1
|
Mayyas F. Short-term effect of atorvastatin on renal oxidative stress, inflammation, and fibrosis in a rat model of streptozotocin-induced diabetes. J Diabetes Metab Disord 2025; 24:12. [PMID: 39697866 PMCID: PMC11649593 DOI: 10.1007/s40200-024-01514-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 11/14/2024] [Indexed: 12/20/2024]
Abstract
Objectives Diabetes mellitus (DM) contributes to the development and progression of nephropathy and kidney diseases. Statins are known to have anti-inflammatory and antifibrotic effects. We aimed to test the short-term effect of atorvastatin on renal biomarkers of oxidative damage, inflammation, and fibrosis in a rat model of streptozotocin-induced DM. Methods Wistar rats were divided into; control rats, rats treated with atorvastatin (Ator, oral 40 mg/kg for 6 weeks), DM rats (DM, one intraperitoneal 40 mg/kg streptozotocin), and atorvastatin-treated DM rats (DM + Ator). Renal oxidative stress markers, inflammatory and mitogenic factors were measured. Results Streptozotocin induced an increase in serum glucose, blood urea nitrogen, and creatinine levels. A marked increase in kidney to body weight ratio was found in DM groups. Diabetes resulted in an elevation in inflammatory biomarkers of galectin-3 and endothelin-1. Hyperglycemia induced an increase in lipid peroxides and a decrease in the superoxide dismutase (SOD) antioxidant level in the DM group. A significant increase in the fibrotic factor platelet derived factor-BB (PDGF-BB) expression was documented in the DM group. Six weeks use of atorvastatin normalized kidney endothelin-1, galectin-3, and the PDGF-BB, and attenuated the increase in lipid peroxides and the reduction in SOD levels. Conclusion Our findings suggest that short-term use of atorvastatin may attenuate the substrates for diabetic nephropathy via partial decrease of renal markers of inflammation, oxidative stress, and fibrosis.
Collapse
Affiliation(s)
- Fadia Mayyas
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, P.O. Box 566, Irbid, 21163 Jordan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
2
|
Tian D, Chen Q, Zeng L, Hao Y. The impact of blood lipids and statins on renal function and mortality in patients with diabetic nephropathy: A meta-analysis. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2025; 75:1-22. [PMID: 39686670 DOI: 10.2478/acph-2025-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/12/2024] [Indexed: 12/18/2024]
Abstract
The aim of this study is to explore the impact of blood lipids and statins on renal function and all-cause mortality in patients with diabetic nephropathy (DN). PubMed, Embase, Web of Science, and Cochrane Library were systematically searched until April 9, 2024, for relevant studies of blood lipids and statins on renal function and all-cause mortality in patients with DN. After the selection, total cholesterol levels (TC), total triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), estimated glomerular filtration rate (eGFR), urinary albumin excretion (UAE), serum creati-nine (SCR), end-stage renal disease (ESRD), and all-cause mortality indexes were extracted for finally meta-analysis. In total, 25 papers containing 21,411 patients with DN were finally included in this study. Levels of TC and LDL-C, which are continuous variables, were higher in DN patients who developed ESRD [TC/weighted mean difference (WMD) = 0.517, 95 % confidence interval (CI): (0.223, 0.812), p = 0.001; LDL-C/WMD = 0.449, 95%CI: (0.200, 0.698), p < 0.001]. In addition, this study also observed that statins may reduce UAE levels [WMD = -46.814, 95% CI: (-71.767, -21.861), p < 0.001]. Finally, the survey indicated that statins may be associated with an ESRD reduction [HR = 0.884, 95% CI: (0.784, 0.998), p = 0.045]. Blood lipids, particularly TC and LDL-C, may slow the progression of DN to ESRD. Besides, statins may protect the kidneys by lowering the excretion of UAE levels and reducing the risk of ESRD. Based on the above outcomes, the findings of this study provided robust evidence-based medical support for the future prevention, surveillance, and management of DN.
