It is demonstrated that NG and HP could protect ovarian granulosa cells from CIS-induced damage through dual regulation of the Nrf2/heme oxygenase-1 (HO-1) antioxidant and nuclear factor kappa B (NF-κB) inflammatory axis, highlighting their potential as adjuvant therapies to mitigate chemotherapy-induced ovarian toxicity.
Abstract
Cisplatin (CIS) is an effective chemotherapeutic agent whose clinical use is limited by off-target toxicity, including damage to ovarian granulosa cells, characterized by oxidative stress and inflammation. Here, the cytoprotective potential of the citrus flavonoids, naringin (NG) and hesperidin (HP), was investigated in ovarian granulosa cells exposed to CIS-induced toxicity. Molecular docking demonstrated that NG and HP exhibited strong binding affinities for key antioxidant, nuclear factor erythroid 2–related factor 2 (Nrf2) and catalase (CAT) as well as anti-apoptotic B-cell lymphoma-2 (Bcl-2) proteins, while CIS preferentially interacted with pro-apoptotic targets. In vitro, CIS dose-dependently reduced cell viability and hormone secretion (progesterone and estradiol), and these reductions were significantly restored by co-treatment with NG or HP. CIS-induced oxidative injury, marked by elevated accumulation of reactive oxygen species (ROS), lipid peroxidation, and depletion of reduced glutathione (GSH), as well as key antioxidant defenses (superoxide dismutase (SOD) and catalase (CAT), was effectively mitigated by the NG and HP. Furthermore, NG and HP suppressed the CIS-triggered inflammation by inhibiting NF-κB activation and downregulating the release of major pro-inflammatory mediators (tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-8, IL-1β). They also counteracted CIS-induced apoptosis by reducing phosphorylation of protein kinase B (Akt), cytochrome c (Cyt c) release, caspase (Cas) activation, and the Bcl-2-associated X protein (Bax)/Bcl-2 ratio. These findings demonstrated that NG and HP could protect ovarian granulosa cells from CIS-induced damage through dual regulation of the Nrf2/heme oxygenase-1 (HO-1) antioxidant and nuclear factor kappa B (NF-κB) inflammatory axis, highlighting their potential as adjuvant therapies to mitigate chemotherapy-induced ovarian toxicity.
The antioxidant, anti-inflammatory, anti-apoptotic, and Nrf2-pathway-modulating properties of quinic acid markedly attenuate cisplatin-induced acute kidney injury in rats and its impact on the associated oxidative, inflammatory, apoptotic, and Nrf2/HO-1/NQO1 pathways.
Mehdi Goudarzi, Z. Lamoochi, Susan Sabbagh et al.· Immunopharmacology and immun...· 1 citation
N-Cur mitigates oxidative damage and inflammation, thereby preserving hepatic function during CDDP-based chemotherapy, and demonstrates significant potential as a hepatoprotective agent when administered concomitantly with CDDP chemotherapy.
Q. Alqahtani, M. Atteya, T. Almatrafi et al.· Biomedicines· 0 citations
Cyclophosphamide (Cyclo) is an effective chemotherapeutic agent, but its clinical use is limited by severe cardiotoxicity driven by oxidative stress, inflammation, and apoptosis. Natural antioxidants such as carnosic acid (CA) may offer protection. This study aimed to investigate the protective effects of CA against Cyclo-induced cardiotoxicity in rats and to elucidate the underlying molecular mechanisms. Forty male Wistar rats were divided into four groups: control, CA alone, Cyclo alone, and Cyclo + CA. CA was administered orally at 100 mg/kg for 14 days, while Cyclo was injected intraperitoneally at 100 mg/kg on day 14. Cardiac injury was assessed using serum biomarkers, histology, immunohistochemistry (NF-κB, TNF-α, IL-1β, caspase-3), RT-PCR (Keap-1, Nrf2, HO-1, Bax, Bcl-2), and oxidative stress markers. Cyclo significantly elevated serum cardiac injury markers (CK, troponin, and LDH), as well as hepatic injury markers (ALT and AST), and induced severe histopathological damage, including leukocytic infiltration, congestion, edema, and fibrosis. Mechanistically, Cyclo suppressed the Keap1/Nrf2/HO-1 pathway by downregulating Nrf2 and HO-1 while upregulating Keap-1. Cyclo also depleted antioxidant enzyme activities (SOD, GPx, CAT), increased lipid peroxidation (MDA), activated NF-κB-driven pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), and promoted apoptosis via upregulation of Bax and caspase-3 alongside downregulation of Bcl-2. Co-treatment with CA markedly reversed all these pathological changes, restoring antioxidant and Nrf2/HO-1 signaling, reducing inflammatory markers, inhibiting apoptosis, and improving cardiac histology. CA effectively attenuates Cyclo-induced cardiotoxicity through its antioxidant, anti-inflammatory, and anti-apoptotic properties. These protective effects are likely associated with modulation of the Keap-1/Nrf2/HO-1 and NF-κB signaling pathways, highlighting CA’s therapeutic potential as a natural cardioprotective agent in chemotherapy-associated cardiac injury. Proposed schematic representation of the cardioprotective mechanism of CA against Cyclo-induced cardiotoxicity based on the present findings and previously published literature. Cyclophosphamide exposure leads to cardiac damage through the induction of oxidative stress, inflammation (NF-κB-mediated), and disorganization of cardiac histology, ultimately resulting in cardiotoxicity. Carnosic Acid mitigates this damage by activating the KEAP-1/NRF2/HO-1 pathway. This activation inhibits cytosolic Nrf2 degradation, allowing it to translocate to the nucleus and activate the Antioxidant Response Element (ARE). Concurrently, CA inhibits the NF-κB cascade, reducing the expression of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6). The combined effect is a reduction in oxidative stress (↓ROS, ↓MDA), inflammation, and apoptosis (as indicated by modulated Bax, Bcl-2, and Caspase-3), leading to decreased serum injury markers (CK, LDH, Troponin, AST, ALT, MDA), improved cardiac histology, and mitigation of cardiotoxicity.
Basma Salah, A. Abdelmonsef, Medhat Taha et al.· Bratislava Medical Journal· 0 citations
The protective mechanism involves anti-oxidant enhancement and inhibition of oxidative stress-induced inflammation and apoptosis, supporting the therapeutic potential of HSP in managing phthalate-related renal injury.
Tuba Karaarslan, B. Yıldırım, F. Yildirim et al.· Iranian Journal of Basic Med...· 0 citations
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