Department of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.
Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan.
Clin Transl Sci. 2023 Nov;16(11):2369-2381. doi: 10.1111/cts.13638. Epub 2023 Sep 25.
Cisplatin treatment is effective against several types of carcinomas. However, it frequently leads to kidney injury, which warrants effective prevention methods. Sodium valproic acid is a prophylactic drug candidate with a high potential for clinical application against cisplatin-induced kidney injury. Therefore, in this study, we aimed to elucidate the mechanism underlying the prophylactic effect of valproic acid on cisplatin-induced kidney injury in a mouse model and HK2 and PODO cells with cisplatin-induced toxicity. In the mouse model of cisplatin-induced kidney injury, various renal function parameters and tubular damage scores were worsened by cisplatin, but they were significantly improved upon combination with valproic acid. No difference was observed in cisplatin accumulation between the cisplatin-treated and valproic acid-treated groups in whole blood and the kidneys. The mRNA expression levels of proximal tubular damage markers, apoptosis markers, and inflammatory cytokines significantly increased in the cisplatin group 72 h after cisplatin administration but significantly decreased upon combination with valproic acid. In HK2 cells, a human proximal tubular cell line, the cisplatin-induced decrease in cell viability was significantly suppressed by co-treatment with valproic acid. Valproic acid may inhibit cisplatin-induced kidney injury by suppressing apoptosis, inflammatory responses, and glomerular damage throughout the kidneys by suppressing proximal tubular cell damage. However, prospective controlled trials need to evaluate these findings before their practical application.
顺铂治疗对几种类型的癌有效。然而,它经常导致肾脏损伤,这需要有效的预防方法。丙戊酸钠是一种具有高临床应用潜力的预防药物候选物,可预防顺铂引起的肾损伤。因此,在这项研究中,我们旨在阐明丙戊酸钠对顺铂诱导的小鼠模型和 HK2 和 PODO 细胞肾毒性的预防作用机制。在顺铂诱导的肾损伤小鼠模型中,各种肾功能参数和肾小管损伤评分因顺铂而恶化,但与丙戊酸钠联合使用时则显著改善。在全血和肾脏中,顺铂处理组和丙戊酸钠处理组之间的顺铂积累没有差异。顺铂给药 72 小时后,顺铂组近端肾小管损伤标志物、凋亡标志物和炎症细胞因子的 mRNA 表达水平显著增加,但与丙戊酸钠联合使用后显著降低。在 HK2 细胞(一种人近端肾小管细胞系)中,丙戊酸钠与顺铂联合治疗可显著抑制顺铂诱导的细胞活力下降。丙戊酸钠可能通过抑制近端肾小管细胞损伤,抑制细胞凋亡、炎症反应和整个肾脏的肾小球损伤,从而抑制顺铂诱导的肾损伤。然而,在实际应用之前,需要前瞻性对照试验来评估这些发现。