Mostafa Fatma, Mantawy Eman M, Said Riham S, Azab Samar S, El-Demerdash Ebtehal
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
Department of Drug Radiation Research, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt.
Psychopharmacology (Berl). 2025 Mar;242(3):563-578. doi: 10.1007/s00213-024-06706-6. Epub 2025 Jan 15.
One of the most debilitating drawbacks of cisplatin chemotherapy is neurotoxicity which elicits memory impairment and cognitive dysfunction (chemobrain). This is primarily triggered by oxidative stress and inflammation. Captopril, an angiotensin-converting enzyme inhibitor, has been reported as a neuroprotective agent owing to its antioxidant and anti-inflammatory effects.
We examined the possible neuroprotective effect of captopril against cisplatin-induced neurological and behavioral abnormalities in rats.
Chemobrain was induced in rats by cisplatin (5 mg/kg, i.p.) on the 7th and 14th days of the study while captopril was administered orally (25 mg/kg) daily for three weeks. The effects of captopril were assessed by performing behavioral tests, histological examination, and evaluation of oxidative stress and inflammatory markers.
Cisplatin caused learning/memory dysfunction assessed by passive avoidance and Y-maze tests, decline in locomotion, and rotarod motor balance loss which were further verified by neurodegeneration observed in histological examination. Also, cisplatin aggravated oxidative stress by elevating lipid peroxidation (MDA) levels and diminishing catalase activity. Moreover, cisplatin upregulated the neuroinflammatory markers (TNF, IL-6, GFAP, and NF-κB). Captopril successfully ameliorated cisplatin damage on the levels of neurobehavioral and histopathological changes. Mechanistically, captopril significantly diminished MDA production and preserved catalase antioxidant activity. Captopril also counteracted neuroinflammation through inhibiting NF-κB and its downstream proinflammatory cytokines besides repressing astrocyte activity by reducing GFAP expression.
Our findings revealed that captopril could abrogate cisplatin neurotoxicity via reducing oxidative stress and neuroinflammation thus enhancing cognitive and behavioral performance. This could suggest the repurposing of captopril as a neuroprotective agent, especially in hypertensive cancer patients receiving cisplatin.
顺铂化疗最严重的缺点之一是神经毒性,可引发记忆障碍和认知功能障碍(化疗脑)。这主要是由氧化应激和炎症引发的。卡托普利是一种血管紧张素转换酶抑制剂,因其抗氧化和抗炎作用,已被报道为一种神经保护剂。
我们研究了卡托普利对顺铂诱导的大鼠神经和行为异常可能具有的神经保护作用。
在研究的第7天和第14天,通过腹腔注射顺铂(5mg/kg)诱导大鼠出现化疗脑,同时每天口服卡托普利(25mg/kg),持续三周。通过进行行为测试、组织学检查以及评估氧化应激和炎症标志物来评估卡托普利的作用。
通过被动回避和Y迷宫测试评估,顺铂导致学习/记忆功能障碍、运动能力下降以及转棒试验中运动平衡丧失,组织学检查中观察到的神经退行性变进一步证实了这些结果。此外,顺铂通过提高脂质过氧化(丙二醛)水平和降低过氧化氢酶活性加剧了氧化应激。而且,顺铂上调了神经炎症标志物(肿瘤坏死因子、白细胞介素-6、胶质纤维酸性蛋白和核因子-κB)。卡托普利成功改善了顺铂对神经行为和组织病理学变化水平的损害。从机制上讲,卡托普利显著减少了丙二醛的产生并保留了过氧化氢酶的抗氧化活性。卡托普利还通过抑制核因子-κB及其下游促炎细胞因子来对抗神经炎症,此外通过降低胶质纤维酸性蛋白的表达来抑制星形胶质细胞的活性。
我们的研究结果表明,卡托普利可以通过减少氧化应激和神经炎症来消除顺铂的神经毒性,从而提高认知和行为表现。这可能意味着卡托普利可重新用作神经保护剂,特别是在接受顺铂治疗的高血压癌症患者中。