Probing the Nephroprotective Potential of Chrysin against Methotrexate-Induced Tubulointerstitial Nephritis and Oxidative Damage
Main Article Content
Abstract
In a bid to treat cancer, there may be a possibility of adverse consequences for tissues such as the kidneys. Methotrexate is an effective drug of choice used in high dosages as a first-line treatment in the management of cancer. Nevertheless, it can induce tubulointerstitial nephritis (TIN), which may finally result in renal failure. Therefore, there is need to identify substances that can alleviate and protect the kidneys from such TIN, and, by extension, provide a safe environment to be co-administered with methotrexate. The study aimed to probe the nephroprotective efficacy of chrysin on the kidneys against methotrexate-induced TIN. A total of 25 adult female Wistar rats with an average weight of 200 g were randomly segregated into five (A-E, n = 5). Group A was allowed feed and water only, serving as the normal control. Group B received 20 mg/kg bw of methotrexate only. Group C received chrysin (100 mg/kg bw). In groups D and E, methotrexate administration was followed by chrysin treatment in low (50 mg/kg bw) and high (100 mg/kg bw) dosages, respectively. The results obtained from the study demonstrated significant attenuation of serum urea, creatinine, and electrolyte disturbances, attenuation of oxidative stress (superoxide dismutase, glutathione peroxidase, and catalase), and lipid peroxidation via malondialdehyde optimization while preserving the histoarchitecture of the kidneys of rats treated with chrysin in high dosage. The extrapolation from this study proposes the nephroprotective effect of high-dose chrysin against methotrexate-induced tubulointerstitial nephritis by suppressing oxidative stress and inflammation in the renal parenchyma.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
May J, Carson KR, Butler S, Liu W, Bartlett NL, Wagner-Johnston ND. High incidence of methotrexate associated renal toxicity in patients with lymphoma: a retrospective analysis. Leuk Lymphoma. 2014; 55(6): 1345-1349.
Babiak RM, Campello AP, Carnieri EGS, Oliveira MBM. Methotrexate: pentose cycle and oxidative stress; in Cell Biochemistry and its modulation by active agents or disease. Cell Biochem Func. 1998; 16(4): 283-293.
Bannwarth B, Péhourcq F, Schaeverbeke T, Dehais J. Clinical pharmacokinetics of low-dose pulse methotrexate in rheumatoid arthritis. Clin Pharmacokinet. 1996; 30(3): 194-210.
Ciarimboli G, Holle SK, Vollenbröcker B, Hagos Y, Reuter S, Burckhardt G, Bierer S, Herrmann E, Pavenstädt H, Rossi R, Kleta R. New Clues for Nephrotoxicity Induced by Ifosfamide: Preferential Renal Uptake via the Human Organic Cation Transporter 2. Mol Pharm. 2011; 8(1): 270-279.
Perazella MA. Renal Vulnerability to Drug Toxicity. Clin J Am Soc Nephrol. 2009; 4(7): 1275.
Hughes KS, Ambinder EP, Hess GP, Yu PP, Bernstam EV, Routbort MJ, Clemenceau JR, Hamm JT, Febbo PG, Domchek SM, Chen JL. Identifying Health Information Technology Needs of Oncologists to Facilitate the Adoption of Genomic Medicine: Recommendations From the 2016 American Society of Clinical Oncology Omics and Precision Oncology Workshop. J Clin Oncol. 2017; 35(27): 3153-3159.
Birtle AJ, Jones R, Chester J, Lewis R, Biscombe K, Johnson M, Blacker A, Bryan RT, Catto JW, Choudhury A, Das P. Improved disease-free survival with adjuvant chemotherapy after nephroureterectomy for upper tract urothelial cancer: final results of the POUT trial. J Clin Oncol. 2024; 42(13): 1466-1471.
Malyszko J, Lee MW, Capasso G, Kulicki P, Matuszkiewicz-Rowinska J, Ronco P, Stevens P, Tesarova P, Viggiano D, Capasso A. How to assess kidney function in oncology patients. Kidney Int. 2020; 97(5): 894-903.
Muto S, Matsubara T, Inoue T, Kitamura H, Yamamoto K, Ishii T, Yazawa M, Yamamoto R, Okada N, Mori K, Yamada H. Chapter 1: Evaluation of kidney function in patients undergoing anticancer drug therapy, from clinical practice guidelines for the management of kidney injury during anticancer drug therapy. Int J Clin Oncol. 2023; 28(10): 1259-1297.
Funakoshi Y, Fujiwara Y, Kiyota N, Mukohara T, Shimada T, Toyoda M, Imamura Y, Chayahara N, Tomioka H, Umezu M, Otsuki N. Validity of new methods to evaluate renal function in cancer patients treated with cisplatin. Cancer Chemother Pharmacol. 2016; 77: 281-288.
Ramalanjaona B, Hevroni G, Cham S, Page C, O. Salifu M, I. McFarlane S. Nephrotoxicity Associated with Low-dose Methotrexate and Outpatient Parenteral Microbial Therapy: A Case Report, Review of the Literature and Pathophysiologic Insights. Am J Med Case Rep. 2020; 8(11): 400-404.