Collapse
Affiliation(s)
- Dongqin Tian
- 1Department of Nephrology, Zigong First People's Hospital Zigong 643000, Sichuan P.R. China
| | - Qian Chen
- 1Department of Nephrology, Zigong First People's Hospital Zigong 643000, Sichuan P.R. China
| | - Lingli Zeng
- 1Department of Nephrology, Zigong First People's Hospital Zigong 643000, Sichuan P.R. China
| | - Yan Hao
- 1Department of Nephrology, Zigong First People's Hospital Zigong 643000, Sichuan P.R. China
| |
Collapse
|
3
|
Jairoun AA, Ping CC, Ibrahim B, Al Jawamis DF, Al Jaberi AK, Dawoud T, Mohammed KJ, El-Dahiyat F, Shahwan M. Effect of statins and antihyperglycemics on chronic kidney disease in patients with type 2 diabetes mellitus: a retrospective cohort study with a 12-year follow-up. J Pharm Policy Pract 2024; 18:2414293. [PMID: 39776464 PMCID: PMC11703420 DOI: 10.1080/20523211.2024.2414293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 10/02/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Chronic Kidney Disease (CKD) represents a significant worldwide health challenge, with far-reaching implications for both patients and healthcare systems. This study aimed to identify the incidence of CKD at stages 3-5, analyzed the impact of statin and other antihyperglycemic interventions, on the CKD progression in individuals with T2DM. METHODS This was a single-center retrospective cohort study based on data derived from electronic medical records (EMR) of UAE populations with diabetes mellitus, registered at outpatient clinics at Tawam Hospital in Al Ain, UAE, between January 2011 and December 2021. T2DM patients aged ≥ 18 years who had serum HbA1c level ≥ 6.5% and using one of the statin therapies were inclusion criteria. Patients with T1DM, who had undergone permanent renal replacement therapy, with under 1 year of follow-up and missing or incomplete data were excluded from the study. The collected data encompassed socio-demographics, detailed medical history, anthropometric measurements, laboratory analyses, clinical parameters, disease characteristics, and medications. RESULTS Our study included a cohort of 1,003 individuals. We observed 388 subjects developed CKD stages 3-5 across an average monitoring duration of 11.7 years. This resulted in a cumulative incidence of 38.7%, translating to an incidence rate of 38 cases per 1000 person-years. There was a statistically significant difference in the cumulative incidence of CKD stages 3 ± 5 according to statin therapy (P = 0.047). High intensity statin users are more likely to develop a CKD stage 3-5 compared to low/moderate intensity users and to no statin users respectively (44.3% vs 37.9%), (44.3% vs 30.9%). Conversely, the use of Biguanides was associated with a decreased probability of CKD progression (37.9% vs. 52.8%; P = 0.001), whereas Insulin users demonstrated a heightened risk (54.2% vs. 34.1%; P < 0.001). CONCLUSION The findings emphasise the pivotal role of personalised treatment strategies, particularly concerning statin therapy and other medications, in populations at high risk.
Collapse
Affiliation(s)
- Ammar Abdulrahman Jairoun
- Discipline of clinical pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinang, Malaysia
| | - Chong Chee Ping
- Discipline of clinical pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinang, Malaysia
| | | | | | | | - Tasnim Dawoud
- Pharmacy Department, Tawam Hospital, SEHA, Al Ain, United Arab Emirates
| | | | - Faris El-Dahiyat
- Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Moyad Shahwan
- College of Pharmacy and Health Sciences, Ajman University, Ajman, UAE
- Centre of Medical and Bio allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| |
Collapse
|
4
|
Zhang Y, Qu Y, Cai R, Gao J, Xu Q, Zhang L, Kang M, Jia H, Chen Q, Liu Y, Ren F, Zhou MS. Atorvastatin ameliorates diabetic nephropathy through inhibiting oxidative stress and ferroptosis signaling. Eur J Pharmacol 2024; 976:176699. [PMID: 38825302 DOI: 10.1016/j.ejphar.2024.176699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/04/2024]
Abstract
Clinically, statins have long been used for the prevention and treatment of chronic renal diseases, however, the underlying mechanisms are not fully elucidated. The present study investigated the effects of atorvastatin on diabetes renal injury and ferroptosis signaling. A mouse model of diabetes was established by the intraperitoneal injection of streptozotocin (50 mg/kg/day) plus a high fat diet with or without atorvastatin treatment. Diabetes mice manifested increased plasma glucose and lipid profile, proteinuria, renal injury and fibrosis, atorvastatin significantly lowered plasma lipid profile, proteinuria, renal injury in diabetes mice. Atorvastatin reduced renal reactive oxygen species (ROS), iron accumulation and renal expression of malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), transferrin receptor 1 (TFR1), and increased renal expression of glutathione peroxidase 4 (GPX4), nuclear factor erythroid 2-related factor (NRF2) and ferritin heavy chain (FTH) in diabetes mice. Consistent with the findings in vivo, atorvastatin prevented high glucose-induced ROS formation and Fe2+ accumulation, an increase in the expression of 4-HNE, MDA and TFR1, and a decrease in cell viability and the expression of NRF2, GPX4 and FTH in HK2 cells. Atorvastatin also reversed ferroptosis inducer erastin-induced ROS production, intracellular Fe2+ accumulation and the changes in the expression of above-mentioned ferroptosis signaling molecules in HK2 cells. In addition, atorvastatin alleviated high glucose- or erastin-induced mitochondria injury. Ferroptosis inhibitor ferrostatin-1 and antioxidant N-acetylcysteine (NAC) equally reversed the expression of high glucose-induced ferroptosis signaling molecules. Our data support the notion that statins can inhibit diabetes-induced renal oxidative stress and ferroptosis, which may contribute to statins protection of diabetic nephropathy.
