Luteolin Reduces Blood Pressure via Down-regulation of Renal Angiotensin II Receptor and Mineralocorticoid Receptor Expressions in Rats Co-exposed to Diclofenac and Sodium Fluoride

This study was designed to investigate the modulatory role of Luteolin (Lut) on haemodynamic parameters and the potential mechanisms involving renal Angiotensin II (AT2R) and Mineralocorticoid (MCR) receptors in renal toxicity induced by co-exposure to Diclofenac (Dcf) and sodium fluoride (NaF) in rats. Male Wistar rats were administered with either vehicle (control), Dcf only (9 mg/kg orally) or concurrently with NaF (300 ppm in drinking water). Other groups were treated with LutA (100 mg/kg) or LutB (200 mg/kg) along with Dcf and NaF exposures. All treatments lasted 8 days, following which blood pressure indices were measured using tail-cuff plethysmography. Renal expressions of AT2R and MCR were studied with immunohistochemistry, while biomarkers of oxidative and antioxidant status were also measured in the kidneys. Systolic, diastolic and mean arterial pressures were significantly (p<0.05) reduced in Dcf-treated rats, compared to control values. However, co-treatment with NaF or Lut restored these parameters. While the expression of AT2R and MCR was high in the Dcf and Dcf+NaF groups, treatment with Lut caused obvious reduction in the renal expression of these receptors. Increased lipid peroxidation (Malondialdehyde) and protein oxidation (protein carbonyls) with a lowering of reduced glutathione levels contributed to the renal toxicity of Dcf, which was significantly ameliorated in Lut-treated rats. The protective effect of Lut on blood pressure was probably mediated by stimulation of renal expressions of AT2R and MCR, reduction of oxidative stress and an improvement of renal antioxidant status.

Protective Effect of Gallic Acid Against Thioacetamide Induced Metabolic Dysfunction of Lipids and Hepatic and Renal Toxicity

BackgroundGallic acid (GA) has a potential antioxidant bio-activity and inhibits diet-induced hypertriglyceridemia with reducing the size of adipocytes. GA also was found to increase the uptake of glucose by cell.MethodsThe present research studied the influence of gallic acid (GA) (100mg, 200 mg/Kg orally) on the liver and kidney injuries motivated by thioacetamide (TAA; 100 mg/Kg IP). The treatment of TAA was carried out three times weekly for eight weeks, while gallic acid was given daily. ResultsGA relieved the decrease of hepatic or renal reduced glutathione (GSH) or increase of malondialdehyde (MDA, an indicator for lipid peroxidation) induced by TAA. TAA treatment led to a significant increase in plasma inflammatory markers (TNF-α, CRP), liver enzymes (Gamma-glutamyltransferase (GGT), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), alkaline phosphatase (ALP) and kidney function parameters (creatinine, urea, uric acid). However, these parameters were reduced after treatment with GA. Moreover, GA reduced the significant decline in plasma protein induced by TAA. In addition, the hepatic fibrosis or histopathological changes of the liver and kidney were lowered by GA. ConclusionOur results suggested that GA may attenuate TAA induced liver and kidney toxicity via suppression of oxidative stress.

Nano-Structured Lipid Carrier-Based Oral Glutathione Formulation Mediates Renoprotection against Cyclophosphamide-Induced Nephrotoxicity, and Improves Oral Bioavailability of Glutathione Confirmed through RP-HPLC Micellar Liquid Chromatography

The study aimed to develop a new glutathione (GSH) oral formulation to enhance the delivery of GSH and counter the nephrotoxicity of the anticancer drug, cyclophosphamide (CP). A nanostructured lipid carrier glutathione formulation (GSH-NLCs) composed of glutathione (500 mg), stearic and oleic acid (300 mg, each), and Tween® 80 (2%, w/v) was prepared through the emulsification-solvent-evaporation technique, which exhibited a 452.4 ± 33.19 nm spheroidal-sized particulate material with narrow particle size distributions, −38.5 ± 1.4 mV zeta potential, and an entrapment efficiency of 79.8 ± 1.9%. The GSH formulation was orally delivered, and biologically tested to ameliorate the CP-induced renal toxicity in a rat model. Detailed renal morphology, before and after the GSH-NLCs administration, including the histopathological examinations, confirmed the ameliorating effects of the prepared glutathione formulation together with its safe oral delivery. CP-induced oxidative stress, superoxide dismutase depletion, elevation of malondialdehyde levels, depletion of Bcl-2 concentration levels, and upregulated NF-KB levels were observed and were controlled within the recommended and near normal/control levels. Additionally, the inflammatory mediator marker, IL-1β, serum levels were marginally normalized by delivery of the GHS-NLCs formulation. Oral administration of the pure glutathione did not exhibit any ameliorating effects on the renal tissues, which suggested that the pure glutathione is reactive and is chemically transformed during the oral delivery, which affected its pharmacological action at the renal site. The protective effects of the GSH-NLCs formulation through its antioxidant and anti-inflammatory effects suggested its prominent role in containing CP-induced renal toxicity and renal tissue damage, together with the possibility of administrating higher doses of the anticancer drug, cyclophosphamide, to achieve higher and effective anticancer action in combination with the GSH-NLCs formulation.

Durable response after immunotherapy discontinuation for delayed and severe immune-related adverse event: a case report

Recent studies have shown that immune-related adverse events (irAEs), occurring even after the discontinuation of immune checkpoint inhibitors (ICIs), may be associated with favorable disease outcomes, particularly in patients with melanoma and lung cancer. However, a few clinical cases have been described on the correlation between irAEs and ICIs efficacy in renal cell carcinoma (RCC) patients. This study reports the clinical case of a metastatic RCC patient who has experienced severe immune-related renal toxicity after 19 months of nivolumab use. Despite immunotherapy discontinuation, the patient has maintained clinical benefit and disease progression-free for 3 years. We examined the correlation between the occurrence and the severity of irAEs, treatment discontinuation and clinical benefits. The evidence on ICI retreatment following ICI discontinuation due to irAEs was also reviewed.