• Toxicological Research
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• 제34권2호
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• pp.133-141
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• 2018

Anti-cancer drugs such as cisplatin and doxorubicin are effectively used more than radiotherapy. Cisplatin is a chemotherapeutic drug, used for treatment of various forms of cancer. However, it has side effects such as ototoxicity and nephrotoxicity. Cisplatin-induced nephrotoxicity increases tubular damage and renal dysfunction. Consequently, we investigated the beneficial effect of cynaroside on cisplatin-induced kidney injury using HK-2 cell (human proximal tubule cell line) and an animal model. Results indicated that $10{\mu}M$ cynaroside diminished cisplatin-induced apoptosis, mitochondrial dysfunction and caspase-3 activation, cisplatin-induced upregulation of caspase-3/MST-1 pathway decreased by treatment of cynaroside in HK-2 cells. To confirm the effect of cynaroside on cisplatin-induced kidney injury in vivo, we used cisplatin exposure animal model (20 mg/kg, balb/c mice, i.p., once a day for 3 days). Renal dysfunction, tubular damage and neutrophilia induced by cisplatin injection were decreased by cynaroside (10 mg/kg, i.p., once a day for 3 days). Results indicated that cynaroside decreased cisplatin-induced kidney injury in vitro and in vivo, and it could be used for improving cisplatin-induced side effects. However, further experiments are required regarding toxicity by high dose cynaroside and caspase-3/MST-1-linked signal transduction in the animal model.

• Journal of Applied Biological Chemistry
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• 제59권2호
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• pp.113-124
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• 2016

홍삼은 인삼을 찌고 말리는 과정을 거쳐 제조한 것으로 많은 약리 및 생리활성이 알려져 있다. Cisplatin은 항암제로 사용되고 있으나 부작용으로 골수억제, 위장관계독성, 신경독성, 신독성 등이 보고되어있다. 특히 cisplatin이 신장에 집중적으로 축적됨으로써 투여환자의 25-30%에서 신장독성이 유발된다. 따라서 본 실험에서는 발효홍삼을 이용한 cisplatin의 부작용인 신독성예방효능을 확인하고자 하였다. 시료에 따른 DPPH와 ABTS 라디칼소거능을 실험 결과 RG8F3에서 가장 우수한 소거능을 확인하였고 따라서 RG0SF0와 RG8F3 간의 비교실험이 가능할 것으로 사료되었다. 동물실험은 정상군, 대조군, RG0SF0 투여군 및RG8F3 투여군 4그룹으로 나누었다. 약물투여군은 200 mg/kg/day의 농도로 4일간 투여한 후,cisplatin은 20 mg/kg으로 대조군 및 약물투여군에복강주사하였다. RG8F3 투여한 결과 대조군과 비교하여 GSH의 수치는 증가하였고 ROS, BUN, creatinine 및 염증인자들의 감소를 보였다. 조직학적 결과에서도 신손상으로 인한 변형이 거의 없었다. 결론적으로 발효홍삼은 cisplatin으로 유발되는 신 손상 예방에 유의한 효과를 보이는 것으로 사료된다.

• Journal of Ginseng Research
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• 제41권2호
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• pp.188-194
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• 2017

Background: Fermented black ginseng (FBG) is processed ginseng by the repeated heat treatment and fermentation of raw ginseng. The protective effect and mechanism of FBG on cisplatin-induced nephrotoxicity was investigated to evaluate its therapeutic potential. Methods: The free radical scavenging activity of FBG was measured using 1,1-diphenyl-2-picrylhydrazyl (DPPH). In addition, the protective effect against cisplatin-induced renal damage was tested in rats. FBG was orally administered every day at a dose of 150 mg/kg body weight for 10 d, and a single dose of cisplatin was administered intraperitoneally (7.5 mg/kg body weight) with 0.9% saline on the $4^{th}$ d. Results: The DPPH radical-scavenging activity of FBG ($IC_{50}=384{\mu}g/mL$) was stronger than that of raw ginseng. The improved DPPH radical-scavenging activity was mediated by the generation phenolic compounds. The decreased cell viability by cisplatin was recovered significantly after treatment with FBG in a dose-dependent manner. Then, the protective effect of FBG on cisplatin-induced oxidative renal damage was investigated in rats. The decreased creatinine clearance levels, which are a reliable marker for renal dysfunction in cisplatin-treated rats, were reduced to the normal level after the administration of FBG. Moreover, FBG showed protective effects against cisplatin-induced oxidative renal damage in rats through the inhibition of $NF-{\kappa}B/p65$, COX-2, and caspase-3 activation. Conclusion: These results collectively show that the therapeutic evidence for FBG ameliorates the nephrotoxicity via regulating oxidative stress, inflammation, and apoptosis.

