Cisplatin is a powerful chemotherapy drug that is administered to treat a wide range of cancers. However, its clinical use is limited due to kidney damage and the reduction in glomerular filtration rate that occurs in 15% to 30% of patients. Several mechanisms lead to renal dysfunction after cisplatin administration, including direct damage to proximal tubular epithelial cells that causes necrosis and apoptosis. Cisplatin administration is accompanied by the production of reactive oxygen species (ROS), which causes lipid peroxidation, proteins and nucleic acids oxidation, cell membrane degradation, and finally reduction in glomerular filtration. The most prominent effect of cisplatin-induced nephrotoxicity (CIN), which can be progressive, is hypomagnesemia, Fanconi syndrome and anemia. Cisplatin nephrotoxicity is more prominent in individuals who received higher doses of this drug, or in patients who had previous chemotherapy regimen and presence of renal dysfunction. This paper is sought to describe cisplatin nephrotoxicity and the protective role of medicinal plants in preventing the renal toxicity. In this regard, the role of antioxidants will be specifically addressed.
Introduction: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that involves multiple organs including the kidneys, skin, joints and serous membranes. Previous studies have shown that elevated Ki-67 indices are correlated with the cellular proliferation and clinical findings in lupus nephritis (LN). Objectives: The aim of this study was to examine the relationship between glomerular, tubular and interstitial expression of Ki-67 in kidney biopsy specimens of different classes of LN and and various clinicopathological features. Patients and Methods: This cross-sectional study was conducted on 16 biopsy-proven LN patients. The diagnosis of LN was based on renal biopsy findings, particularly by immunofluorescence (IF) study. The diagnosis of LN with IF was concluded by the deposition of C1q in association with prominent IgG and C3 deposits and the deposition of IgM and IgA (full-house pattern). The morphologic variables on light microscopy were also examined. In this study, the glomerular (gKi-67), interstitial (iKi-67) and tubular (tKi-67) expressions of Ki-67 were assessed. Results: This study comprised of 16 cases of biopsy-proven LN which were stained for Ki-67 with immunohistochemistry. Of the 16 patients, 13 (81.2%) were females. The mean ± SD of age, quantity of proteinuria and serum creatinine in all patients were 37±11.6 years, 1844±582 mg/d and 1.5±0.93 mg/ dL, respectively. Our study showed that the association between gKi-67, iKi-67, and tKi-67 with age, gender, level of proteinuria and serum creatinine was not significant (P>0.05). The association between Ki-67 with interstitial fibrosis, the number of crescents, and the activity and chronicity percentages was also not significant (P>0.05). Moreover, the relationship of gKi-67 with global versus segmental involvement of the glomeruli was not significant (P>0.05). Furthermore, the correlation of gKi-67 with IgA, IgG, IgM, C3 and C1q deposits was not significant (P>0.05). The association of iKi-67 with age, gender, level of proteinuria and serum creatinine was not significant as well. However, the correlation of iKi-67 with C1q deposits was inversely significant (r=-0.544, P=0.029); however this correlation was not significant with IgA, IgG, IgM and C3 deposits (P>0.05). Conclusion: In this study, the relationship of iKi-67 with C1q deposits suggests that C1q has a significant role in the inflammatory process of LN. Since our study was conducted on a relatively small sample size, it, therefore, requires further investigations on larger samples.
Chemotherapeutic agents are still the major and most common therapy to prevent tumor growth. These drugs have various adverse effects in different organs in addition to systemic effects. Finding more specific and effective drugs or new adjuvant therapeutic substance is needed to improve the success rate. Several studies have proposed the possible mechanisms of anti-neoplastic of metformin, however, its exact mechanism is still obscure. The suggested mechanisms are; alteration in the host metabolic environment after administration of metformin, such as decreases in insulin-dependent stimulation of tumor growth or direct effect on cancer cells, such as the impact on adenosine monophosphate (AMP)-activated protein kinase signaling pathway. Metformin, as an adjuvant therapy, synergistically exerts growth inhibitory effects against cell growth and can induce cell apoptosis in an animal model. Adding metformin to the chemotherapy regimen may reduce resistance and enhance therapeutic efficacy.
Introduction: The administration of iodinated contrast medium is extensive in various imaging techniques including coronary angiography. Objectives: The present investigation was designed to examine the ameliorative effect of clove buds (Syzygium aromaticum) on contrast-induced acute kidney injury (CI-AKI) in rats Materials and Methods: Forty male Wistar rats with a mean body weight of 200-250 g were studied. Rats randomly assigned into four groups, 10 rats for each; Group 1; normal rats (control group; sham group); they did not receive any drugs. Group 2; rats were received 10 mL/kg as a single dose of iodixanol (contrast media) by intravenous (IV) injection. Group 3; rats received 10 mg/kg clove by intraperitoneal (IP) injection for three days, while in day forth, they received a single dose of iodixanol (10 mL/kg). Group 4; rats of this group first received a single dose of iodixanol (10 mL/ kg). Then rats treated by clove (10 mg/kg) by intraperitoneal (IP) injection for three days (days 2, 3 and 4th). Kidney sections were examined for degeneration, flattening, and necrosis of renal tubular cells and also dilatation of tubular lumen. Results: We found a significant difference between groups regarding the sum of injury (degeneration, flattening, necrosis and dilatation). A significant difference in types of injury (degeneration, flattening, necrosis and dilatation) among the groups (P=0.001) was seen too. We detected a significant difference between groups II (contrast media) and III (rats pretreated by clove; P<0.001). Accordingly, we detected a significant difference between groups II (contrast media) and IV (rats post-pone treated by Clove buds; P<0.001) too. There was not a significant difference between groups of III and IV (P> 0.05). Conclusion: In this animal study, we found that post-pone treatment of clove was as effective as pretreatment to mitigate the injury induced by contrast media.
Introduction: IgA nephropathy (IgAN) regarded as the main type of primary glomerulonephritis globally. It has a diverse clinical course and unpredictable prognosis. Traditionally, clinical and pathological features are conducted to prognosticate the outcome of the disease. Recently, attention has been directed towards other indices that may have prognostic implications for IgAN progression. The Ki-67 index have been extensively detected as a proliferation marker of malignant cells for several years. Objectives: In this study, we aimed to determine the prognostic impact of Ki-67 expression in IgAN biopsies. Patients and Methods: This cross-sectional study was conducted on 18 biopsy-proven IgAN patients. IgAN was diagnosed by significant IgA deposits and according to the morphologic variables of Oxford (MEST) classification for this disease. The expression of Ki-67 in the glomeruli, interstitium and tubules was described as the intensity percentage of the immunohistochemical staining. Results: In all of the eighteen cases with biopsy-proven IgAN, the mean ± SD of age, degree of proteinuria and serum creatinine were 36.3±17 years, 1600±733 mg/day and 1.2±0.4 mg/dL, respectively. In this study, we found a significant correlation between glomerular Ki-67 immunohistochemical staining and MEST scores (r: 0.780, P< 0.001). We also detected a significant correlation between interstitial Ki-67 staining and MEST scores (r: 0.700, P=0.001). Moreover, Ki-67 immunohistochemical staining of the interstitium had a significant relationship with IgM deposits (r=0.544, P=0.02). Conclusion: In this pilot study, we found that interstitial and glomerular Ki-67 immunohistochemical staining had positive and significant associations with MEST scores. Our data also showed that interstitial Ki-67 staining had a significant relationship with IgM deposits. These preliminary results require further investigation in large-scale studies.
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