Shirali AC, Perazella MA. Tubulointerstitial injury associated with chemotherapeutic agents. Adv Kidney Dis Health. 2014; 21(1): 56-63.
Egwuatu IA, Anyanwu EG, Oviosun A, Chukwuebuka AJ, Ozoemena CL, Ugbor EV, Godswill MA. Ameliorative Effects of 5-7, Dihydroxy Flavone (Chrysin) on Hippocampus of Wistar Rats with Doxorubicin-induced Cognitive Impairment. J Complement Altern Med Res. 2023; 22(2): 49–61.
Egwuatu IA, Ozoemena CL, Ugwuishi EW, Ozor CC, Oviosun A, Onwene F. Deciphering the Ameliorative Potential of 5, 7-dihydroxyflavone (Chrysin) on Doxorubicin-Induced Cardiotoxicity by Modulating Oxidative Stress in Rats. Sch Int J Anat Physiol. 2023; 6(11): 180-191.
National Research Council. Guide for the Care and Use of Laboratory Animals. (8th ed.). Washington, DC: The National Academies Press; 2011.
Şen HS, Şen V, Bozkurt M, Türkçü G, Güzel A, Sezgi C, Abakay Ö, Kaplan I. Carvacrol and Pomegranate Extract in Treating Methotrexate-Induced Lung Oxidative Injury in Rats. Med Sci Monit Int Med J Exp Clin Res. 2014; 20: 1983-1990.
Orororo OC, Mordi JC, Opute UA, Efejene IO, Egbune EO,Busari AA, Badmos K, Obadiah CC, Akinshipo WA. Black Seed Oil-induced Amelioration of Renal Dysfunction in a Rat Model of DiabetesMellitus and Periodontitis. Trop J Nat Prod Res. 2023; 7(7): 3524-3531.
Marklund S, Marklund G. Involvement of the superoxide anion radical in the autoxidation of pyrogallol and a convenient assay for superoxide dismutase. Eur J Biochem. 1974; 47(3): 469-474.
Wendel A. Glutathione peroxidase. Methods Enzymol. 1981; 77: 325-333.
Aebi H. Catalase in vitro. Methods Enzymol. 1984; 105: 121-126.
Satyam SM, Bairy LK, Pirasanthan R, Vaishnav RL. Grape seed extract and zinc containing nutritional food supplement prevents onset and progression of age-related cataract in Wistar rats. J Nutr Health Aging. 2014; 18(5): 524-530.
Kawano M, Mizushima I, Yamaguchi Y, Imai N, Nakashima H, Nishi S, Hisano S, Yamanaka N, Yamamoto M, Takahashi H, Umehara H. Immunohistochemical Characteristics of IgG4-Related Tubulointerstitial Nephritis: Detailed Analysis of 20 Japanese Cases. Int J Rheumatol. 2012; 2012(1): 609795.
Widemann BC, Balis FM, Kempf‐Bielack B, Bielack S, Pratt CB, Ferrari S, Bacci G, Craft AW, Adamson PC. High-dose methotrexate-induced nephrotoxicity in patients with osteosarcoma. Cancer. 2004; 100(10): 2222-2232.
Widemann BC, Adamson PC. Understanding and Managing Methotrexate Nephrotoxicity. The Oncologist. 2006; 11(6): 694-703.
Moledina DG, Perazella MA. Drug-Induced Acute Interstitial Nephritis. Clin J Am Soc Nephrol CJASN. 2017; 12(12): 2046-2049.
Krishnan N, Perazella MA. Drug-induced acute interstitial nephritis: pathology, pathogenesis, and treatment. Iran J Kidney Dis. 2015; 9(1): 3-13.
Hirai T, Yamaga R, Kei M, Hosohata K, Itoh T. Acute Kidney Injury Impacts on Hypokalemia Associated with Yokukansan Preparation: A Retrospective Observational Study. Biol Pharm Bull. 2021; 44(1): 118-124.
Sparks JA, Vanni KM, Sparks MA, Xu C, Santacroce LM, Glynn RJ, Ridker PM, Solomon DH. Effect of Low-Dose Methotrexate on eGFR and Kidney Adverse Events: A Randomized Clinical Trial. J Am Soc Nephrol. 2021; 32(12): 3197.
Hosohata K. Role of Oxidative Stress in Drug-Induced Kidney Injury. Int J Mol Sci. 2016; 17(11): 1826.
Mahadik SP, Evans D, Lal H. Oxidative stress and role of antioxidant and ω-3 essential fatty acid supplementation in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2001; 25: 463-493.
Davis CA, Nick HS, Agarwal A. Manganese Superoxide Dismutase Attenuates Cisplatin-Induced Renal Injury: Importance of Superoxide. J Am Soc Nephrol. 2001; 12(12): 2683.
Bhandari J, Thada PK, Arif H. Tubulointerstitial Nephritis. In: StatPearls [Internet]. StatPearls Publishing; 2024 [cited 2024 May 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557537/