Evaluation of Cytotoxicity of Ribavirin and Hydroxychloroquine Used in Treatment of Coronavirus Disease 2019 on Mucosal Epithelium: An in vitro Study
Janan Ghapanchi, Sara Maroufi, Fahimeh Rezazadeh, Afagh Moatari, Saeid Maroufi, Amir Tabesh, Elham Tayebi KhoramiAbstract
Background:
During the coronavirus disease 2019 (COVID-19) pandemic, specialists faced therapeutic challenges with various medications administered in different doses for patients. This study aimed to evaluate the cytotoxicity of some of these treatments on epithelial cells.
Methods:
In this experimental study, the 2,5-diphenyl-2H-tetrazolium bromide assay was utilized to assess the cytotoxicity of chloroquine (CQ) and ribavirin on HeLa cells, which were obtained from the Pasteur Institute Cell Bank, at various concentrations. The cells were then exposed to trypan blue, loaded into a hemocytometer, and examined under low-power microscopy to count the number of viable cells (unstained). The concentration of cells per milliliter was then calculated. Untreated cells were the control, and each treatment was conducted in triplicate.
Results:
The results indicated that ribavirin had a cytotoxic effect on the cultured cells at commonly accessible concentrations, up to a 1:32 dilution, while CQ was highly toxic, even at a dilution of 1/1024. The experiment demonstrated that, throughout the exposure period, CQ reduced the number of cells across all concentrations (0.001–1 mg/ml). Ribavirin exhibited lower toxicity than CQ. Both the medications used for COVID-19 treatment were toxic, with CQ showing a higher level of toxicity than ribavirin in epithelial cells.
Conclusion:
Based on the results of this study, ribavirin exhibited cytotoxic effects on the cultured cells, and CQ was found to be highly toxic. Therefore, the cytotoxicity may be observed in the oral cavity due to medication use.