1
|
Cysteine Donor-Based Brain-Targeting Prodrug: Opportunities and Challenges. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:4834117. [PMID: 35251474 PMCID: PMC8894025 DOI: 10.1155/2022/4834117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/11/2022] [Indexed: 12/20/2022]
Abstract
Overcoming blood-brain barrier (BBB) to improve brain bioavailability of therapeutic drug remains an ongoing concern. Prodrug is one of the most reliable approaches for delivering agents with low-level BBB permeability into the brain. The well-known antioxidant capacities of cysteine (Cys) and its vital role in glutathione (GSH) synthesis indicate that Cys-based prodrug could potentiate therapeutic drugs against oxidative stress-related neurodegenerative disorders. Moreover, prodrug with Cys moiety could be recognized by the excitatory amino acid transporter 3 (EAAT3) that is highly expressed at the BBB and transports drug into the brain. In this review, we summarized the strategies of crossing BBB, properties of EAAT3 and its natural substrates, Cys and its donors, and Cys donor-based brain-targeting prodrugs by referring to recent investigations. Moreover, the challenges that we are faced with and future research orientations were also addressed and proposed. It is hoped that present review will provide evidence for the pursuit of novel Cys donor-based brain-targeting prodrug.
Collapse
|
2
|
Ahamed M, Akhtar MJ, Khan MM, Alhadlaq HA, Aldalbahi A. Nanocubes of indium oxide induce cytotoxicity and apoptosis through oxidative stress in human lung epithelial cells. Colloids Surf B Biointerfaces 2017; 156:157-164. [DOI: 10.1016/j.colsurfb.2017.05.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/27/2017] [Accepted: 05/08/2017] [Indexed: 01/07/2023]
|
3
|
Evidence of a Redox-Dependent Regulation of Immune Responses to Exercise-Induced Inflammation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:2840643. [PMID: 27974950 PMCID: PMC5126438 DOI: 10.1155/2016/2840643] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 09/21/2016] [Indexed: 12/16/2022]
Abstract
We used thiol-based antioxidant supplementation (n-acetylcysteine, NAC) to determine whether immune mobilisation following skeletal muscle microtrauma induced by exercise is redox-sensitive in healthy humans. According to a two-trial, double-blind, crossover, repeated measures design, 10 young men received either placebo or NAC (20 mg/kg/day) immediately after a muscle-damaging exercise protocol (300 eccentric contractions) and for eight consecutive days. Blood sampling and performance assessments were performed before exercise, after exercise, and daily throughout recovery. NAC reduced the decline of reduced glutathione in erythrocytes and the increase of plasma protein carbonyls, serum TAC and erythrocyte oxidized glutathione, and TBARS and catalase activity during recovery thereby altering postexercise redox status. The rise of muscle damage and inflammatory markers (muscle strength, creatine kinase activity, CRP, proinflammatory cytokines, and adhesion molecules) was less pronounced in NAC during the first phase of recovery. The rise of leukocyte and neutrophil count was decreased by NAC after exercise. Results on immune cell subpopulations obtained by flow cytometry indicated that NAC ingestion reduced the exercise-induced rise of total macrophages, HLA+ macrophages, and 11B+ macrophages and abolished the exercise-induced upregulation of B lymphocytes. Natural killer cells declined only in PLA immediately after exercise. These results indicate that thiol-based antioxidant supplementation blunts immune cell mobilisation in response to exercise-induced inflammation suggesting that leukocyte mobilization may be under redox-dependent regulation.