Collapse
Affiliation(s)
- Yaoxia Zhang
- Science and Experiment Research Center & Shenyang Key Laboratory of Vascular Biology, Shenyang Medical College, Shenyang, 110034, China; Department of Physiology, Shenyang Medical College, Shenyang, 110034, China.
| | - Yuanyuan Qu
- Science and Experiment Research Center & Shenyang Key Laboratory of Vascular Biology, Shenyang Medical College, Shenyang, 110034, China; Department of Physiology, Shenyang Medical College, Shenyang, 110034, China
| | - Ruiping Cai
- Department of Physiology, Shenyang Medical College, Shenyang, 110034, China
| | - Junjia Gao
- Department of Cardiology, 2nd Affiliated Hospital, Shenyang Medical College, 110000, China
| | - Qian Xu
- Science and Experiment Research Center & Shenyang Key Laboratory of Vascular Biology, Shenyang Medical College, Shenyang, 110034, China
| | - Lu Zhang
- Science and Experiment Research Center & Shenyang Key Laboratory of Vascular Biology, Shenyang Medical College, Shenyang, 110034, China
| | - Mengjie Kang
- Science and Experiment Research Center & Shenyang Key Laboratory of Vascular Biology, Shenyang Medical College, Shenyang, 110034, China; Department of Physiology, Shenyang Medical College, Shenyang, 110034, China
| | - Hui Jia
- School of Traditional Chinese Medicine, Shenyang Medical College, Shenyang, 110034, China
| | - Qing Chen
- Department of Pharmacy, Shenyang Medical College, Shenyang, 110034, China
| | - Yueyang Liu
- Department of Pharmacy, Shenyang Medical College, Shenyang, 110034, China
| | - Fu Ren
- Department of Anatomy, Shenyang Medical College, Shenyang, 110034, China.
| | - Ming-Sheng Zhou
- Science and Experiment Research Center & Shenyang Key Laboratory of Vascular Biology, Shenyang Medical College, Shenyang, 110034, China; Department of Physiology, Shenyang Medical College, Shenyang, 110034, China.
| |
Collapse
|
5
|
Torrado-Salmerón C, Guarnizo-Herrero V, Torrado G, Peña MÁ, Torrado-Santiago S, de la Torre-Iglesias PM. Solid dispersions of atorvastatin with Kolliphor RH40: Enhanced supersaturation and improvement in a hyperlipidemic rat model. Int J Pharm 2023; 631:122520. [PMID: 36581105 DOI: 10.1016/j.ijpharm.2022.122520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/25/2022] [Accepted: 12/16/2022] [Indexed: 12/27/2022]
Abstract
Atorvastatin is a potent lipid-lowering drug with poor solubility and high presystemic clearance that limits its therapeutic efficacy. The aim of this study was to develop solid dispersions and micellar systems to obtain fast-dissolving atorvastatin systems that enhances their anti-hyperlipidemic effect. Solubility and wettability studies allow the development of solid dispersions with low proportions of croscarmellose sodium as hydrophilic carrier. Solid state characterization studies indicated that the addition of Kolliphor® RH40 surfactant to solid dispersions increases intermolecular hydrogen bonding between drug and polymer chains. Dissolution studies in biorelevant Fasted State Simulate Intestinal Fluid (FaSSIF pH 6.5) medium showed for atorvastatin solid dispersion a supersaturation peak of atorvastatin followed by an aggregation/precipitation process. Only the presence of a surfactant such as Kolliphor® RH40 in atorvastatin micellar system, promotes the presence of micelles that achieve delayed recrystallization. Efficacy studies were carried out using a hyperlipidemic model of rats fed with a high- fat diet. The atorvastatin micellar system at doses of 10 mg/kg, revealed a significant improvement in serum levels of total cholesterol, low-density lipoproteins, and triglycerides compared to atorvastatin raw material. This micellar system also exhibited more beneficial effects on liver steatosis, inflammation and ballooning injury.
Collapse
Affiliation(s)
- Carlos Torrado-Salmerón
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto Universitario de Farmacia Industrial (IUFI), Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain.
| | - Víctor Guarnizo-Herrero
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain.
| | - Guillermo Torrado
- Department of Biomedical Science, Faculty of Pharmacy, University of Alcalá de Henares, Ctra Madrid-Barcelona Km 33,600, 28805 Madrid, Spain.
| | - M Ángeles Peña
- Department of Biomedical Science, Faculty of Pharmacy, University of Alcalá de Henares, Ctra Madrid-Barcelona Km 33,600, 28805 Madrid, Spain.
| | - Santiago Torrado-Santiago
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto Universitario de Farmacia Industrial (IUFI), Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain.
| | - Paloma Marina de la Torre-Iglesias
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto Universitario de Farmacia Industrial (IUFI), Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain.
