Introduction: Hepatotoxicity is a highly complex process. Many factors, such as personal medical history, viral infection, mainly hepatitis, tumor, suppression of the immune responses, and nutritional insufficiencies, can make humans susceptible to liver damage. The liver, a critical organ that metabolizes various drugs and toxic compounds, is sensitive to damage, especially in the case of the cytotoxic effect of chemotherapy drugs-induced damage. The side effects of these drugs might be multiplied; they alter the drug's mechanism, leading to more toxicity. One of the drugs used in the chemotherapy is cytarabine, or Ara-C, that was used to treat non-Hodgkin lymphoma and acute myeloid leukemia. Tribulus terrestris have many chemical and biologically active substances, Including steroidal saponins, flavonoids, glycosides, phytosterols, tannins, terpenes, amide derivatives, amino acids and proteins. This investigation aimed to examine the effect of the Tribulus terrestris on liver injuries caused by chemotherapeutic agents such as cytarabine. Material and method Twenty-four adult male rats were classified into four groups, with 6 rats in each group. The first group (G1), as a control group was administered with normal saline, the second group (G2) was the group injected with cytarabine (25 mg/kg/B.W.) intraperitoneally, the third group (G3), was administered with T.terrestris extract (250 mg/kg/B.W.) orally, combined with cytarabine (Ara-C 25 mg/kg/B.W.) intraperitoneally, and the fourth group (G4) was administered with T. terrestris extract (250 mg/kg/B.W.) orally respectively. results This study demonstrated that the T.terrestris extract could significantly diminish the cytarabine-induced hepatotoxicity compared to control (p-value <0.05) and cytarabine-injected groups. The activity levels of liver enzymes, specifically alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), angiotensin-converting enzyme (ACE), aspartate aminotransferase (AST), and malondialdehyde (MDA), were found to be significantly elevated in the second group. Conversely, the levels of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) were markedly reduced in this same group. On the other hand, the third group exhibited significantly increased levels of SOD and CAT compared to the fourth group, which had significantly lower levels of ALT, GGT, ACE, AST, and MDA (p-value <0.05). This data was taken from the combined group (G3). The histology results demonstrated a significant modification in the combined-injected group compared to the group injected with only cytarabine. concluded that T. terrestris extract with a dose of 250 mg/kg/B.W. has a significant conservation effect against hepatotoxicity regarding the reduced level of liver enzymes and improved level of antioxidants. In conclusion, the present study indicates that Tribulus terrestris could provide a significant protective effect against cytarabine-chemotherapy.
