الفهرس 
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Abstract
Bleomycin is a commonly used chemotherapeutic agent which causes pulmonary fibrosis. Proton pump inhibitors such as esomeprazole are commonly used antacid drugs which are used also as potential antifibrotic agents. Ginsenoside, extracted from the root of Panax ginseng, is commonly used in treating respiratory, gastrointestinal and cardio vascular diseases. The aim of the present work was to study the histological and immunohistochemical alterations in the lung of adult male albino rats after administration of bleomycin and to clarify the possible protective effects of esomeprazole and ginsenoside on bleomycin induced changes and the possible effect of their combination. Fifty five adult male albino rats weighing 180-200 grams were used in this study and divided into five groups: group I: (Control group): Included 15 rats, subdivided into 3 subgroups) each contain 5 rats(: group Ia: received 0.5 ml of isotonic saline twice weekly by intraperitonial injection and oral saline by orogastric tube for 4 weeks. group Ib: received 0.5 ml of isotonic saline twice weekly by intraperitonial injection followed by 300 mg/kg esomeprazole dissolved in 10% ethanol by orogastric tube for 4 weeks. group Ic: received 0.5 ml of isotonic saline twice weekly by intraperitonial injection followed by 80 mg/kg ginsenoside dissolved in normal saline by orogastric tube for 4 weeks. group II: received 0.5 mg of bleomycin sulphate dissolved in 0.5 ml of saline injected IP twice weekly for 4 weeks. group III: received bleomycin injection like group II and 300mg/kg esomeprazole dissolved in 10% ethanol by orogastric tube once daily for one week before injection of bleomycin and continued for 4 weeks after the first bleomycin injection. group IV: received bleomycin injection like group II and 80 mg/kg ginsenoside dissolved in normal saline by orogastric tube intubation once daily for one week before injection of bleomycin and continued for 4 weeks after the first bleomycin injection. group V: received bleomycin injection like group II and esomeprazole followed by ginsenoside by orogastric tube with the same above mentioned in group III and IV. At the end of the experiment, the lung was rapidly dissected and prepared for histological and immunohistochemical studies. Paraffin sections were prepared and stained with hematoxylin and eosin stain (H&E), Mallory’s trichrome stain and immunohistochemical stain with anti NF-κB (p65). For TEM examination, semithin sections and ultrathin sections were prepared. Morphometric study and statistical analysis were done to assess the mean thickness of the interalveolar septa, the percentage area of collagenous fibers, the percentage area of positive NF-κB immune reaction and the mean number of type II pneumocytes. The results of the present study showed that both esomeprazole and ginseng are effective in amelioration of bleomycin induced lung fibrosis with better improvement in ginseng treated group and that the use of their combination was more effective than using each of them alone. The protective effect of esomeprazole and ginseng are mostly due to their antifibrotic, antioxidant and anti-inflammatory activities.