis group. Compared to the control group, NF-kB translation levels increased by 6% and 21% in the sham and osteomyelitis groups, respectively. However, this value decreased by 9% in the treatment group compared to the osteomyelitis group. Radiographically, the combined score reduced by 65% in the treatment group in comparison to the osteomyelitis group. In conclusion, hesperidin showed anti-inflammatory activity by suppressing NF-kB and antioxidant activity by increasing Nrf-2, both of which play a role in inflammatory pathways. In light of all these findings, it can be said that hesperidin can be used as a potential therapeutic or an agent that can contribute to the treatment of osteomyelitis.