Targeting KEAP1/Nrf2, AKT, and PPAR-γ signals as a potential protective mechanism of diosmin against gentamicin-induced nephrotoxicity

Life Sci. 2021 Jun 15:275:119349. doi: 10.1016/j.lfs.2021.119349. Epub 2021 Mar 17.

Abstract

Aim: Gentamicin (GM) is an aminoglycoside antibiotic effectively used for severe/life-threatening infections. However, the clinical application of GM is limited by nephrotoxic side effects. Diosmin (DS) is a flavonoid with a wide range of bioactivities. However, its therapeutic potential in GM-induced nephrotoxicity remains unclear.

Methods: Rats received GM (100 mg/kg, i.p.) for 7 days either separately or in combination with oral DS (50 mg/kg).

Results: GM injection disrupted kidney function along with oxidant/antioxidant imbalance. Also, GM significantly decreased renal nuclear factor erythroid 2-related factor 2 (Nrf2), glutamyl cysteine synthetase (GCLC), heme oxygenase-1 (HO-1), superoxide dismutase3 (SOD-3), protein kinase B (AKT), and p-AKT expressions along with Kelch-like ECH-associated protein 1 (KEAP1) up-regulation. On the contrary, DS administration significantly attenuated GM-induced kidney dysfunction and restored kidney oxidant/antioxidant status. In addition, co-treatment with DS plus GM significantly enhanced Nrf2, GCLC, HO-1, SOD3, AKT, and p-AKT expressions along with KEAP1 down-regulation. Additionally, GM-treated rats exhibited a significant decrease in the expressions of renal peroxisome-proliferator activated receptor-gamma (PPAR-γ) and this reduction was alleviated by DS treatment. Furthermore, histopathological findings demonstrated that DS significantly reduced the GM-induced histological abrasions. Besides, an in-silico study was conducted to confirm our biochemical results. Interestingly, in-silico results strongly supported our biochemical investigation by studying the binding affinity of DS to KEAP1, AKT, and PPAR-γ proteins.

Significance: DS could be a promising protective agent against GM-induced nephrotoxicity through targeting of KEAP1/Nrf2/ARE, AKT, and PPAR-γ signaling pathways.

Keywords: Diosmin; Gentamicin; KEAP1/Nrf2/ARE; P-AKT/AKT; PPAR-γ.

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / pathology
  • Acute Kidney Injury / prevention & control
  • Animals
  • Blotting, Western
  • Creatinine / blood
  • Diosmin / pharmacology
  • Diosmin / therapeutic use*
  • Gentamicins / toxicity*
  • Kelch-Like ECH-Associated Protein 1 / metabolism*
  • Kidney / drug effects
  • Kidney / pathology
  • Male
  • NF-E2-Related Factor 2 / metabolism
  • Oncogene Protein v-akt / metabolism*
  • PPAR gamma / metabolism*
  • Rats
  • Rats, Wistar
  • Signal Transduction / drug effects*
  • Urea / blood
  • Uric Acid / blood

Substances

  • Gentamicins
  • KEAP1 protein, rat
  • Kelch-Like ECH-Associated Protein 1
  • NF-E2-Related Factor 2
  • Nfe2l2 protein, rat
  • PPAR gamma
  • PPAR gamma, rat
  • Uric Acid
  • Diosmin
  • Urea
  • Creatinine
  • Oncogene Protein v-akt