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Bushau-Sprinkle AM, Barati MT, Zheng Y, Watson WH, Gagnon KB, Khundmiri SJ, Kitterman KT, Clark BJ, Siskind LJ, Doll MA, Brier ME, Coventry S, Lederer ED. Na/H Exchange Regulatory Factor 1 Deficient Mice Show Evidence of Oxidative Stress and Altered Cisplatin Pharmacokinetics. Antioxidants (Basel) 2021; 10:1036. [PMID: 34203453 PMCID: PMC8300832 DOI: 10.3390/antiox10071036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 11/22/2022] Open
Abstract
(1) Background: One third of patients who receive cisplatin develop an acute kidney injury. We previously demonstrated the Na/H Exchange Regulatory Factor 1 (NHERF1) loss resulted in increased kidney enzyme activity of the pentose phosphate pathway and was associated with more severe cisplatin nephrotoxicity. We hypothesized that changes in proximal tubule biochemical pathways associated with NHERF1 loss alters renal metabolism of cisplatin or response to cisplatin, resulting in exacerbated nephrotoxicity. (2) Methods: 2-4 month-old male wild-type and NHERF1 knock out littermate mice were treated with either vehicle or cisplatin (20 mg/kg dose IP), with samples taken at either 4, 24, or 72 h. Kidney injury was determined by urinary neutrophil gelatinase-associated lipocalin and histology. Glutathione metabolites were measured by HPLC and genes involved in glutathione synthesis were measured by qPCR. Kidney handling of cisplatin was assessed by a kidney cortex measurement of γ-glutamyl transferase activity, Western blot for γ-glutamyl transferase and cysteine S-conjugate beta lyase, and ICP-MS for platinum content. (3) Results: At 24 h knock out kidneys show evidence of greater tubular injury after cisplatin and exhibit a decreased reduced/oxidized glutathione ratio under baseline conditions in comparison to wild-type. KO kidneys fail to show an increase in γ-glutamyl transferase activity and experience a more rapid decline in tissue platinum when compared to wild-type. (4) Conclusions: Knock out kidneys show evidence of greater oxidative stress than wild-type accompanied by a greater degree of early injury in response to cisplatin. NHERF1 loss has no effect on the initial accumulation of cisplatin in the kidney cortex but is associated with an altered redox status which may alter the activity of enzymes involved in cisplatin metabolism.
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Affiliation(s)
- Adrienne M. Bushau-Sprinkle
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40202, USA; (A.M.B.-S.); (Y.Z.); (W.H.W.); (L.J.S.); (M.A.D.); (M.E.B.)
| | - Michelle T. Barati
- Department of Medicine, Division of Nephrology, University of Louisville, Louisville, KY 40202, USA; (M.T.B.); (K.T.K.)
| | - Yuxuan Zheng
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40202, USA; (A.M.B.-S.); (Y.Z.); (W.H.W.); (L.J.S.); (M.A.D.); (M.E.B.)
| | - Walter H. Watson
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40202, USA; (A.M.B.-S.); (Y.Z.); (W.H.W.); (L.J.S.); (M.A.D.); (M.E.B.)
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, KY 40202, USA
| | - Kenneth B. Gagnon
- Division of Nephrology and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Department of Medicine, Dallas, TX 75390, USA;
| | - Syed Jalal Khundmiri
- Department of Physiology and Biophysics, College of Medicine, Howard University, Washington, DC 20059, USA;
| | - Kathleen T. Kitterman
- Department of Medicine, Division of Nephrology, University of Louisville, Louisville, KY 40202, USA; (M.T.B.); (K.T.K.)
| | - Barbara J. Clark
- Department of Biochemistry and Molecular Genetics, University of Louisville, Louisville, KY 40202, USA;
| | - Leah J. Siskind
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40202, USA; (A.M.B.-S.); (Y.Z.); (W.H.W.); (L.J.S.); (M.A.D.); (M.E.B.)
| | - Mark A. Doll
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40202, USA; (A.M.B.-S.); (Y.Z.); (W.H.W.); (L.J.S.); (M.A.D.); (M.E.B.)
| | - Michael E. Brier
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40202, USA; (A.M.B.-S.); (Y.Z.); (W.H.W.); (L.J.S.); (M.A.D.); (M.E.B.)
- Department of Medicine, Division of Nephrology, University of Louisville, Louisville, KY 40202, USA; (M.T.B.); (K.T.K.)
