Involvement of NOX-4/JAK/STAT pathway in the protective effect of aprepitant against diclofenac-induced renal toxicity

Life Sci. 2022 Apr 1:294:120381. doi: 10.1016/j.lfs.2022.120381. Epub 2022 Feb 8.

Abstract

Aims: Aprepitant, a neurokinin-1 (NK1) receptor antagonist, is a clinically approved anti-emetic drug. Recently, inhibition of the NK1 receptor has been reported as a potential nephroprotective strategy. We aimed to assess the pharmacological mechanisms of aprepitant against diclofenac (DIC)-induced renal toxicity.

Main methods: An in vivo study was conducted using twenty-four male Wistar rats, divided into 4 groups. Aprepitant was administered for 5 days (5 mg/kg/day) with or without DIC which was given on the 4th and 5th days (50 mg/kg, i.p.). At the end of the study, renal function biomarkers, renal oxidative parameters, prostaglandin E (PGE-2), and NADPH oxidase (NOX-4) were measured. Histopathological changes as well as expression of renal inflammatory and apoptotic markers (tumor necrosis factor alpha (TNF-α) and caspase-3) were investigated.

Key findings: DIC caused significant renal damage, as evidenced by deterioration of renal functions, oxidative stress, inflammatory and apoptotic markers, and confirmed by histopathological findings. Pretreatment with aprepitant successfully ameliorated and improved all biochemical and molecular parameters induced by DIC. Moreover, aprepitant restored the decrease in renal PGE-2 concentration and inhibited DIC-activated Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling in renal tissues.

Significance: The protective effect of aprepitant is possibly attributed to its anti-oxidant and anti-inflammatory roles via the NOX-4/JAK/STAT pathway.

Keywords: Aprepitant; Diclofenac; JAK/STAT; NADPH oxidase; Nephrotoxicity.

MeSH terms

  • Animals
  • Aprepitant / pharmacology*
  • Cyclooxygenase Inhibitors / toxicity
  • Diclofenac / toxicity*
  • Gene Expression Regulation / drug effects*
  • Janus Kinase 1 / genetics
  • Janus Kinase 1 / metabolism*
  • Male
  • NADPH Oxidase 4 / genetics
  • NADPH Oxidase 4 / metabolism*
  • Neurokinin-1 Receptor Antagonists / pharmacology
  • Protective Agents / pharmacology
  • Rats
  • Rats, Wistar
  • Renal Insufficiency / chemically induced
  • Renal Insufficiency / drug therapy*
  • Renal Insufficiency / metabolism
  • Renal Insufficiency / pathology
  • STAT3 Transcription Factor / genetics
  • STAT3 Transcription Factor / metabolism*

Substances

  • Cyclooxygenase Inhibitors
  • Neurokinin-1 Receptor Antagonists
  • Protective Agents
  • STAT3 Transcription Factor
  • Stat3 protein, rat
  • Diclofenac
  • Aprepitant
  • NADPH Oxidase 4
  • Nox4 protein, rat
  • Jak1 protein, rat
  • Janus Kinase 1