The effect of N-acetylcysteine on inflammation and oxidative stress in cisplatin-induced nephrotoxicity: a rat model

The effect of N-acetylcysteine on inflammation and oxidative stress in cisplatin-induced nephrotoxicity: a rat model

Background/Aim:Cisplatin is a highly effective chemotherapeutic agent used in the treatment of solid organ cancers. Besides its chemotherapeutic effectiveness, cisplatin administration is associated with numerous side effects. Of those, the most clinically significant and common effect is nephrotoxicity. Recent studies reported that oxidative stress and inflammation are probably the most important mechanisms that contribute to the nephrotoxicity. N-acetylcysteine (NAC) is an antioxidant and antiinflammatory agent. In the present study, the effects of NAC on cisplatin-induced nephrotoxicity were investigated. Materials and methods: Rats were divided into four groups each including eight rats: CONT, NAC-250, CP, and CP+NAC. Rats in experimental groups were treated intraperitoneally (i.p.) with a single dose of cisplatin (10 mg/kg body weight) and i.p. with NAC (250 mg/kg body weight) for three consecutive days. Nephrotoxicity was determined by plasma BUN and creatinine levels. In tissue samples, myeloperoxidase (MPO), nuclear factor-kappa B (NF-kB), high mobility group box-1 (HMGB-1), total oxidant status (TOS), and total antioxidant status (TAS) levels were measured. Kidneys were analyzed histopathologically as well. Results: It was revealed that cisplatin was not effective on MPO, HMGB-1 and NF-kB levels but did increase TOS levels and decrease TAS levels in tissue samples. Interestingly, NAC elevated MPO and HMGB-1 levels significantly. Nevertheless, NAC ameliorated histological and functional changes in kidney tissues. Conclusion:It is suggested that inflammation has a limited effect on cisplatin nephrotoxicity in this experimental design, and, as reflected by decreased BUN and creatinine levels, NAC can be used as an additional therapeutic agent in standard cisplatin treatment protocols.