• Natural Product Sciences
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• 제20권4호
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• pp.251-257
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• 2014

Chungsimyeonja-tang (CSYJT) is an herbal decoction that consists with 12 herbal medicines. CSYJT has been shown to have anti-stress, anti-allergic and anti-oxidant effects. The aim of this study was to determine flavonoid contents in CSYJT and evaluate its protective effect against cisplatin induced nephrotoxicity using both in vitro (porcine renal epithelial cell; PK15 cell) and in vivo (Sprague Dawley rat) experiments. In the present study, thee mean contents of baicalin, wogonoside and baicalein in CSYJT were 14.65, 5.27 and 0.02 mg/g, respectively. The CSYJT extract treatment attenuated the following alteration in porcine renal epithelial (PK15) cell: the increase in reactive oxygen species (ROS), the glutathione depletion and the increase in p53 expression induced by cisplatin treatment. In the in vivo study, rats were orally treated with CSYJT extract once a day for 28 days. Five days before the last treatment, cisplatin (5 mg/kg) was intraperitoneally injected to induce acute renal failure. Increased blood urea nitrogen (BUN) and creatinine (CRE) levels after cisplatin treatment were ameliorated by pretreatment of CSYJT extract. In addition, lipid peroxidation was decreased and antioxidant enzyme (glutathione) was recovered in CSYJT pretreated kidney tissue. In histopathological examination, CSYJT pretreated group showed ameliorated pathological alteration after cisplatin injection with decreased apoptosis. Taken together, pretreatment of CSYJT could ameliorate cisplatin-induced nephrotoxicity.

• Molecules and Cells
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• 제37권3호
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• pp.234-240
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• 2014

Cisplatin is one of the most potent chemotherapy agents. However, its use is limited due to its toxicity in normal tissues, including the kidney and ear. In particular, nephrotoxicity induced by cisplatin is closely associated with oxidative stress and inflammation. Heme oxygenase-1(HO-1), the rate-limiting enzyme in the heme metabolism, has been implicated in a various cellular processes, such as inflammatory injury and anti-oxidant/oxidant homeostasis. Capsaicin is reported to have therapeutic potential in cisplatin-induced renal failures. However, the mechanisms underlying its protective effects on cisplatin-induced nephrotoxicity remain largely unknown. Herein, we demonstrated that administration of capsaicin ameliorates cisplatin-induced renal dysfunction by assessing the levels of serum creatinine and blood urea nitrogen (BUN) as well as tissue histology. In addition, capsaicin treatment attenuates the expression of inflammatory mediators and oxidative stress markers for renal damage. We also found that capsaicin induces HO-1 expression in kidney tissues and HK-2 cells. Notably, the protective effects of capsaicin were completely abrogated by treatment with either the HO inhibitor ZnPP IX or HO-1 knockdown in HK-2 cells. These results suggest that capsaicin has protective effects against cisplatin-induced renal dysfunction through induction of HO-1 as well as inhibition oxidative stress and inflammation.

