Asuman Feda BAYRAK, Yuksel OLGUN, Hande EVİN ESKİCİOĞLU, Selen KUM ÖZŞENGEZER, Efe Özgür SERİNAN, Hatice Efsun KOLATAN, Hasan Oğuz ÇETİNAYAK, Günay KIRKIM, Safiye AKTAŞ, Osman YILMAZ, Nur OLGUN, Zekiye ALTUN

SİSPLATİNE BAĞLI OTOTOKSİSİTEDE DARBEPOETİNİN KORUYUCU ROLÜ

Amaç: Darbepoetin-alfa (DPO) uygulamasının sisplatine bağlı ototoksik etkiyi önleyici rolü olup olmadığının in-vivo olarak değerlendirilmesi amaçlandı. Materyal metod: Çalışmada 28 adet wistar albino rat kullanılarak 4 grup oluşturuldu. Grup 1 (intraperitoneal) IP salin verilen kontrol grubu, Grup 2 sisplatin (16mg/kg IP tek doz), Grup 3 DPO (25 μg/kg IP), Grup 4 sisplatin verilmeden 24 saat önce ve verildikten yarım saat sonra 25 μg/kg tek doz IP DPO uygulanan grup. Ratlara ajan uygulamalarından önce ve deneyin 7. gününde distorsiyon ürünü otoakustik emisyon (DPOAE) ve işitsel uyarılmış beyin sapı potansiyelleri (ABR) yapıldı. İşitme ölçümleri sonrasında ratlar sakrifiye edildi. Apoptotik hücre ölümü kulak dokusunda kaspaz-3, -8, -9 ve Nrf2 ve Hem oksijenaz-1 (HO-1), NQQ1, Glutatyon (GST) gibi Nrf2 ilişkili antioksidan ve iNOS, nNOS ekspresyon düzeyleri immünohistokimyasal yöntemle çalışıldı. Serum glutatyon (GSH) ve anti-inflamatuar TNF-α ve IL-1 protein düzeyleri ELISA kitleri kullanılarak belirlendi. Bulgular: Sisplatin uygulaması ile işitme ölçümlerinde kontrole göre ototoksik etkileri gösteren tüm frekanslarda işitme kaybı saptandı. İmmunohistokimyasal doku düzeyinde gerçekleştirilen incelemelerde sisplatin uygulanan grupta iç kulakta strüktürel değişiklikler, beyin ve sinir dokularında nekroz ve nekroptoz saptandı. Darbepoetinin sisplatinin ortaya çıkardığı iç kulak ve beyin hasarlarını önleyici etkileri hem apoptotik protein ekspresyonları hem de oksidatif stres ile ilişkili belirteçler olan Nrf-2 ve ilişkili HO-1, NQO1, iNOS ve nNOS, GST ve anti-inflamatuar proteinleri üzerinden saptandı. Sonuç: Bu çalışmada sisplatinin oluşturduğu ototoksisitede DPO’in koruyucu etkileri apoptozun azaltılması, antioksidan Nrf-2 ve hedef proteinler ve glutatyon düzeylerinin artışı yanında anti-inflamatuar proteinler üzerinden geliştiği gösterilmiştir.

Anahtar Kelimeler:

Darbepoetin, Cisplatin, Ototoxicity, Nrf2, antioxidant system

PROTECTIVE ROLE OF DARBEPOETIN IN CISPLATIN-INDUCED OTOTOXICITY

AIM: It was aimed to evaluate in-vivo whether darbepoetin-alpha (DPO) application has a preventive role in the cisplatin-induced ototoxic effect. MATERIALS and METHODS: In the study, four groups were formed using 28 Wistar albino rats. Group 1 (intraperitoneal) IP saline given control group, Group 2 cisplatin (16mg/kg IP single dose), Group 3 DPO (25 μg/kg IP), and Group 4 is the group in which a single dose of 25 μg/kg IP DPO was administered 24 hours before and half an hour after cisplatin administration. Distortion product otoacoustic emission (DPOAE) and brainstem auditory evoked potentials (BAEP) were performed on rats before agent administration and on the 7th day of the experiment. After hearing measurements, the rats were sacrificed. Apoptotic cell death in ear tissue, caspase-3, -8, -9 expression, Inducible Nitric Oxide Synthase (iNOS), Neuronal Nitric Oxide Synthase (nNOS) expression levels, antioxidant Nrf2 (Nuclear factor (erythroid-derived 2)) - like 2) and related Heme oxygenase-1 (HO-1), NAD(P)H quinone oxidoreductase 1 (NQQ1) were studied by immunohistochemical method. Serum glutathione (GSH) and anti-inflammatory TNF-α and IL-1β protein levels were determined using ELISA kits. RESULTS: The hearing loss was detected at all frequencies showing ototoxic effects compared to control in hearing measurements with cisplatin application. In the examinations performed at the immunohistochemical tissue level, structural changes in the inner ear, necrosis, and necroptosis in the brain and nerve tissues were detected in the cisplatin-administered group. The preventive effects of darbepoetin on the inner ear and brain damage induced by cisplatin are detected by apoptotic protein expressions and oxidative stress-related markers, iNOS and nNOS, Nrf-2 and related HO-1, NQO1, serum GSH, and TNF-α and IL-1β proteins. CONCLUSION: In this study, the protective effects of DPO in ototoxicity caused by cisplatin were demonstrated by reducing apoptosis, increasing antioxidant Nrf-2 and target proteins and glutathione levels, and through anti-inflammatory proteins.

Keywords:

Darbepoetin, Cisplatin, Ototoxicity, Nrf2, antioxidant system,

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