___

  • 1. Perše M, Večerić-Haler Ž. Cisplatin-induced rodent model of kidney injury: characteristics and challenges. BioMed Research International 2018; 2018: 1462802.
  • 2. Wang D, Lippard SJ. Cellular processing of platinum anticancer drugs. Nature Reviews Drug Discovery 2005; 4: 307-320.
  • 3. Yao X, Panichpisal K, Kurtzman N, Nugent K. Cisplatin nephrotoxicity: a review. American Journal of the Medical Sciences 2007; 334: 115-124.
  • 4. Florea AM, Büsselberg D. Cisplatin as an anti-tumor drug: cellular mechanisms of activity, drug resistance and induced side effects. Cancers 2011; 3: 1351-1371.
  • 5. Sánchez-González PD, López-Hernández FJ, López-Novoa JM, Morales AI. An integrative view of the pathophysiological events leading to cisplatin nephrotoxicity. Critical Reviews in Toxicology 2011; 41: 803-821.
  • 6. Barabas K, Milner R, Lurie D, Adin C. Cisplatin: a review of toxicities and therapeutic applications. Veterinary and Comparative Oncology 2008; 6: 1-18.
  • 7. Uozumi J, Ueda T, Yasumasu T, Koikawa Y, Naito S et al. Platinum accumulation in the kidney and changes in creatinine clearance following chemotherapy with cisplatin in humans. Urologia Internationalis 1993; 51: 57-61.
  • 8. Samuni Y, Goldstein S, Dean OM, Berk M. The chemistry and biological activities of N-acetylcysteine. Biochimica et Biophysica Acta - General Subjects 2013; 1830: 4117-4129.
  • 9. Atkuri KR, Mantovani JJ, Herzenberg LA, Herzenberg LA. N-Acetylcysteine--a safe antidote for cysteine/glutathione deficiency. Current Opinion in Pharmacology 2007; 7: 355- 359.
  • 10. Zafarullah M, Li WQ, Sylvester J, Ahmad M. Molecular mechanisms of N-acetylcysteine actions. Cellular and Molecular Life Sciences 2003; 60: 6-20.
  • 11. Muldoon LL, Wu YJ, Pagel MA, Neuwelt EA. N-Acetylcysteine chemoprotection without decreased cisplatin antitumor efficacy in pediatric tumor models. Journal of Neuro-Oncology 2015; 121: 433-440.
  • 12. Lowry OH, Rosebrough NJ, Farr AL, Randall RJ. Protein measurement with the Folin phenol reagent. Journal of Biological Chemistry 1951; 193: 265-275.
  • 13. Abdelrahman AM, Al Salam S, Al Mahruqi AS, Al Husseni IS, Mansour MA et al. N-Acetylcysteine improves renal hemodynamics in rats with cisplatin-induced nephrotoxicity. Journal of Applied Toxicology 2010; 30: 15-21.
  • 14. Miller RP, Tadagavadi RK, Ramesh G, Reeves WB. Mechanisms of cisplatin nephrotoxicity. Toxins (Basel) 2010; 2: 2490-2518.
  • 15. Hayati F, Hossainzadeh M, Shayanpour S, Abedi-Gheshlaghi Z, Beladi Mousavi SS. Prevention of cisplatin nephrotoxicity. Journal of Nephropharmacology 2016; 5: 57-60.
  • 16. Manohar S, Leung N. Cisplatin nephrotoxicity: a review of the literature. Journal of Nephrology 2018; 31: 15-25.
  • 17. dos Santos NAG, Carvalho Rodrigues MA, Martins NM, dos Santos AC. Cisplatin-induced nephrotoxicity and targets of nephroprotection: an update. Archives of Toxicology 2012; 86: 1233-1250.
  • 18. Elbini Dhouib I, Jallouli M, Annabi A, Gharbi N, Elfazaa S et al. A minireview on N-acetylcysteine: an old drug with new approaches. Life Sciences 2016; 151: 359-363.
  • 19. Lawrence T. The nuclear factor NF-κB pathway in inflammation. Cold Spring Harbor Perspectives in Biology 2009; 1: a001651.
  • 20. Wu YJ, Muldoon LL, Neuwelt EA. The chemoprotective agent N-acetylcysteine blocks cisplatin-induced apoptosis through caspase signaling pathway. Journal of Pharmacology and Experimental Therapeutics 2005; 312: 424-431.
  • 21. Dickey DT, Muldoon LL, Doolittle ND, Peterson DR, Kraemer DF et al. Effect of N-acetylcysteine route of administration on chemoprotection against cisplatin-induced toxicity in rat models. Cancer Chemotherapy and Pharmacology 2008; 62: 235-241.
  • 22. Abdel-Wahab WM, Moussa FI, Saad NA. Synergistic protective effect of N-acetylcysteine and taurine against cisplatin-induced nephrotoxicity in rats. Drug Design, Development and Therapy 2017; 11: 901-908.
  • 23. Luo J, Tsuji T, Yasuda H, Sun Y, Fujigaki Y et al. The molecular mechanisms of the attenuation of cisplatin-induced acute renal failure by N-acetylcysteine in rats. Nephrology Dialysis Transplantation 2008; 23: 2198-2205.
  • 24. Shalby AB, Assaf N, Ahmed HH. Possible mechanisms for N-acetyl cysteine and taurine in ameliorating acute renal failure induced by cisplatin in rats. Toxicology Mechanisms and Methods 2011; 21: 538-546.
  • 25. Mishima K, Baba A, Matsuo M, Itoh Y, Oishi R. Protective effect of cyclic AMP against cisplatin-induced nephrotoxicity. Free Radical Biology and Medicine 2006; 40: 1564-1577.
  • 26. Shahid F, Farooqui Z, Khan F. Cisplatin-induced gastrointestinal toxicity: an update on possible mechanisms and on available gastroprotective strategies. European Journal of Pharmacology 2018; 827: 49-57.
  • 27. Karakoc HT, Altintas R, Parlakpinar H, Polat A, Samdanci E et al. Protective effects of molsidomine against cisplatininduced nephrotoxicity. Advances in Clinical and Experimental Medicine 2015; 24: 585-593.
  • 28. Ashrafi F, Nematbakhsh M, Safari T, Talebi A, Nasri H et al. A combination of vitamin C and losartan for cisplatin-induced nephrotoxicity in rats. Iranian Journal of Kidney Diseases 2012; 6: 361-365.
  • 29. Francescato HDC, Coimbra TM, Costa RS, Bianchi MLP. Protective effect of quercetin on the evolution of cisplatininduced acute tubular necrosis. Kidney and Blood Pressure Research 2004; 27: 148-158.
  • 30. Bhat SG, Mishra S, Mei Y, Nie Z, Whitworth CA et al. Cisplatin up-regulates the adenosine A(1) receptor in the rat kidney. European Journal of Pharmacology 2002; 442: 251-264.
  • 31. Appenroth D, Winnefeld K, Schröter H, Rost M. Beneficial effect of acetylcysteine on cisplatin nephrotoxicity in rats. Journal of Applied Toxicology 1993; 13: 189-192.
  • 32. Matsushima H, Yonemura K, Ohishi K, Hishida A. The role of oxygen free radicals in cisplatin-induced acute renal failure in rats. Journal of Laboratory and Clinical Medicine 1998; 131: 518-526.
  • 33. Arany I, Safirstein RL. Cisplatin nephrotoxicity. Seminars in Nephrology 2003; 23: 460-464.
  • 34. Topcu-Tarladacalisir Y, Sapmaz-Metin M, Karaca T. Curcumin counteracts cisplatin-induced nephrotoxicity by preventing renal tubular cell apoptosis. Renal Failure 2016; 38: 1741-1748.
  • 35. Faubel S, Lewis EC, Reznikov L, Ljubanovic D, Hoke TS et al. Cisplatin-induced acute renal failure is associated with an increase in the cytokines interleukin (IL)-1β, IL-18, IL-6, and neutrophil infiltration in the kidney. Journal of Pharmacology and Experimental Therapeutics 2007; 322: 8-15.
  • 36. Ueta E, Osaki T. Suppression by anticancer agents of reactive oxygen generation from polymorphonuclear leukocytes. Free Radical Research 1996; 24: 39-53.
  • 37. Sahu BD, Kalvala AK, Koneru M, Mahesh Kumar J, Kuncha M et al. Ameliorative effect of fisetin on cisplatin-induced nephrotoxicity in rats via modulation of NF-κB activation and antioxidant defence. PLoS One 2014; 9: e105070.
  • 38. Sherif IO. Amelioration of cisplatin-induced nephrotoxicity in rats by triterpenoid saponin of Terminalia arjuna. Clinical and Experimental Nephrology 2015; 19: 591-597.
  • 39. Sahin K, Tuzcu M, Gencoglu H, Dogukan A, Timurkan M et al. Epigallocatechin-3-gallate activates Nrf2/HO-1 signaling pathway in cisplatin-induced nephrotoxicity in rats. Life Sciences 2010; 87: 240-245.
  • 40. Kasparkova J, Thibault T, Kostrhunova H, Stepankova J, Vojtiskova M et al. Different affinity of nuclear factor-kappa B proteins to DNA modified by antitumor cisplatin and its clinically ineffective trans isomer. FEBS Journal 2014; 281: 1393-1408.
  • 41. Morgan MJ, Liu Z. Crosstalk of reactive oxygen species and NF-κB signaling. Cell Research 2011; 21: 103-115.
  • 42. Liu J, Yoshida Y, Yamashita U. DNA-binding activity of NF-κB and phosphorylation of p65 are induced by N-acetylcysteine through phosphatidylinositol (PI) 3-kinase. Molecular Immunology 2008; 45: 3984-3989.
  • 43. Vénéreau E, Ceriotti C, Bianchi ME. DAMPs from cell death to new life. Frontiers in Immunology 2015; 6: 422.
  • 44. Park S, Lippard SJ. Redox state-dependent interaction of HMGB1 and cisplatin-modified DNA. Biochemistry 2011; 50: 2567-2574.
  • 45. Park S, Yoon SP, Kim J. Cisplatin induces primary necrosis through poly[ADP-ribose) polymerase 1 activation in kidney proximal tubular cells. Anatomy & Cell Biology 2015; 48: 66-74.
  • 46. Wu H, Li R, Wei ZH, Zhang XL, Chen JZ et al. Diabetesinduced oxidative stress in endothelial progenitor cells may be sustained by a positive feedback loop involving high mobility group box-1. Oxidative Medicine and Cellular Longevity 2016; 2016: 1943918.
  • 47. Yang WS, Kim JS, Han NJ, Lee MJ, Park SK. Toll-like receptor 4/spleen tyrosine kinase complex in high glucose signal transduction of proximal tubular epithelial cells. Cellular Physiology and Biochemistry 2015; 35: 2309-2319.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Ömer KARACA, Hüseyin Ulaş PINAR, Ahmet Fevzi ÖZGÜR, Sevsen KULAKSIZOĞLU, Rafi DOĞAN

