dr.Ayad A Hussein.....The protection from cisplatin nephrotoxicity by herbal extracts

Cisplatin-induced nephrotoxicity is a dose-limiting side effect facing cisplatin-based chemotherapy of a wide variety of cancers. Acute kidney injury (AKI) occurs after cisplatin chemotherapy in approximately 20-30% of patients. AKI stills a significant cause of increased morbidity and mortality. Severe and lifelong nephrotoxicity can result regardless of the use of currently available preventive measures. In spite of scientific efforts to find relatively less toxic but equally effective substitutes, cisplatin continues to be widely involved in chemotherapy as first line antitumor agent.

    Apoptosis and necrosis, due to DNA damage response pathways, oxidative stress in association with severe inflammatory response and caspase activation, are the major source of acute kidney injury due to cisplatin.

    There is increasing evidence that dietary phytoestrogens present primarily in soybeans as isoflavones have a beneficial role in chronic renal disease. Nutritional intervention studies have shown that consumption of soy-based protein reduces proteinuria and attenuates renal functional or structural damage in animals and humans with various forms of chronic renal disease and AKI that caused by cisplatin.

   Curcumin, an extract of Curcuma longa Linn., is used as a natural drug or a flavoring in Asia and India. Curcumin is an orange-yellow polyphenol present in curry spice and has anti-inflammatory and antioxidant effects. Early studies have also claimed that curcumin down-regulates the transcription factor NFkB and suppresses various inflammatory mediators. Curcumin attenuates cisplatin-induced nephrotoxicity and therefore represents a potential therapeutic strategy for renal injury caused by cisplatin.

      Rosemary, a well known aromatic plant, has been used in the food industry to flavour and to prevent oxidation of meat or stews. Rosemary oil finds use in the production of bath products, detergents and insecticides. The published data on the antioxidant effect of rosemary extracts is attributed to the phenolic diterpenes such as carnosol, carnosic acid, methyl carnosate and phenolic acids such as rosmarinic and caffeic acids. Carnosic acid, a naturally occurring catechol type poly-phenolic diterpene present in rosemary (Rosmarinus officinalis; Lamiaceae) has a wide array of pharmacological and biological activities such as antioxidant, antimicrobial, neuroprotective, hepatoprotective, antiobesity, anti-inflammatory, anticancer  and antidepressant properties. Administration of carnosic acid protected from nephrotoxicity by its antioxidant and antiapoptotic properties.

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