• 대한한방내과학회지
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• 제35권1호
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• pp.92-105
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• 2014

목 적 : 본 연구는 청허열약(淸虛熱藥)으로서 폐(肺), 간(肝), 신경(腎經)에 귀경(歸經)하여 양혈제증(凉血除蒸), 청폐강화(淸肺降火)의 효능으로 음허조열(陰虛潮熱), 골증도한(骨蒸盜汗), 폐열해수(骨蒸盜汗), 객혈(喀血), 육혈(衄血), 내열소갈(內熱消渴) 등의 치료에 상용되는 지골피(地骨皮)에 대해, 산화적 스트레스를 유발하여 신 독성을 일으키는 것으로 알려진 cisplatin을 투여한 Wistar rats에서의 신기능 손상 방지 효능을 관찰하고, 산화적 스트레스 및 그로 인한 염증반응 관련 전사인자와 효소들에 대한 억제효과와 항산화제를 촉진하는 효능을 확인하였다. 방 법 : Cisplatin으로 급성신부전증이 유도된 Wistar rats에서 地骨皮의 복용으로 인한 혈중 BUN 수치 변화를 관찰함으로써 신기능 보호효과를 확인하였다. Cisplatin으로 인한 신 손상의 주요 기전으로 알려진 산화적 스트레스에 대한 억제 효과를 확인하기 위하여 신 조직에서의 ROS, TBARS 수치를 관찰하고, ROS를 생성시키는 NADPH oxidase의 subunits인 NOX-4, $p47^{phox}$, $p22^{phox}$와 산화적 스트레스로 유도되는 염증반응과 관련한 NF-${\kappa}B$의 활성 및 COX-2, iNOS의 단백질 발현정도를 Western blotting을 통해 확인하였다. 또한 주요 항산화제인 glutathione의 환원형과 산화형 수치를 각각 확인하고 그 비율을 조사하였으며, 또 다른 항산화제인 SOD, catalase의 발현정도를 Western blotting을 통해 확인함으로써 地骨皮의 항산화제 촉진 효능을 관찰하였다. 결 과 : 지골피(地骨皮)는 cisplatin으로 유도된 급성신부전증 모델에서 증가한 혈중 BUN 수치를 감소시켜 신기능 손상을 유효하게 방지하였다. 또한 cisplatin 투여는 Wistar rats에서 산화적 스트레스 및 그로 인한 염증반응 관련 전사인자와 효소들의 발현을 항진시켜 cisplatin의 신 독성 기전이 산화적 스트레스로 초래됨을 확인할 수 있었으며, 지골피(地骨皮) 투여군의 경우 신조직 ROS, TBARS, NADPH oxidase를 유의하게 감소시켰고 NF-${\kappa}B$의 활성과 COX-2, iNOS 발현 또한 억제하는 것을 관찰하였다. 나아가 주요 항산화제로 알려진 GSH, SOD 및 catalase에 대한 지골피(地骨皮)의 촉진효과를 확인하였다. 결 론 : 이상의 결과로 지골피(地骨皮)는 신기능 손상을 방지하고, 항산화제 활성을 촉진시켜 산화적 스트레스와 염증반응을 효과적으로 저해함으로써 cisplatin으로 유발되는 급성신부전증의 치료 및 예방에 활용될 수 있음이 시사되었다.

• Journal of Ginseng Research
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• 제40권2호
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• pp.135-140
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• 2016

Background: Nephrotoxicity is a common side effect of medications. Panax ginseng is one of the best-known herbal medicines, and its individual constituents enhance renal function. Identification of its efficacy and mechanisms of action against drug-induced nephrotoxicity, as well as the specific constituents mediating this effect, have recently emerged as an interesting research area focusing on the kidney protective efficacy of P. ginseng. Methods: The present study investigated the kidney protective effect of fermented black ginseng (FBG) and its active component ginsenoside 20(S)-Rg3 against cisplatin (chemotherapy drug)-induced damage in pig kidney (LLC-PK1) cells. It focused on assessing the role of mitogen-activated protein kinases as important mechanistic elements in kidney protection. Results: The reduced cell viability induced by cisplatin was significantly recovered with FBG extract and ginsenoside 20(S)-Rg3 dose-dependently. The cisplatin-induced elevated protein levels of phosphorylated c-Jun N-terminal kinase (JNK), p53, and cleaved caspase-3 were decreased after cotreatment with FBG extract or ginsenoside 20(S)-Rg3. The elevated percentage of apoptotic LLC-PK1 cells induced by cisplatin treatment was significantly abrogated by cotreatment with FBG and the ginsenoside 20(S)-Rg3. Conclusion: FBG and its major ginsenoside 20(S)-Rg3, ameliorated cisplatin-induced nephrotoxicity in LLC-PK1 cells by blocking the JNKep53ecaspase-3 signaling cascade.