Collapse
|
4
|
Akhtar MJ, Ahamed M, Alhadlaq HA, Alshamsan A, Majeed Khan M, Alrokayan SA. Antioxidative and cytoprotective response elicited by molybdenum nanoparticles in human cells. J Colloid Interface Sci 2015. [DOI: 10.1016/j.jcis.2015.07.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
5
|
Akhtar MJ, Ahamed M, Alhadlaq HA, Khan MM, Alrokayan SA. Glutathione replenishing potential of CeO 2 nanoparticles in human breast and fibrosarcoma cells. J Colloid Interface Sci 2015; 453:21-27. [DOI: 10.1016/j.jcis.2015.04.049] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 04/24/2015] [Accepted: 04/24/2015] [Indexed: 01/28/2023]
|
6
|
Abstract
SIGNIFICANCE Glutathione (GSH) depletion is a central signaling event that regulates the activation of cell death pathways. GSH depletion is often taken as a marker of oxidative stress and thus, as a consequence of its antioxidant properties scavenging reactive species of both oxygen and nitrogen (ROS/RNS). RECENT ADVANCES There is increasing evidence demonstrating that GSH loss is an active phenomenon regulating the redox signaling events modulating cell death activation and progression. CRITICAL ISSUES In this work, we review the role of GSH depletion by its efflux, as an important event regulating alterations in the cellular redox balance during cell death independent from oxidative stress and ROS/RNS formation. We discuss the mechanisms involved in GSH efflux during cell death progression and the redox signaling events by which GSH depletion regulates the activation of the cell death machinery. FUTURE DIRECTIONS The evidence summarized here clearly places GSH transport as a central mechanism mediating redox signaling during cell death progression. Future studies should be directed toward identifying the molecular identity of GSH transporters mediating GSH extrusion during cell death, and addressing the lack of sensitive approaches to quantify GSH efflux.
Collapse
Affiliation(s)
- Rodrigo Franco
- Redox Biology Center, University of Nebraska-Lincoln, Lincoln, NE 68583, USA.
| | | |
Collapse
|
7
|
Abstract
Apoptosis is a conserved homeostatic process critical for organ and tissue morphogenesis, development, and senescence. This form of programmed cell death also participates in the etiology of several human diseases including cancer, neurodegenerative, and autoimmune disorders. Although the signaling pathways leading to the progression of apoptosis have been extensively characterized, recent studies highlight the regulatory role of changes in the intracellular milieu (permissive apoptotic environment) in the efficient activation of the cell death machinery. In particular, glutathione (GSH) depletion is a common feature of apoptotic cell death triggered by a wide variety of stimuli including activation of death receptors, stress, environmental agents, and cytotoxic drugs. Although initial studies suggested that GSH depletion was only a byproduct of oxidative stress generated during cell death, recent discoveries suggest that GSH depletion and post-translational modifications of proteins through glutathionylation are critical regulators of apoptosis. Here, we reformulate these emerging paradigms into our current understanding of cell death mechanisms.
Collapse
Affiliation(s)
- R Franco
- Laboratory of Signal Transduction, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | | |
Collapse
|
8
|
Chirino YI, Pedraza-Chaverri J. Role of oxidative and nitrosative stress in cisplatin-induced nephrotoxicity. ACTA ACUST UNITED AC 2008; 61:223-42. [PMID: 18986801 DOI: 10.1016/j.etp.2008.09.003] [Citation(s) in RCA: 343] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Revised: 09/04/2008] [Accepted: 09/10/2008] [Indexed: 02/07/2023]
Abstract
cis-Diamminedichloroplatinum (II) (cisplatin) is an important chemotherapeutic agent useful in the treatment of several cancers; however, it has several side effects such as nephrotoxicity. The role of the oxidative and nitrosative stress in cisplatin-induced nephrotoxicity is additionally supported by the protective effect of several free radical scavengers and antioxidants. Furthermore, in in vitro experiments, antioxidants or reactive oxygen species (ROS) scavengers have a cytoprotective effect on cells exposed to cisplatin. Recently, the participation of nitrosative stress has been more explored in cisplatin-induced renal damage. The use of a water-soluble Fe(III) porphyrin complex able to metabolize peroxynitrite (ONOO(-)) has demonstrated that this anion contributes to both in vivo and in vitro cisplatin-induced toxicity. ONOO(-) is produced when nitric oxide (NO*) reacts with superoxide anion (O(2)(*-)); currently, there are evidences suggesting alterations in NO* production after cisplatin treatment and the evidence appear to NO* has a toxic effect. This article goes through current evidence of the mechanism by more than a few compounds have beneficial effects on cisplatin-induced nephrotoxicity, contribute to understanding the role of oxidative and nitrosative stress and suggest several points as part of the mechanism of cisplatin toxicity.