| |
Collapse
|
6
|
Shaghaghi Z, Alvandi M, Farzipour S, Dehbanpour MR, Nosrati S. A review of effects of atorvastatin in cancer therapy. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2022; 40:27. [PMID: 36459301 DOI: 10.1007/s12032-022-01892-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
Cancer is one of the most challenging diseases to manage. A sizeable number of researches are done each year to find better diagnostic and therapeutic strategies. At the present time, a package of chemotherapy, targeted therapy, radiotherapy, and immunotherapy is available to cope with cancer cells. Regarding chemo-radiation therapy, low effectiveness and normal tissue toxicity are like barriers against optimal response. To remedy the situation, some agents have been proposed as adjuvants to improve tumor responses. Statins, the known substances for reducing lipid, have shown a considerable capability for cancer treatment. Among them, atorvastatin as a reductase (HMG-CoA) inhibitor might affect proliferation, migration, and survival of cancer cells. Since finding an appropriate adjutant is of great importance, numerous studies have been conducted to precisely unveil antitumor effects of atorvastatin and its associated pathways. In this review, we aim to comprehensively review the most highlighted studies which focus on the use of atorvastatin in cancer therapy.
Collapse
Affiliation(s)
- Zahra Shaghaghi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Alvandi
- Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. .,Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Soghra Farzipour
- Department of Cardiology, Cardiovascular Diseases Research Center, School of Medicine, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran.,Department of Pharmaceutical Biotechnology, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Reza Dehbanpour
- Department of Radiology, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Nosrati
- Institute of Nuclear Chemistry and Technology, Dorodna 16 Str, 03-195, Warsaw, Poland
| |
Collapse
|
7
|
Zuo Y, Chen L, He X, Ye Z, Li L, Liu Z, Zhou S. Atorvastatin Regulates MALAT1/miR-200c/NRF2 Activity to Protect Against Podocyte Pyroptosis Induced by High Glucose. Diabetes Metab Syndr Obes 2021; 14:1631-1645. [PMID: 33880049 PMCID: PMC8053520 DOI: 10.2147/dmso.s298950] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/18/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diabetic nephropathy (DN) is one of the main complications of diabetes mellitus (DM), which leads to the long-term loss of kidney functions. Long noncoding RNAs (LncRNAs) can alleviate DN by interacting with microRNAs (miRNAs). In this work, we aimed to explore the effects of the MALAT1/miR-200c/NRF2 regulatory axis on the pyroptosis and oxidative stress (Oxidative stress, OS) of renal podocytes in high glucose (HG) environment and whether the lipid-lowering drug atorvastatin (AT) can relieve renal OS through this approach. METHODS MPC-5, a mouse podocyte cell line, was induced by HG as a cell model. The protein expressions of caspase-1, GSDMD, NLRP3, NRF2, etc. were detected by Western blotting and immunofluorescence, and the mRNA level of caspase-1, GSDMD, NLRP3, NRF2, MALAT1, miR-200c was tested by qRT-PCR. The cell pyroptosis of podocytes treated with AT was verified by CCK-8 or flow cytometry. The levels of Malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione (GSH) were measured by spectrophotometer, respectively. RESULTS The caspase-1 was upregulated in time-dependent manner and got the peak at 48 h and 30 mmol/L respectively in MPC-5 cells treated with HG. Further, the expression of GSDMD, MALAT1 and miR-200c were increased, while the level of NRF2, HO-1, OS-related indicators, were decreased simultaneously. Knockdown the MALAT1 protected MPC-5 cells from pyroptosis and OS induced by HG. However, overexpressing miR-200c in control-group cells increased pyroptosis and upregulated the OS level with HG culture medium. Further, atorvastatin protected MPC-5 cells from cell pyroptosis and downregulated the level of renal OS via attenuating the expression of MALAT1 and miR-200c. CONCLUSION Atorvastatin protects podocyte cells via MALAT1/miR-200c/NRF2 signal pathway from pyroptosis and OS induced by HG.
