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      Protective Effect of Shikimic Acid against Cisplatin-Induced Renal Injury: In Vitro and In Vivo Studies

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          Abstract

          Nephrotoxicity is a serious side effect of cisplatin, which is one of the most frequently used drugs for cancer treatment. This study aimed to assess the renoprotective effect of Artemisia absinthium extract and its bioactive compound (shikimic acid) against cisplatin-induced renal injury. An in vitro assay was performed in kidney tubular epithelial cells (LLC-PK1) with 50, 100, and 200 µg/mL A. absinthium extract and 25 and 50 µM shikimic acid, and cytotoxicity was induced by 25 µM cisplatin. BALB/c mice (6 weeks old) were injected with 16 mg/kg cisplatin once and orally administered 25 and 50 mg/kg shikimic acid daily for 4 days. The results showed that the A. absinthium extract reversed the decrease in renal cell viability induced by cisplatin, whereas it decreased the reactive oxidative stress accumulation and apoptosis in LLC-PK1 cells. Shikimic acid also reversed the effect on cell viability but decreased oxidative stress and apoptosis in renal cells compared with the levels in the cisplatin-treated group. Furthermore, shikimic acid protected against kidney injury in cisplatin-treated mice by reducing serum creatinine levels. The protective effect of shikimic acid against cisplatin-mediated kidney injury was confirmed by the recovery of histological kidney injury in cisplatin-treated mice. To the best of our knowledge, this study is the first report on the nephroprotective effect of A. absinthium extract and its mechanism of action against cisplatin-induced renal injury.

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          Mechanisms of Cisplatin Nephrotoxicity

          Cisplatin is a widely used and highly effective cancer chemotherapeutic agent. One of the limiting side effects of cisplatin use is nephrotoxicity. Research over the past 10 years has uncovered many of the cellular mechanisms which underlie cisplatin-induced renal cell death. It has also become apparent that inflammation provoked by injury to renal epithelial cells serves to amplify kidney injury and dysfunction in vivo. This review summarizes recent advances in our understanding of cisplatin nephrotoxicity and discusses how these advances might lead to more effective prevention.
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            The side effects of platinum-based chemotherapy drugs: a review for chemists

            The platinum chemotherapy drugs cisplatin, carboplatin, and oxaliplatin are known to cause seven different types of side effects in patients. The platinum-based drugs cisplatin, carboplatin and oxaliplatin are regularly prescribed in the treatment of cancer and while they are effective, their use is limited by their severe, dose-limiting side effects (also referred to as adverse effects/events). In total, a cancer patient can experience any combination of around 40 specific side effects. The dose-limiting side effect for cisplatin is nephrotoxicity, for carboplatin it is myelosuppression, and for oxaliplatin it is neurotoxicity. Other common side effects include anaphylaxis, cytopenias (including leukopenia and neutropenia, thrombocytopenia, and anaemia), hepatotoxicity, ototoxicity, cardiotoxicity, nausea and vomiting, diarrhea, mucositis, stomatitis, pain, alopecia, anorexia, cachexia, and asthenia. The side effects may require patients to be prescribed dose reductions in their platinum drugs of between 25 and 100%. Furthermore, patients require extensive monitoring of their biochemistries, kidney and liver function, and depending on the drug, hearing tests. Finally, patients are commonly co-prescribed additional non-chemotherapy based drugs to treat the side effects which can include antiemetics, antibiotics and myeloid growth factors, mannitol, propafenone, saline hyperhydration, magnesium supplements, monoclonal antibody cytokine blockers, and antioxidants.
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              Platinum Compounds: a New Class of Potent Antitumour Agents

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                Author and article information

                Journal
                Plants (Basel)
                Plants (Basel)
                plants
                Plants
                MDPI
                2223-7747
                01 December 2020
                December 2020
                : 9
                : 12
                : 1681
                Affiliations
                [1 ]College of Korean Medicine, Gachon University, Seongnam 13120, Korea; jklee9441@ 123456hanmail.net (J.L.), nnquynh173@ 123456gmail.com (Q.N.N.); seoul@ 123456gachon.ac.kr (G.S.H.); norikoy@ 123456gachon.ac.kr (N.Y.)
                [2 ]Department of Food Science and Biotechnology, Kyonggi University, Suwon 16227, Korea; rhemf@ 123456kgu.ac.kr
                [3 ]College of Bio-Nano Technology, Gachon University, Seongnam-si, Gyeonggi-do 13120, Korea; sullimlee@ 123456gachon.ac.kr
                Author notes
                [* ]Correspondence: pc1075@ 123456gachon.ac.kr (S.C.); kkang@ 123456gachon.ac.kr (K.S.K.); Tel.: +82-32-770-1343 (S.C.); +82-31-750-5402 (K.S.K.)
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0003-2553-3690
                https://orcid.org/0000-0002-4187-2177
                Article
                plants-09-01681
                10.3390/plants9121681
                7759863
                33271750
                54867142-5d78-4d00-b0db-6cfde8ba0b6b
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 28 September 2020
                : 26 November 2020
                Categories
                Article

                artemisia absinthium,shikimic acid,cisplatin,nephrotoxicity,apoptosis

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