Collapse
Affiliation(s)
- Yolanda I Chirino
- Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Tlalpan, DF, Mexico.
| | | |
Collapse
|
9
|
Zhang F, Bartels MJ, Geter DR, Jeong YC, Schisler MR, Wood AJ, Kan L, Gollapudi BB. Quantitation of glutathione by liquid chromatography/positive electrospray ionization tandem mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2008; 22:3608-3614. [PMID: 18937228 DOI: 10.1002/rcm.3776] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Glutathione (GSH) is a tripeptide composed of glutamate, cysteine, and glycine. It is present in practically all cells and has several important roles, such as preventing the oxidation of the sulfhydryl groups of proteins within a cell. Evidence for GSH deficiency or depletion has been found in a variety of diseases and toxicity-related studies, including diabetes and induction of oxidative stress to form reactive oxygen species which cause DNA, lipid, and protein oxidations. A simple, selective, and sensitive analytical method for measuring low levels of GSH in biological fluids would therefore be desirable to conduct GSH deficiency or depletion-related mechanistic toxicity studies. Here a method for both low- and high-level quantitation of GSH from cultured cells and rat liver tissues via liquid chromatography/positive electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) has been developed. The lower limit of quantitation (LOQ) of the method was 5 ng/mL. The method is linear over a wide dynamic concentration range of 5.0 to 5000.0 ng/mL, with a correlation coefficient R2 > 0.99. The intra-day assay precision relative standard deviation (RSD) values for all quality control (QC) samples were < or =16.31%, with accuracy values ranging from 94.13 to 97.80%. The inter-day assay precision RSD values for all QC samples were < or =15.94%, with accuracy values ranging from 94.51 to 100.29%. With this method, low levels of GSH from diethyl maleate (DEM)-treated mouse lymphoma cells, and GSH in rat liver tissues, were quantified.
Collapse
Affiliation(s)
- Fagen Zhang
- Toxicology and Environmental Research & Consulting, The Dow Chemical Company, 1803 Building, Midland, MI 48674, USA.
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Silanikove N. Milk lipoprotein membranes and their imperative enzymes. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2007; 606:143-61. [PMID: 18183928 DOI: 10.1007/978-0-387-74087-4_5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There are two main sources of lipoprotein membranes in milk: the relatively well-defined milk fat globule membrane (MFGM) that covers the milk fat globules, and the much less attended lipoprotein source, in the form of vesicles floating in the milk serum. We challenge the common view that the milk serum lipoprotein membrane (MSLM) is secondly derived from the MFGM and present a different view suggesting that it represents Golgi-derived vesicles that are released intact to milk. The potential role of enzymes attached to the MSLM and MFGM is considered in detail for select ubiquitously expressed enzymes.
Collapse
Affiliation(s)
- Nissim Silanikove
- Agricultural Research Organization, Institute of Animal Science, Bet Dagan, 50-250, Israel.