Collapse
Affiliation(s)
- Yi Zuo
- Department of Endocrinology, Affiliated Hospital of Guilin Medical University, Guilin, 541001, People’s Republic of China
| | - Li Chen
- Guangxi Key Laboratory of Brain and Cognitive Neuroscience, Guilin, Guangxi, 541004, People’s Republic of China
| | - Xiaoyun He
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of China
| | - Zhen Ye
- Guangxi Key Laboratory of Brain and Cognitive Neuroscience, Guilin, Guangxi, 541004, People’s Republic of China
| | - Ling Li
- Department of Endocrinology, Affiliated Hospital of Guilin Medical University, Guilin, 541001, People’s Republic of China
| | - Zhanhong Liu
- Department of Endocrinology, Affiliated Hospital of Guilin Medical University, Guilin, 541001, People’s Republic of China
| | - Suxian Zhou
- Department of Endocrinology, Affiliated Hospital of Guilin Medical University, Guilin, 541001, People’s Republic of China
- Correspondence: Suxian Zhou Department of Endocrinology, Affiliated Hospital of Guilin Medical University, 15 Lequn Road, Guilin, Guangxi, 541001, People’s Republic of China Email
| |
Collapse
|
8
|
Torrado-Salmerón C, Guarnizo-Herrero V, Gallego-Arranz T, del Val-Sabugo Y, Torrado G, Morales J, Torrado-Santiago S. Improvement in the Oral Bioavailability and Efficacy of New Ezetimibe Formulations-Comparative Study of a Solid Dispersion and Different Micellar Systems. Pharmaceutics 2020; 12:pharmaceutics12070617. [PMID: 32630626 PMCID: PMC7408513 DOI: 10.3390/pharmaceutics12070617] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/27/2020] [Accepted: 07/01/2020] [Indexed: 12/22/2022] Open
Abstract
Ezetimibe (EZ) is a poorly water-soluble drug with low bioavailability. Strategies such as solid dispersions (SD) and micellar systems (MS) were developed to identify the most effective drug delivery formulations with the highest oral bioavailability, and to improve their lipid-lowering effect. The EZ formulations were prepared with different proportions of Kolliphor® RH40 as a surfactant (1:0.25, 1:0.5 and 1:0.75) and croscarmellose as a hydrophilic carrier. These excipients, and the addition of microcrystalline cellulose during the production process, led to significant improvements in the dissolution profiles of MS. Powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC) and scanning electron microscopy (SEM) revealed an amorphous form of ezetimibe with different semicrystalline states of microcrystalline cellulose for MS-I (1:0.75) and MS-II (1:0.75). Pharmacokinetic analysis after administration of MS-II (1:0.75) demonstrated a 173.86% increase in maximum plasma concentration (Cmax) and a 142.99% increase in oral bioavailability compared to EZ raw material (EZ-RM). Efficacy studies with the micellar system MS-II (1:0.75) in rats with hyperlipidemia showed that total cholesterol, triglycerides and high-density lipoprotein were reduced to normal levels and revealed improvements in low-density lipoprotein, aspartate and alanine aminotransferase. The improvement in the dissolution rate with micellar systems increases bioavailability and enhances the anti-hyperlipidemic effect of EZ.
Collapse
Affiliation(s)
- Carlos Torrado-Salmerón
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.T.-S.); (V.G.-H.); (T.G.-A.); (Y.d.V.-S.)
| | - Víctor Guarnizo-Herrero
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.T.-S.); (V.G.-H.); (T.G.-A.); (Y.d.V.-S.)
| | - Teresa Gallego-Arranz
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.T.-S.); (V.G.-H.); (T.G.-A.); (Y.d.V.-S.)
| | - Yvonne del Val-Sabugo
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.T.-S.); (V.G.-H.); (T.G.-A.); (Y.d.V.-S.)
| | - Guillermo Torrado
- Department of Biomedical Science, Faculty of Pharmacy, University of Alcalá de Henares, Ctra Madrid-Barcelona Km 33,600, 28805 Madrid, Spain;
| | - Javier Morales
- Department of Science and Pharmaceutical Technology, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago 8380494, Chile;
| | - Santiago Torrado-Santiago
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.T.-S.); (V.G.-H.); (T.G.-A.); (Y.d.V.-S.)
- Instituto Universitario de Farmacia Industrial, Complutense University, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-091-394-1620
| |
Collapse
|
9
|
Self-Micellizing Technology Improves the Properties of Ezetimibe and Increases Its Effect on Hyperlipidemic Rats. Pharmaceutics 2019; 11:pharmaceutics11120647. [PMID: 31817021 PMCID: PMC6956093 DOI: 10.3390/pharmaceutics11120647] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/22/2019] [Accepted: 11/29/2019] [Indexed: 01/02/2023] Open
Abstract
The aim of this work was to develop ezetimibe self-micellizing solid dispersions using Kolliphor® RH40 (MS-K) as a surfactant incorporating ezetimibe (EZ) into the croscarmellose hydrophilic carrier. Different ezetimibe:Kolliphor® ratios were studied to select micellar systems that improve the dissolution properties of ezetimibe. The different formulations were characterized by means of solid state analysis by SEM, powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC), and dissolution studies. These physicochemical studies showed a decrease from the crystalline structure of ezetimibe (EZ) to its amorphous state in the micellar systems (MS-K). A rapid dissolution profile was observed in these micellar systems compared to the drug raw material and physical mixture. Efficacy studies were conducted using a high-fat diet that induced hyperlipidemic rats. The micellar system selected (MS-K 1:0.75) revealed a significant improvement in serum levels of total cholesterol (TC), low-density lipoproteins (LDL), and triglycerides (TG) compared to ezetimibe raw material. The histopathological examination of liver tissue also showed that this micellar system exhibited more beneficial effects on liver steatosis compared to ezetimibe raw material (EZ-RM) and the high-fat diet group (HFD). This study suggests that EZ micellar systems using Kolliphor® RH40 could enhance the antihyperlipidemic effect of ezetimibe and reduce liver steatosis.
