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Fontecha-Barriuso M, Martín-Sanchez D, Martinez-Moreno JM, Cardenas-Villacres D, Carrasco S, Sanchez-Niño MD, Ruiz-Ortega M, Ortiz A, Sanz AB. Molecular pathways driving omeprazole nephrotoxicity. Redox Biol 2020; 32:101464. [PMID: 32092686 PMCID: PMC7038587 DOI: 10.1016/j.redox.2020.101464] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 12/22/2022] Open
Abstract
Omeprazole, a proton pump inhibitor used to treat peptic ulcer and gastroesophageal reflux disease, has been associated to chronic kidney disease and acute interstitial nephritis. However, whether omeprazole is toxic to renal cells is unknown. Omeprazole has a lethal effect over some cancer cells, and cell death is a key process in kidney disease. Thus, we evaluated the potential lethal effect of omeprazole over tubular cells. Omeprazole induced dose-dependent cell death in human and murine proximal tubular cell lines and in human primary proximal tubular cell cultures. Increased cell death was observed at the high concentrations used in cancer cell studies and also at lower concentrations similar to those in peptic ulcer patient serum. Cell death induced by omeprazole had features of necrosis such as annexin V/7-AAD staining, LDH release, vacuolization and irregular chromatin condensation. Weak activation of caspase-3 was observed but inhibitors of caspases (zVAD), necroptosis (Necrostatin-1) or ferroptosis (Ferrostatin-1) did not prevent omeprazole-induced death. However, omeprazole promoted a strong oxidative stress response affecting mitochondria and lysosomes and the antioxidant N-acetyl-cysteine reduced oxidative stress and cell death. By contrast, iron overload increased cell death. An adaptive increase in the antiapoptotic protein BclxL failed to protect cells. In mice, parenteral omeprazole increased tubular cell death and the expression of NGAL and HO-1, markers of renal injury and oxidative stress, respectively. In conclusion, omeprazole nephrotoxicity may be related to induction of oxidative stress and renal tubular cell death.
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Affiliation(s)
- Miguel Fontecha-Barriuso
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain; REDINREN, Madrid, Spain
| | - Diego Martín-Sanchez
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain; REDINREN, Madrid, Spain
| | | | | | - Susana Carrasco
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain
| | - Maria D Sanchez-Niño
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain; REDINREN, Madrid, Spain
| | - Marta Ruiz-Ortega
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain; REDINREN, Madrid, Spain; School of Medicine, UAM, Madrid, 28040, Spain
| | - Alberto Ortiz
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain; REDINREN, Madrid, Spain; School of Medicine, UAM, Madrid, 28040, Spain; IRSIN, Madrid, 28040, Spain.
| | - Ana B Sanz
- Research Institute-Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain; REDINREN, Madrid, Spain.
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