State Key Laboratory of Agricultural Microbiology, College of Animal Science & Technology and College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, China.
Hubei Hongshan Laboratory, Wuhan, 430070, China.
Adv Sci (Weinh). 2024 Jul;11(28):e2400527. doi: 10.1002/advs.202400527. Epub 2024 Apr 30.
Cisplatin-associated acute kidney injury (AKI) is a severe clinical syndrome that significantly restricts the chemotherapeutic application of cisplatin in cancer patients. Ferroptosis, a newly characterized programmed cell death driven by the lethal accumulation of lipid peroxidation, is widely reported to be involved in the pathogenesis of cisplatin-associated AKI. Targeted inhibition of ferroptosis holds great promise for developing novel therapeutics to alleviate AKI. Unfortunately, current ferroptosis inhibitors possess low bioavailability or perform non-specific accumulation in the body, making them inefficient in alleviating cisplatin-associated AKI or inadvertently reducing the anti-tumor efficacy of cisplatin, thus not suitable for clinical application. In this study, a novel selenium nanomaterial, polyacrylic acid-coated selenium-doped carbon dots (SeCD), is rationally developed. SeCD exhibits high biocompatibility and specifically accumulates in the kidney. Administration of SeCD effectively scavenges broad-spectrum reactive oxygen species and significantly facilitates GPX4 expression by releasing selenium, resulting in strong mitigation of ferroptosis in renal tubular epithelial cells and substantial alleviation of cisplatin-associated AKI, without compromising the chemotherapeutic efficacy of cisplatin. This study highlights a novel and promising therapeutic approach for the clinical prevention of AKI in cancer patients undergoing cisplatin chemotherapy.
顺铂相关性急性肾损伤(AKI)是一种严重的临床综合征,显著限制了顺铂在癌症患者中的化疗应用。铁死亡是一种新发现的由脂质过氧化致命积累驱动的程序性细胞死亡,广泛报道与顺铂相关性 AKI 的发病机制有关。靶向抑制铁死亡为开发新型治疗方法以缓解 AKI 提供了巨大的希望。不幸的是,目前的铁死亡抑制剂生物利用度低或在体内非特异性积累,导致其在缓解顺铂相关性 AKI 方面效率低下,或无意中降低顺铂的抗肿瘤疗效,因此不适合临床应用。在本研究中,合理开发了一种新型硒纳米材料,即聚丙烯酸包覆的硒掺杂碳点(SeCD)。SeCD 具有高生物相容性,并且特异性地在肾脏中积累。SeCD 的给药可有效清除广谱活性氧,并通过释放硒显著促进 GPX4 的表达,从而强烈抑制肾小管上皮细胞中的铁死亡,并显著缓解顺铂相关性 AKI,而不影响顺铂的化疗疗效。本研究为癌症患者接受顺铂化疗时临床预防 AKI 提供了一种新颖而有前途的治疗方法。