Collapse
|
10
|
Kaushik S, Tomar A, Puthanmadhom Narayanan S, Nag TC, Arya DS, Bhatia J. Pitavastatin attenuates cisplatin-induced renal injury by targeting MAPK and apoptotic pathways. ACTA ACUST UNITED AC 2019; 71:1072-1081. [PMID: 30957246 DOI: 10.1111/jphp.13090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 03/09/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Anti-neoplastic drug cisplatin is prescribed widely for treatment of a variety of malignancies. Its use has been restricted lately due to severe renal toxicity. The purpose of current study was to investigate the effect of pitavastatin (a hypolipidaemic drug) in cisplatin-induced acute kidney injury in rats. METHOD Male Wistar rats (150-200 g) were treated with different doses of pitavastatin (0.16, 0.32 and 0.64 mg/kg per day p.o.; 10 days). On 7th day of the study, rats were administered cisplatin (8 mg/kg i.p.). Rats were euthanized (11th day), and blood and tissues were processed to evaluate biochemical, histopathological and ultrastructural parameters along with the analysis of immunohistochemistry and DNA-fragmentation studies. Protein expressions were analysed to demonstrate the underlying molecular mechanisms. KEY FINDINGS In the study group with cisplatin insult, KFT parameters were found to be elevated, concentration of apoptotic markers was found to be increased, histopathological and ultramicroscopical architecture was found to be distorted and the expression of MAPK proteins was also found to be elevated as compared to the normal group rats. Pitavastatin treatment alleviated all these anomalies. CONCLUSION Cisplatin-induced acute renal injury was improved on administration of pitavastatin via inhibition of MAPK and apoptotic pathway.
Collapse
Affiliation(s)
- Swati Kaushik
- Cardiovascular Research Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - Ameesha Tomar
- Cardiovascular Research Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Tapas Chandra Nag
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Dharamvir Singh Arya
- Cardiovascular Research Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - Jagriti Bhatia
- Cardiovascular Research Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
11
|
Packer M. Role of the sodium-hydrogen exchanger in mediating the renal effects of drugs commonly used in the treatment of type 2 diabetes. Diabetes Obes Metab 2018; 20:800-811. [PMID: 29227582 DOI: 10.1111/dom.13191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 01/19/2023]
Abstract
Diabetes is characterized by increased activity of the sodium-hydrogen exchanger (NHE) in the glomerulus and renal tubules, which contributes importantly to the development of nephropathy. Despite the established role played by the exchanger in experimental studies, it has not been specifically targeted by those seeking to develop novel pharmacological treatments for diabetes. This review demonstrates that many existing drugs that are commonly prescribed to patients with diabetes act on the NHE1 and NHE3 isoforms in the kidney. This action may explain their effects on sodium excretion, albuminuria and the progressive decline of glomerular function in clinical trials; these responses cannot be readily explained by the influence of these drugs on blood glucose. Agents that may affect the kidney in diabetes by virtue of an action on NHE include: (1) insulin and insulin sensitizers; (2) incretin-based agents; (3) sodium-glucose cotransporter 2 inhibitors; (4) antagonists of the renin-angiotensin system (angiotensin converting-enzyme inhibitors, angiotensin receptor blockers and angiotensin receptor neprilysin inhibitors); and (5) inhibitors of aldosterone action and cholesterol synthesis (spironolactone, amiloride and statins). The renal effects of each of these drug classes in patients with type 2 diabetes may be related to a single shared biological mechanism.
Collapse
Affiliation(s)
- Milton Packer
- Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas
| |
Collapse
|
12
|
Akbas F. PROTECTIVE EFFECT OF INSULIN TREATMENT ON EARLY RENAL CHANGES IN STREPTOZOTOCIN-INDUCED DIABETIC RATS. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2018; 14:169-174. [PMID: 31149254 PMCID: PMC6516527 DOI: 10.4183/aeb.2018.169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Chronic kidney disease is a progressive complication of diabetes mellitus (DM). This study aimed to analyse early renal changes in streptozotocin induced diabetic rats and demonstrate the effect of early treatment with insulin on kidney's histology. METHODS 30 male-adult Sprague-Dawley rats were included in the study. Diabetes was induced in 24 of the rats by a single injection of 65 mg/kg streptozotocin dissolved in saline. 5 units/day NPH insulin injection was started to 10 rats as treatment group and 11 rats were followed untreated. 6 rats constituted the control group. Induction of diabetes failed in 3 animals and 3 untreated rats died during the study. After 21 days, all rats were sacrificed and their kidneys were removed to obtain histological sections to be evaluated by light microscopy. RESULTS Ten treated and 8 untreated diabetic rats and 6 healthy controls, totally 24 rats completed the study. There was a significant weight loss in treated and untreated diabetic groups and a weight gain in the control group (p<0.05). Final blood glucose levels were significantly higher in untreated diabetic group when compared to treated diabetic and control groups and higher in treated diabetic group when compared to control group. Histological analysis of kidney sections showed normal morphology in control group. Changes like increased mesangium, tubular atrophy and tubules with dilated lumen and irregular cell shapes were found in the untreated group whereas, glomerulus and mesangium showed similar morphology with control group with a few changes in tubules, in insulin-treated group. CONCLUSION In DM, renal changes start at an early point and it is possible to prevent/delay those changes at this point with early intervention of insulin treatment.
