Abstract
Acute kidney injury (AKI) is characterized by a rapid loss of renal function. Drug-induced AKI accounts for up to 60% of all cases, resulting in a severe threat particularly to hospitalized patients, but there are no effective treatments. Four polyherbal formulas, Bojungikki-tang (BJ), Palmijihwang-tang (PJ), Oryeong-san (OR), and Wiryeong-tang (WR), have long been used for treatments of symptoms of kidney disease in traditional Korean medicine. Even though they are commercially available, evidences supporting the efficacy on AKI are still lacking. Therefore, the effectiveness of polyherbs on AKI and the underlying mechanisms were examined. Renal cell damage was induced by cisplatin at 20 μM and 16 μM in proximal tubular epithelial cell lines of rat NRK-52E and human HK-2, respectively. The cells were treated with the polyherbal formals for 3 days, and the cell viability, antioxidant activities, and apoptosis were examined. In addition, the proliferative effects were assessed under serum-free conditions. The results were compared with those of the vehicle-treated cells as a control. Three polyherbs BJ, PJ, and WR but not OR showed strong free radical scavenging activities in the 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay. The treatments of BJ, PJ, OR, and WR significantly increased the cell viabilities under cisplatin-induced nephrotoxicity. Consistent with the results of the DPPH assay, superoxide dismutase and catalase activities were increased in the cisplatin-induced cell model treated with BJ, PJ, and WR but not with OR. However, annexin-V-positive cells and cleaved caspase 3 expression were significantly reduced in the cell model treated with all of the polyherbs. Cell proliferation was observed in treatment with all of the polyherbs, which was particularly evident in the OR-treated cells. This provides effective complementary evidences to promote the development of traditional herbal formulas to treat AKI.
Highlights
Acute kidney injury (AKI) is a clinical symptom characterized by an acute loss of renal function with high morbidity and mortality (9.5% of in-hospital mortality) [1, 2]
Were kindly provided by Hanpoong Pharmaceutical Co., Ltd. (Daejeon, Korea), and OR was provided by Jeil Pharmaceutical Co., Ltd. (Seongnam, Korea). ese commercial products are approved by the Korea Food and Drug Administration, and their main herbal components are listed in Table 1. e polyherbs were dissolved in dimethyl sulfoxide
We showed that four traditional polyherbal formulas potentially prevented cisplatin-induced renal cell injury by inhibiting oxidative stress and apoptotic cell death and enhancing cellular proliferation
Summary
Acute kidney injury (AKI) is a clinical symptom characterized by an acute loss of renal function with high morbidity and mortality (9.5% of in-hospital mortality) [1, 2]. AKI can be caused by renal ischemia-reperfusion injury, nephrotoxic damage, and sepsis. E pathogenesis involves excessive inflammatory responses, oxidative stress, and an imbalance in the renal cell injury and repair; specific treatment targets in the pathological process and effective therapies are still lacking [3]. E main treatments for AKI include rehydration therapy, antibiotics, dialysis, and the discontinuation of certain medicines until renal function recovers. AKI is a reversible condition that can be cured, it can progress to chronic kidney disease and endstage renal disease. Drug-induced AKI accounts for up to 60% of all cases, resulting in a severe threat to hospitalized patients [4].
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