| |
Collapse
|
11
|
Tome ME, Johnson DBF, Samulitis BK, Dorr RT, Briehl MM. Glucose 6-phosphate dehydrogenase overexpression models glucose deprivation and sensitizes lymphoma cells to apoptosis. Antioxid Redox Signal 2006; 8:1315-27. [PMID: 16910779 DOI: 10.1089/ars.2006.8.1315] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Glucocorticoids are one component of combined treatment regimens for many types of lymphoma due to their ability to induce apoptosis in lymphoid cells. In WEHI7.2 murine thymic lymphoma cells, altering catalase and glutathione peroxidase activity by transfection or the use of chemical agents modulates the ability of glucocorticoids to induce apoptosis. This suggests that the oxidative stress response is important in determining the glucocorticoid sensitivity of the cells. For glutathione peroxidase and catalase to detoxify reactive oxygen species (ROS), reducing equivalents in the form of nicotinamide adenine dinucleotide phosphate, reduced form (NADPH) are ultimately required. The major source of NADPH in the cell is glucose 6-phosphate dehydrogenase (G6PDH). Therefore, we created G6PDH-overexpressing WEHI7.2 variants to test whether G6PDH activity is a key determinant of glucocorticoid sensitivity in WEHI7.2 cells. G6PDH-overexpressing WEHI7.2 cells were more sensitive to oxidative stress and glucocorticoids. The G6PDH-overexpressing WEHI7.2 variants appeared similar to cells undergoing glucose deprivation with decreased adenosine triphosphate (ATP) synthesis by the mitochondria and increased basal levels of ROS. Overexpression of G6PDH also sensitized the cells to other standard lymphoma chemotherapeutics including cyclophosphamide, doxorubicin, and vincristine. The decreased ATP and elevated ROS due to G6PDH overexpression may be key factors in increasing the sensitivity of the WEHI7.2 cells to lymphoma chemotherapeutics.
Collapse
Affiliation(s)
- Margaret E Tome
- Department of Pathology, University of Arizona, Tucson, 85724, USA
| | | | | | | | | |
Collapse
|
12
|
Miquel J, Ramírez-Boscá A, Ramírez-Bosca JV, Alperi JD. Menopause: a review on the role of oxygen stress and favorable effects of dietary antioxidants. Arch Gerontol Geriatr 2006; 42:289-306. [PMID: 16442644 DOI: 10.1016/j.archger.2005.08.005] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2005] [Revised: 08/11/2005] [Accepted: 08/15/2005] [Indexed: 12/26/2022]
Abstract
Menopause is often accompanied by hot flashes and degenerative processes such as arteriosclerosis and atrophic changes of the skin that suggest an acceleration of aging triggered by estrogen lack. Therefore, hormone replacement therapy (HRT) has been considered the most suitable treatment for the above symptoms and processes. However, because of the possible serious side effects of HRT (especially the increased risk of thrombo-embolic accidents and breast cancer) there is a growing demand for alternative treatments of the symptoms and pathological processes associated with menopause. In agreement with the above, we review research that supports the concept that oxygen stress contributes to menopause and that some of its physiopathological effects may be prevented and/or treated improving the antioxidant defense of menopausic and postmenopausic women. Accordingly, a selection of micronutrients may be useful as a dietary supplement for protection against the decline of physiological functions caused by age-related oxygen stress. Since aging is accompanied by a progressive oxidation of the physiological sulfur pool, we emphasize the role of the vitamins B that help to maintain the GSH/GSSG ratio in its normal reduced state. Nutritional supplements should also include the key antioxidant vitamins C and E, as well as beta-carotene and the mineral micronutrients found in the oxygen radical-detoxifying enzymes glutathione peroxidase and superoxide dismutase. Moreover, the reviewed data suport the concept that other antioxidants such as lipoic acid and the precursors of glutathione thioproline (TP) and l-2-oxothiazolidine-4-carboxylic acid (OTC), as well as the soy isoflavones and the "coantioxidants" of an hydroalcoholic extract of Curcuma longa may help to prevent antioxidant deficiency with resulting protection of mitochondria against premature oxidative damage with loss of ATP synthesis and especialized cellular functions. Therefore, the administration under medical advice of synergistic combinations of some of the above mentioned antioxidants in the diet as well as topically (for skin protection) may have favorable effects on the health and quality of life of women, especially of those who cannot be treated with HR, suffer high levels of oxygen stress, and do not consume a healthy diet that includes five daily rations of fresh fruit and vegetables.