Collapse
Affiliation(s)
- F. Akbas
- Istanbul Training and Research Hospital, Dept. of Internal Medicine, Samatya, Istanbul, Turkey
| |
Collapse
|
13
|
Singh RS, Chaudhary DK, Mohan A, Kumar P, Chaturvedi CP, Ecelbarger CM, Godbole MM, Tiwari S. Greater efficacy of atorvastatin versus a non-statin lipid-lowering agent against renal injury: potential role as a histone deacetylase inhibitor. Sci Rep 2016; 6:38034. [PMID: 27901066 PMCID: PMC5128790 DOI: 10.1038/srep38034] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 11/01/2016] [Indexed: 12/21/2022] Open
Abstract
Statins, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors have been shown to improve diabetic nephropathy. However, whether they provide protection via Histone deacetylases (HDAC) inhibition is not clear. We conducted a comparative evaluation of Atorvastatin (AT) versus the non-statin cholesterol-lowering drug, Ezetimibe (EZT) on severity of diabetic nephropathy. Streptozotocin-treated male Wistar rats were fed a cholesterol-supplemented diet and gavaged daily with vehicle, AT or EZT. Control rats received normal diet and gavaged vehicle (n = 8-9/group). Diabetes increased blood glucose, urine albumin-to-creatinine ratio (ACR), kidney pathology and HDAC activity, and reduced renal E-cadherin levels. Both AT and EZT reduced circulating cholesterol, attenuated renal pathology, and did not lower blood glucose. However, AT was significantly more effective than EZT at reducing kidney pathology and HDAC activity. Chromatin immunoprecipitation revealed a significantly higher association of acetylated H3 and H4 with the E-cadherin promoter in kidneys from AT-, relative to EZT- or vehicle-treated rats. Moreover, we demonstrated a direct effect of AT, but not EZT, on HDAC-inhibition and, H3 and H4- acetylation in primary glomerular mesangial cells. Overall, both AT and EZT attenuated diabetic nephropathy; however, AT exhibited greater efficacy despite a similar reduction in circulating cholesterol. HDAC-inhibition may underlie greater efficacy of statins in attenuating kidney injury.
Collapse
Affiliation(s)
- Ravi Shankar Singh
- Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Dharmendra Kumar Chaudhary
- Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Aradhana Mohan
- Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Praveen Kumar
- Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | | | | | - Madan M. Godbole
- Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Swasti Tiwari
- Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| |
Collapse
|
14
|
Shen X, Zhang Z, Zhang X, Zhao J, Zhou X, Xu Q, Shang H, Dong J, Liao L. Efficacy of statins in patients with diabetic nephropathy: a meta-analysis of randomized controlled trials. Lipids Health Dis 2016; 15:179. [PMID: 27733168 PMCID: PMC5062823 DOI: 10.1186/s12944-016-0350-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 10/07/2016] [Indexed: 01/13/2023] Open
Abstract
Background The effects of statins in patients with diabetic nephropathy are controversial. With increasing interest in the potential therapeutic role of statins in diabetic nephropathy, it is essential to evaluate its real effects. Methods PubMed, EMBASE, Web of Science databases, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure were systematically searched for randomized controlled trials (RCTs) of statins in patients with diabetic nephropathy. Results Fourteen trials with 2866 participants were included in our meta-analysis. Compared with placebo, albuminuria and urinary albumin excretion rates in the statin group were reduced by 0.46 [95 % confidence interval (CI),−0.68 to −0.25, P < 0.0001] and 1.68 (95 % CI, −3.23 to −0.12, P = 0.03), respectively. The reduction of albuminuria was greater in patients of type 2 diabetes mellitus with diabetic nephropathy [standardized mean difference (SMD), −0.56; 95 % CI, −0.80 to −0.32, P < 0.00001] and the decrease was significant during the 1 to 3 years period of statin therapy (SMD, −0.57; 95 % CI, −0.95 to −0.19, P = 0.003). Subgroup analysis demonstrated the effects of statins were much stronger in subjects with pathologic albuminuria: change of −0.71 (95 % CI, −1.09 to −0.33, P = 0.0003) for those with urinary protein excretion 30 to 300 mg/day, −0.37 (95 % CI, −0.67 to −0.06, P = 0.02) for those with excretion more than 300 mg/day and −0.29 (95 % CI, −0.78 to 0.21, P = 0.26) for those with excretion less than 30 mg/day. In contrast, statins did not significantly reduce estimated glomerular filtration rate, serum creatinine and blood urea nitrogen levels. Conclusions Statins decrease the albuminuria and urinary albumin excretion rates significantly. The efficacy of statins on renal function is time dependent and better in type 2 diabetic patients with nephropathy.