Assessment of the visual pathways in patients with neurofibromatosis-1 by 3S-space technique with 3-Tesla MRI

Ali VARAN, Banu ANLAR, Tülay KANSU, Mehmet BEYAZAL, Özge SARAÇ, Oktay ALGIN

Mustafa ÇALIŞKAN, Selvihan BEYSEL, Muhammed KIZILGÜL, Mustafa ÖZBEK, Erman ÇAKAL

Serkan GÖKASLAN, Çiğdem Özer GÖKASLAN, Emin DEMİREL, Sefa ÇELİK

The effect of parathyroidectomy on bone mineral density in primary hyperparathyroidism

Mustafa ÖZBEK, Muhammed KIZILGÜL, Mustafa ÇALIŞKAN, Erman ÇAKAL, Selvihan BEYSEL

Tevfik ÖZLÜ, Mehtap Pehlivanlar KÜÇÜK, Akin KAYA, Esra YARAR, Sami Cenk KIRAKLI, Özlem Şengören DİKİŞ, Hale Kefeli ÇELİK, Serdar ÖZKAN, Hayriye Bektaş AKSOY, Ahmet Oğuzhan KÜÇÜK

İnayet GÜNTÜRK, Cevat YAZICI, Sema Kader KÖSE, Fatma DAĞLI, Bilal YÜCEL, Arzu Hanim YAY

Does transrectal ultrasonography-guided biopsy of the prostate lead to possible further metastasis via circulating tumor cells?

Mahmut ULUBAY, Mustafa Kemal ATİLLA, Bahattin AVCI, Alper BİTKİN, Mevlüt KELEŞ, İnci YÜCEL, Lokman İRKILATA, Mustafa AYDIN

Ayşegül CEYLAN, İbrahim AŞIK, Güngör Enver ÖZGENCİL, Burak ERKEN

Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV Mortality Prediction Score (IMPRES

Akın KAYA, Cenk KIRAKLI, Mehtap PEHLİVANLAR KÜÇÜK, Esra YARAR, Hayriye BEKTAŞ AKSOY, Özlem ŞENGÖREN DİKİŞ, Hale KEFELİ ÇELİK, Serdar ÖZKAN, Tevfik ÖZLÜ, Ahmet Oğuzhan KÜÇÜK