Collapse
Affiliation(s)
- Jaime Miquel
- Department of Biotechnology, University of Alicante, San Vicente, Ap. 99, E-03080 Alicante, Spain
| | | | | | | |
Collapse
|
13
|
Echevarria-Lima J, Kyle-Cezar F, P Leite DF, Capella L, Capella MAM, Rumjanek VM. Expression and activity of multidrug resistance protein 1 in a murine thymoma cell line. Immunology 2005; 114:468-75. [PMID: 15804283 PMCID: PMC1782113 DOI: 10.1111/j.1365-2567.2005.02116.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Multidrug resistance proteins [MRPs and P-glycoprotein (Pgp)] are members of the family of ATP-binding cassette (ABC) transport proteins, originally described as being involved in the resistance against anti-cancer agents in tumour cells. These proteins act as ATP-dependent efflux pumps and have now been described in normal cells where they exert physiological roles. The aim of this work was to investigate the expression and activity of MRP and Pgp in the thymoma cell line, EL4. It was observed that EL4 cells expressed mRNA for MRP1, but not for MRP2, MRP3 or Pgp. The activity of ABC transport proteins was evaluated by using the efflux of the fluorescent probes carboxy-2'-7'-dichlorofluorescein diacetate (CFDA) and rhodamine 123 (Rho 123). EL4 cells did not retain CFDA intracellularly, and MRP inhibitors (probenecid, indomethacin and MK 571) decreased MRP1 activity in a concentration-dependent manner. As expected, EL4 cells accumulated Rho 123, and the presence of cyclosporin A and verapamil did not modify this accumulation. Most importantly, when EL4 cells were incubated in the presence of the MRP1 inhibitors indomethacin and MK 571 for 6 days, they started to express CD4 and CD8 molecules on their surface, producing double-positive cells and CD8 single-positive cells. Our results suggest that MRP activity is important for the maintenance of the undifferentiated state in this cell type. This finding might have implications in the physiological process of normal thymocyte maturation.
Collapse
Affiliation(s)
- Juliana Echevarria-Lima
- Laboratório de Imunologia Tumoral, Departamento de Bioquímica Médica, Universidade Federal do Rio de Janeiro, Brazil
| | | | | | | | | | | |
Collapse
|
14
|
Vincent S, Tourniaire F, El Yazidi CM, Compe E, Manches O, Plannels R, Roche R. Nelfinavir Induces Necrosis of 3T3F44-2A Adipocytes by Oxidative Stress. J Acquir Immune Defic Syndr 2004; 37:1556-62. [PMID: 15577407 DOI: 10.1097/00126334-200412150-00003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Protease inhibitor treatment strongly diminishes mortality in HIV-infected patients. This treatment has also been associated with lipodystrophy and has been shown to alter adipocyte differentiation. The protease inhibitor nelfinavir has been indirectly implicated in the appearance and development of lipodystrophic syndrome, as well as in adipocyte cell death. The aim of this study was to evaluate the effects of nelfinavir on the 3T3-F442A adipocyte cell line. Nelfinavir (30 microM) induced cell death of 3T3-F442A adipocytes by a necrotic process that was not mediated by TNF-alpha. Treatment of cells with this protease inhibitor led to a significant increase in expression of the heme oxygenase-1 gene that could be reduced by 100 microM of the antioxidant ascorbate. Moreover, ascorbate had a protective effect on nelfinavir-induced necrosis, decreasing the percentage of necrotic cells by 70%. Our results show that nelfinavir induces necrosis of adipocytes mediated by a cellular increase of reactive oxygen species. This deleterious effect could be counterbalanced by ascorbate.
