Involvement of Nrf2, JAK and COX pathways in acetaminophen-induced nephropathy: Role of some antioxidants

Protective effect of empagliflozin against paracetamol-induced acute kidney injury through modulation of AMPK/SIRT1/PGC-1α pathway in experimental mice

Emerging evidences about paracetamol-induced kidney injury in clinical settings are concerning, especially when administered at high doses. Empagliflozin, an oral SGLT2 inhibitor, employed in the management of diabetes mellitus, exhibits antioxidant, anti-inflammatory, and anti-apoptotic attributes. Thus, the objective of this study is to investigate whether empagliflozin may alleviate paracetamol-triggered nephrotoxicity and unravel the mechanistic insights responsible for its protective impact. In this regard, male mice were assigned to four groups: normal, paracetamol, empagliflozin 10, and empagliflozin 20. Kidney function tests, histopathological examination, immunohistochemistry, oxidative stress biomarkers, inflammatory cytokines, and other molecular targets were detected. Our results showed that paracetamol administration impaired kidney functions along with causing aberrations in renal histoarchitecture. Additionally, paracetamol triggered oxidative stress, inflammation, and apoptosis via hindering the AMPK/SIRT1/PGC-1α cascade and Nrf2/HO-1 while activating the NF-κB hub. Nevertheless, pretreatment with empagliflozin markedly enhanced the kidney function tests and mitigated histopathological alterations caused by paracetamol. Additionally, empagliflozin suppressed the oxidative stress as confirmed by an upregulation of Nrf2, which subsequently increased HO-1, SOD, and GSH, while reducing the MDA level. Moreover, it inhibited the NF-κB-mediated inflammatory process by dampening NF-κB, IL-1β, and TNF-α expressions as well as lowering Bax expression-induced apoptosis. The observed safeguards effects were facilitated via boosting AMPK/SIRT1/PGC-1α signaling trajectory. Collectively, our study verified the enduring reno-protective potential of empagliflozin, particularly at high dose, in the context of paracetamol-induced renal injury by instigating the AMPK/SIRT1/PGC-1α hinge.

The potential of curcumin in mitigating acetaminophen-induced liver damage

Acetaminophen (APAP) is a widely used over-the-counter medication for pain and fever, but its overuse can lead to liver toxicity, hepatocyte apoptosis, and necrosis. Despite therapeutic advances in drug-induced hepatotoxicity, APAP-induced liver damage still poses a medical challenge. Recently, natural products have emerged as potential options for mitigating the effects of APAP hepatotoxicity. Curcumin, a natural compound with antioxidant and anti-inflammatory properties, has shown promising results in drug-induced hepatotoxicity. However, further investigations are needed to assess the clinical benefits of curcumin. In this review, we discuss the mechanisms of APAP-induced liver damage and the role of curcumin in preventing liver necrosis, oxidative stress, inflammation, and apoptosis caused by APAP overdose. Through its ability to scavenge free radicals, prevent lipid peroxidation, restore glutathione (GSH) levels, and inhibit apoptosis, curcumin has been found to significantly reduce oxidative stress and protect liver tissue from APAP toxicity in various studies. This paper also reviews the potential of novel nanoformulations to enhance the bioavailability of curcumin for improved therapeutic outcomes. Overall, the evidence suggests that curcumin could be a promising intervention to mitigate the harmful effects of APAP overdose and improve liver health. However, further research is required to assess the optimal dosing and timing of curcumin administration in APAP toxicity.

Magnesium hydride protects against acetaminophen-induced acute kidney injury by inhibiting TXNIP/NLRP3/nf-κb pathway

Acetaminophen (APAP)-induced acute kidney injury (APAP-AKI) has turned into one of reasons for clinic obtained renal insufficiency. Magnesium hydride (MgH2), as a solid-state hydrogen source, might be potentially applied in clinical practice. The current study aimed to investigate the protective effect of MgH2 against APAP-AKI. The results showed that MgH2 improved renal function and histological injury in mice of APAP-AKI. MgH2 also had protective effects on APAP-induced cytotoxicity in HK-2 cells. In addition, the increased level of reactive oxygen species (ROS) and expressions of inflammatory cytokines (TNF-α and IL-1β) and pro-apoptotic factors (Bad, Bax, Caspase3, and CytC) induced by APAP were downregulated with MgH2 treatment. Furthermore, the expressions of molecules related to TXNIP/NLRP3/NF-κB pathway (TXNIP, NLRP3, NF-κB p65 and p-NF-κB p65) in renal tissues and HK-2 cells were enhanced by APAP overdose, which were reduced by MgH2 administration. Collectively, this study indicated that MgH2 protects against APAP-AKI by alleviating oxidative stress, inflammation and apoptosis via inhibition of TXNIP/NLRP3/NF-κB signaling pathway.

Celastrol Mitigates Acetaminophen-Induced Nephrotoxicity in Rats via Targeting Renal Oxidative Stress, Inflammation, Apoptosis with Enhancement in Aquaporin 1 Level

Background

Acetaminophen also name paracetamol is apopular antipyretic and analgesic drug, in alarge doses produces a cute kidney injury either in human and animals. The aim of this study to assess the effect of celastrol in reducing acetaminophen-induced nephrotoxicity and to elucidate its underlying mechanisms.

Methods

Rats were divided into four groups: control, celastrol-treated, acetaminophen-exposed, and a group receiving both acetaminophen and celastrol. After 24 hours, blood samples were taken and kidney tissues were harvested for histological and molecular analyses. The findings shed light on the protective effects of celastrol against acetaminophen-induced nephrotoxicity, offering insights into its therapeutic potential.

Results

paracetamol oral intake altered renal histology with significantly P< 0.05 increased serum creatinine, blood urea nitrogen (BUN), and homogenate malonaldhyde (MDA), and immunoexpression of tumor necrosis- alpha (TNF-α), interleukin-6 (IL-6), caspase-3, Bcl-2-associated X- protein (Bax). Furthermore, it decreases homogenate level of superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), and gene expression of nuclear factor erythroid 2-related factor 2 (Nrf2), and haem oxygenase-1 (HO-1). Meanwhile, intraperitoneal injection of celastrol with acetaminophen reaffirms the previous results.

Conclusions

We provided a novel treatment against acetaminophen induced-nephrotoxicity with targeting renal oxidative stress, inflammation, apoptosis with elevation of Aquaporin 1 (AQP1) level.