Collapse
Affiliation(s)
- Xue Shen
- Department of Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Zhongwen Zhang
- Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China
| | - Xiaoqian Zhang
- Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China
| | - Junyu Zhao
- Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China
| | - Xiaojun Zhou
- Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China
| | - Qinglei Xu
- Department of Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Hongxia Shang
- Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China
| | - Jianjun Dong
- Department of Medicine, Division of Endocrinology, Qilu Hospital of Shandong University, Jinan, 250012, China
| | - Lin Liao
- Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China.
| |
Collapse
|
15
|
Renoprotective Effects of Atorvastatin in Diabetic Mice: Downregulation of RhoA and Upregulation of Akt/GSK3. PLoS One 2016; 11:e0162731. [PMID: 27649495 PMCID: PMC5029810 DOI: 10.1371/journal.pone.0162731] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 08/26/2016] [Indexed: 12/25/2022] Open
Abstract
Potential benefits of statins in the treatment of chronic kidney disease beyond lipid-lowering effects have been described. However, molecular mechanisms involved in renoprotective actions of statins have not been fully elucidated. We questioned whether statins influence development of diabetic nephropathy through reactive oxygen species, RhoA and Akt/GSK3 pathway, known to be important in renal pathology. Diabetic mice (db/db) and their control counterparts (db/+) were treated with atorvastatin (10 mg/Kg/day, p.o., for 2 weeks). Diabetes-associated renal injury was characterized by albuminuria (albumin:creatinine ratio, db/+: 3.2 ± 0.6 vs. db/db: 12.5 ± 3.1*; *P<0.05), increased glomerular/mesangial surface area, and kidney hypertrophy. Renal injury was attenuated in atorvastatin-treated db/db mice. Increased ROS generation in the renal cortex of db/db mice was also inhibited by atorvastatin. ERK1/2 phosphorylation was increased in the renal cortex of db/db mice. Increased renal expression of Nox4 and proliferating cell nuclear antigen, observed in db/db mice, were abrogated by statin treatment. Atorvastatin also upregulated Akt/GSK3β phosphorylation in the renal cortex of db/db mice. Our findings suggest that atorvastatin attenuates diabetes-associated renal injury by reducing ROS generation, RhoA activity and normalizing Akt/GSK3β signaling pathways. The present study provides some new insights into molecular mechanisms whereby statins may protect against renal injury in diabetes.
Collapse
|
16
|
Guo Y, Liu Y, Wang Y. Beneficial effect of lycopene on anti-diabetic nephropathy through diminishing inflammatory response and oxidative stress. Food Funct 2016; 6:1150-6. [PMID: 25689917 DOI: 10.1039/c5fo00004a] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Lycopene is widely used for nutritional supplementation, but the potential benefits in diabetic nephropathy (DN) remains unknown. This study aimed to highlight the therapeutic prospect of lycopene against streptozotocin (STZ)-induced kidney injury in mice. During the process of the experiments, biochemical kits were employed to determine the diabetes-metabolic parameters in STZ-lesioned mice. Routine pathological and ultrastructural observations were screened for the histological changes of kidney tissue. Moreover, immunohistochemical staining was used to investigate the inflammatory conditions expressed in kidney tissue. Furthermore, intrarenal heme oxygenase 1 (HO-1) mRNA level was assayed via RT-PCR and Western blot analyses. The results showed that lycopene alleviated the lesioned signs of DN mice induced by STZ, accompanied with the increase in body weight, reduced serum concentrations of blood sugar and low-density lipoprotein cholesterol (LDL-C), elevated high-density lipoprotein cholesterol (HDL-C) level, and the decrease in urine protein content. In addition, oxidative defense patterns in the kidneys of DN mice were ameliorated, as shown in augmented bioactivities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and in turn lowered malondialdehyde (MDA) content. The immunohistochemical experiment exhibited that lycopene intake contributed to attenuation of nuclear factor-kappa B (NF-κB) and tumor necrosis factor alpha (TNF-α) expressions in kidney tissue. Moreover, intrarenal HO-1 level was up-regulated in the presence of lycopene. Our findings provide the evidence that lycopene protects kidney cells from STZ-induced lesions via inhibiting NF-κB signal pathway for anti-inflammation and attenuating oxidative stress for anti-dysmetabolism.
Collapse
Affiliation(s)
- Ying Guo
- Department of Endocrinology, Affiliated Hospital of Weifang Medical University, Weifang 261031, China
| | | | | |
Collapse
|