Hematological and ultrastructural toxicity of first-line anti-tuberculosis drugs and the ameliorative effects of Berberis aristata in rats

Abstract Background Drug toxicity with respect to adverse drug reactions (ADRs) poses a substantial barrier to meeting global healthcare demands, impacting both the recovery of patients and the economic aspects of healthcare systems. Studies have consistently demonstrated the potential toxicity of the combination of anti-tubercular (anti-TB) drugs, such as isoniazid, rifampicin, and pyrazinamide. Methodology In the present study, Wistar rats have been divided into four groups, namely the GI—control group, GII—the drugs group (combination of anti-TB drugs, i.e., isoniazid + rifampicin + pyrazinamide), GIII— B. aristata group, and GIV—treatment groups (anti-TB drugs + B. aristata ) orally for 28 days. Results The groups exposed to the combination of anti-TB drugs exhibited a significant decrease in hemoglobin concentration and total leukocyte count. In contrast, supplementation with B. aristata resulted in a significant restoration of physiological alterations compared to the drugs group. Scanning electron microscopy revealed significant alterations in the topography of erythrocytes, including acanthocytes, echinocytes, and stomatocytes, in the drugs group, which were observed to be mitigated in the B. aristata group. Conclusion These findings underscore both the impact of anti-TB drugs and B. aristata as a supplement to counter the negative impact. Graphical Abstract