Collapse
|
15
|
Abstract
The mechanisms of alcohol toxicity as related to mitochondrial dysfunction and the glutathione-dependent protective systems are reviewed. The pathophysiology of ethanol-induced liver damage is defined in terms of an early phase and a late phase. CYP2E1 dependent toxicity appears closely related to oxidative stress injury with possible roles of peroxynitrite, TNFalpha, protein adducts, and enhanced protein expression. Modulation of mitochondrial glutathione affects mitochondrial function and cell survival with superoxide and hydrogen peroxide generation being crucial to mitochondrial membrane permeability transition and apoptosis.
Collapse
Affiliation(s)
- Donald J Reed
- Department of Biochemistry and Biophysics, 2011 ALS, Oregon State University, Corvallis, Oregon 97331, USA.
| |
Collapse
|
16
|
Quadrilatero J, Hoffman-Goetz L. N-Acetyl-L-cysteine prevents exercise-induced intestinal lymphocyte apoptosis by maintaining intracellular glutathione levels and reducing mitochondrial membrane depolarization. Biochem Biophys Res Commun 2004; 319:894-901. [PMID: 15184067 DOI: 10.1016/j.bbrc.2004.05.068] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2004] [Indexed: 10/26/2022]
Abstract
Intense exercise leads to post-exercise lymphocytopenia and immunosuppression, possibly by triggering lymphocyte apoptosis. To test the role of oxidative stress on exercise-induced lymphocyte apoptosis, we administered the antioxidant N-acetyl--cysteine (NAC) and measured apoptosis in intestinal lymphocytes (IL) from exhaustively exercised animals. Eighty-seven female C57BL/6 mice were randomly assigned to receive NAC (1 g/kg) or saline 30 min prior to treadmill exercise for 90 min at 2degrees slope (30 min at 22 m min(-1), 30 min at 25 m min(-1), and 30 min at 28 m min(-1)) and sacrificed immediately (Imm) or 24 hours (24 h) after cessation of exercise. Control mice (nonexercised) were exposed to treadmill noise and vibration without running. Exercise increased IL phosphatidylserine externalization (p<0.001), mitochondrial membrane depolarization (p<0.05), and decreased intracellular glutathione concentrations (p<0.05) immediately following exercise in saline relative to nonexercised mice. At 24 h post-exercise, saline injected mice had fewer total (p<0.001) and CD3+ (p<0.005) IL compared to nonexercised animals. NAC injection in mice maintained intracellular glutathione levels, prevented phosphatidylserine externalization, mitochondrial membrane depolarization, and loss of IL immediately and 24 h after exercise. These data suggest that lymphocyte apoptosis precedes post-exercise lymphocytopenia and may be due to oxidative stress.
Collapse
Affiliation(s)
- J Quadrilatero
- Department of Health Studies and Gerontology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ont., Canada
| | | |
Collapse
|
17
|
Abstract
PURPOSE OF REVIEW Radiographic contrast media are used at an increasing rate for several diagnostic and therapeutic applications. Therefore, contrast agent-induced nephropathy will become more important, including the risk of patient impairment and costs. The prevention of radiographic contrast-induced nephropathy is mandatory. Radiographic contrast agent-induced nephropathy is caused by vasoconstriction-mediated renal medullary ischaemia and direct toxic damage to renal tubular epithelial cells. These effects may be partly mediated by the generation of reactive oxygen species. Data from experimental studies indicate that antioxidants, e.g. acetylcysteine, may prevent radiocontrast-induced nephropathy. RECENT FINDINGS Two prospective, randomized, placebo-controlled studies in patients with moderate renal insufficiency confirmed that the prophylactic oral administration of acetylcysteine, at a dose of 600 mg twice a day along with hydration, prevents the reduction in renal function after radiocontrast administration. SUMMARY The use of acetylcysteine together with hydration is the treatment of choice to protect against radiographic contrast media-induced nephropathy.
Collapse
Affiliation(s)
- Martin Tepel
- Medizinische Klinik IV, Universitätsklinikum Benjamin-Franklin, Freie Universität, Berlin, Germany.
| | | |
Collapse
|