| | - Susan Coventry
- Department of Pathology, University of Louisville, Louisville, KY 40202, USA;
- Department of Pediatrics, University of Louisville, Louisville, KY 40202, USA
| | - Eleanor D. Lederer
- Division of Nephrology and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Department of Medicine, Dallas, TX 75390, USA;
- VA North Texas Health Sciences Center, Dallas, TX 75216, USA
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Ohashi N, Uematsu T, Nagashima S, Kanamaru M, Tajima N, Togawa A, Hishida A. Pharmacokinetics of panipenem/betamipron in patients with end-stage renal disease. J Infect Chemother 2005; 11:24-31. [PMID: 15729484 DOI: 10.1007/s10156-004-0359-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2004] [Accepted: 11/02/2004] [Indexed: 10/25/2022]
Abstract
Panipenem/betamipron (Carbenin), a parenteral carbapenem antibiotic, is used for the treatment of severe and intractable bacterial infections caused by gram-positive and gram-negative bacteria. Because 30% of panipenem and most of the betamipron are excreted in the urine in an unchanged form, renal function is the important determinant of the dosage regimen of panipenem/betamipron. In this study, the pharmacokinetics of panipenem/betamipron were investigated in patients with end-stage renal disease (ESRD) undergoing hemodialysis treatment to establish an appropriate dose regimen. We further attempted to predict the in vivo clearance in patients undergoing hemodialysis based on the in vitro dializability. The pharmacokinetics of panipenem/betamipron were investigated in eight patients after a 1-h intravenous infusion of panipenem/betamipron (500 mg/500 mg). The in vitro extraction ratios of panipenem/betamipron through a high-flux dialyzer were obtained, and compared with those obtained in vivo. The clearances of panipenem in patients were 9.53 +/- 1.26 l/h with hemodialysis, and 2.92 +/- 0.238 l/h without hemodialysis. In contrast, those of betamipron were 4.18 +/- 0.643 l/h and 0.615 +/- 0.511 l/h, respectively. The clearance of panipenem with hemodialysis were predicted well from in vitro extraction ratios, while that of betamipron was overestimated about 1.4-fold, probably due to high plasma protein binding and the binding difference between patients and healthy subjects. After comparing the pharmacokinetic behavior of panipenem in patients with ESRD and that of a surrogate marker of efficacy, we recommend that these patients be treated with 500 mg/500 mg of panipenem/betamipron once daily, which gives a similar clinical result in a patient with normal renal function.
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Affiliation(s)
- Naro Ohashi
- First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan.
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Abstract
Nephrotoxicity is an inherent adverse effect of certain anticancer drugs. Renal dysfunction can be categorised as prerenal uraemia, intrinsic damage or postrenal uraemia according to the underlying pathophysiological process. Renal hypoperfusion promulgates prerenal uraemia. Intrinsic renal damage results from prolonged hypoperfusion, exposure to exogenous or endogenous nephrotoxins, renotubular precipitation of xenobiotics or endogenous compounds, renovascular obstruction, glomerular disease, renal microvascular damage or disease, and tubulointerstitial damage or disease. Postrenal uraemia is a consequence of clinically significant urinary tract obstruction. Clinical signs of nephrotoxicity and methods used to assess renal function are discussed. Mechanisms of chemotherapy-induced renal dysfunction generally include damage to vasculature or structures of the kidneys, haemolytic uraemic syndrome and prerenal perfusion deficits. Patients with cancer are frequently at risk of renal impairment secondary to disease-related and iatrogenic causes. This article reviews the incidence, presentation, prevention and management of anticancer drug-induced renal dysfunction. Dose-related nephrotoxicity subsequent to administration of certain chloroethylnitrosourea compounds (carmustine, semustine and streptozocin) is commonly heralded by increased serum creatinine levels, uraemia and proteinuria. Additional signs of streptozocin-induced nephrotoxicity include hypophosphataemia, hypokalaemia, hypouricaemia, renal tubular acidosis, glucosuria, aceturia and aminoaciduria. Cisplatin and carboplatin cause dose-related renal dysfunction. In addition to increased serum creatinine levels and uraemia, electrolyte abnormalities, such as hypomagnesaemia and hypokalaemia, are commonly reported adverse effects. Rarely, cisplatin has been implicated as the underlying cause of haemolytic uraemic syndrome. Pharmaceutical antidotes to cisplatin-induced nephrotoxicity include amifostine, sodium thiosulfate and diethyldithiocarbamate. Dose- and age-related proximal tubular damage is an adverse effect of ifosfamide. In addition to renal wasting of electrolytes, glucose and amino acids, Fanconi syndrome, rickets and osteomalacia have occurred with ifosfamide treatment. High dose azacitidine causes renal dysfunction manifested by tubular acidosis, polyuria and increased urinary excretion of electrolytes, glucose and amino acids. Haemolytic uraemia is a rare adverse effect of gemcitabine. Methotrexate can cause increased serum creatinine levels, uraemia and haematuria. Acute renal failure is reported following administration of high dose methotrexate. Urinary alkalisation and hydration confer protection against methotrexate-induced renal dysfunction. Dose-related nephrotoxicity, including acute renal failure, are reported subsequent to treatment with pentostatin and diaziquone. Acute renal failure is a rare adverse effect of treatment with interferon-alpha. Haemolytic uraemic syndrome occurs with mitomycin administration. A mortality rate of 50 to 100% is reported in patients developing mitomycin-induced haemolytic uraemic syndrome. Capillary leak syndrome occurring with aldesleukin therapy can cause renal dysfunction. Infusion-related hypotension during infusion of high dose carmustine can precipitate renal dysfunction.
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Affiliation(s)
- P E Kintzel
- Department of Pharmacy, Harper Hospital, Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, Michigan 48201, USA.
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