Abstract

Quercetin, a flavonoid with promising therapeutic potential, has been shown to protect from cisplatin nephrotoxicity in rats following intraperitoneal injection, but its low bioavailability curtails its prospective clinical utility in oral therapy. We recently developed a micellar formulation (P-quercetin) with enhanced solubility and bioavailability, and identical nephroprotective properties. As a first aim, we herein evaluated the oral treatment with P-quercetin in rats, which displayed no nephroprotection. In order to unravel this discrepancy, quercetin and its main metabolites were measured by HPLC in the blood and urine after intraperitoneal and oral administrations. Whilst quercetin was absorbed similarly, the profile of its metabolites was different, which led us to hypothesize that nephroprotection might be exerted in vivo by a metabolic derivate. Consequently, we then aimed to evaluate the cytoprotective capacity of quercetin and its main metabolites (quercetin 3-O-glucoside, rutin, tamarixetin, isorhamnetin and quercetin 3-O-glucuronide) against cisplatin toxicity, in HK-2 and NRK-52E tubular cell lines. Cells were incubated for 6 h with quercetin, its metabolites or vehicle (pretreatment), and subsequently 18 h in cotreatment with 10–300 μM cisplatin. Immediately after treatment, cell cultures were subject to the MTT technique as an index of cytotoxicity and photographed under light microscopy for phenotypic assessment. Quercetin afforded no direct cytoprotection and quercetin-3-O-glucuronide was the only metabolite partially preventing the effect of cisplatin in cultured tubule cells. Our results identify a metabolic derivative of quercetin contributing to its nephroprotection and prompt to further explore exogenous quercetin-3-O-glucuronide in the prophylaxis of tubular nephrotoxicity.

Highlights

  • Cisplatin (cis-diaminnedichloroplatin (II)) is an inorganic compound with antineoplastic activity

  • We have previously demonstrated that quercetin protects against cisplatin nephrotoxicity in an in vivo model, without compromising the antineoplasic activity of the drug [3,15]

  • Our results showed that this formulation, administered i.p., increased the plasma concentration of quercetin compared to the dose-equivalent administration of the unformulated flavonoid, and maintained the nephroprotective capacity when it was coadministered with cisplatin [16]

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Summary

Introduction

Cisplatin (cis-diaminnedichloroplatin (II)) is an inorganic compound with antineoplastic activity. The incidence of cisplatin nephrotoxicity is high, occurring in one in every three patients under treatment [3] This nephrotoxicity is due to the drug accumulation in the kidney, since its elimination from the body is carried out through this organ by glomerular filtration and tubular secretion, without being metabolized. The copper transporter 1 (Ctr1) and the organic cation transporter 2 (OCT2) are mainly responsible for the entry of cisplatin into tubular renal cells, since they have a high affinity for the drug. In this way, its concentration in the epithelial cells of the proximal tubule is around 5 times higher than in plasma [4]

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