Concerted outcome of metformin and low dose of radiation in modulation of cisplatin induced uremic encephalopathy via renal and neural preservation

Life Sci. 2021 Jul 1:276:119429. doi: 10.1016/j.lfs.2021.119429. Epub 2021 Mar 27.

Abstract

Aim: The therapeutic expediency of cisplatin was limited due to its nephrotoxic side effects, so this study planned to assess the nephrotic and neuroprotective impact of metformin (MET) and low-dose radiation (LDR) in cisplatin-prompted kidney injury and uremic encephalopathy (UE).

Methods: The effect of the 10-day MET treatment (200 mg/kg, orally) and/or fractionated LDR (0.25 Gy, of the total dose of 0.5 Gy, 1st and 7th day, respectively) on (5 mg/kg, intraperitoneally) cisplatin as a single dose was administered at the 5th day. Serum urea, creatinine and renal kidney injury molecule-1 were measured for the assessment of kidney function. Furthermore, the antioxidant potential in the renal and brain tissues was evaluated through, malondialdehyde and reduced glutathione estimation. Moreover, renal apoptotic markers: AMP-activated protein kinase, lipocalin, B-cell lymphoma 2 associated X protein, B-cell lymphoma 2, P53 and beclin 1 were estimated. UE was evaluated through the determination of serum inflammatory markers: nuclear factor kappa B, tumor-necrosis factor-α and interleukin 1 beta likewise, the cognitive deficits were assessed via forced swimming test, gamma-aminobutyric acid, n-methyl-d-aspartate and neuronal nitric oxide synthases besides AMP-activated protein kinase, light chain 3 and caspase3 levels in rats' cerebella.

Key findings: The obtained results revealed a noticeable improvement in the previously mentioned biochemical factors and behavioral tasks that was reinforced by histopathological examination when using the present remedy.

Significance: metformin and low doses of radiation afforded renoprotection and neuroprotection against cisplatin-induced acute uremic encephalopathy.

Keywords: Cisplatin; Low dose radiation; Metformin; Uremic encephalopathy.

MeSH terms

  • Animals
  • Antineoplastic Agents / toxicity
  • Biomarkers / metabolism*
  • Brain Diseases / chemically induced
  • Brain Diseases / metabolism
  • Brain Diseases / pathology
  • Brain Diseases / prevention & control*
  • Cisplatin / toxicity*
  • Dose-Response Relationship, Radiation
  • Gamma Rays*
  • Glutathione / metabolism
  • Hypoglycemic Agents / pharmacology
  • Male
  • Metformin / pharmacology*
  • NF-kappa B / metabolism
  • Neuroprotective Agents / pharmacology*
  • Oxidative Stress
  • Rats
  • Tumor Necrosis Factor-alpha / metabolism
  • Uremia / chemically induced
  • Uremia / metabolism
  • Uremia / pathology
  • Uremia / prevention & control*

Substances

  • Antineoplastic Agents
  • Biomarkers
  • Hypoglycemic Agents
  • NF-kappa B
  • Neuroprotective Agents
  • Tumor Necrosis Factor-alpha
  • Metformin
  • Glutathione
  • Cisplatin