• 한국임상약학회지
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• 제16권2호
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• pp.131-138
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• 2006

Heptaplatin, a new platinum derivative, has several contradicting reports on the nephrotoxicity. Therefore, the aim of this study is to compare the toxicities of heptaplatin-containing regimens in the chemotherapy. This study was performed retrospectively on seventy-seven patients with advanced gastric cancer who did not receive chemotherapy within the last 1 months before taking of heptaplatin- or cisplatin-containing chemotherapy. The 38 patients among total patients was received heptaplatin-containing regimens (26 with SEF regimens: heptaplatin/epirubicin/5-FU, 12 with SF regimens: heptaplatin/5-FU) and the rest 39 patients was received cisplatin-containg regimens (11 with CEF regimens: cisplatin/epirubicin/5-FU, 28 with ELF regimens: epirubicin/leucovorin/5-FU). Before and after the chemotherapy serum creatinine (Scr) and proteinuria were measured by urine stick test in all patient groups. Also Scr was measured a day before the second cycle and did not vary significantly between groups. However Scr on cycle 3 were significantly higher in SEF and SF groups. In case of proteinuria, it was more frequent on cycle 1 in heptaplatin/5-FU group. Proteinuria before and after on cycle 2 was not different between the two cisplatin -containing groups, but was more frequent in heptaplatin-containing groups. The reason why the Scr measured was not so different could be because we excluded the patients who received only one cycle of heptaplatin and changed the regimen due to signs of nephrotoxcity. As the results nephrotoxicity such as protienuria was appeared to be more frequent with heptaplatin-treated patients. It suggests that the clinical consequences of the toxicity need to further evaluation and also the modalities to prevent or minimize nephrotoxicity of heptaplatin should be studied for future utilization of the drug.

• 동의생리병리학회지
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• 제22권5호
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• pp.1140-1146
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• 2008

One of the major side effects of cisplatin is nephrotoxicity, leading to acute renal failure. Recent study has suggested a role of hydroxyl radicals and p53 in renal cell injury by cisplatin. This study determined the possible involvement of oxidative stress in p53 activation. In rat mesangial cells, cisplatin treatment induced apoptosis and p53 activation. Pifithrin-$\alpha$, a pharmacological inhibitor of p53, suppressed cisplatin-induced apoptosis. Cisplatin also induced reactive oxidative species (ROS) generation. Of interest, cisplatin-induced apoptosis was prevented by N-acetyl-cysteine (NAC), a general antioxidant. NAC diminished p53 activation during cisplatin treatment. Puerariae Radix and Rehmanniae Radix Preparata with antioxidative activity were reduced the cisplatin-induced ROS generation, caspase-3 activity and p53 activation. In conclusion, ROS may contribute to p53 activation to initiate cisplatin-induced apoptosis in rat mesangial cells. In result, antioxidative effect of Puerariae Radix and Rehmanniae Radix Preparata prevented cisplatin-induced apoptosis through inhibition of p53 activation.

• Journal of Ginseng Research
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• 제41권3호
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• pp.233-239
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• 2017

Background: Nephrotoxicity is the major side effect in cisplatin chemotherapy. Previously, we reported that the ginsenosides Rk3 and Rh4 reduced cisplatin toxicity on porcine renal proximal epithelial tubular cells (LLC-PK1). Here, we aimed to evaluate the protective effect of ginsenosides Rk3 and Rh4 on kidney function and elucidate their antioxidant effect using in vitro and in vivo models of cisplatin-induced acute renal failure. Methods: An enriched mixture of ginsenosides Rk3 and Rh4 (KG-KH; 49.3% and 43.1%, respectively) was purified from sun ginseng (heat processed Panax ginseng). Cytotoxicity was induced by treatment of $20{\mu}M$ cisplatin to LLC-PK1 cells and rat model of acute renal failure was generated by single intraperitoneal injection of 5 mg/kg cisplatin. Protective effects were assessed by determining cell viability, reactive oxygen species generation, blood urea nitrogen, serum creatinine, antioxidant enzyme activity, and histopathological examination. Results: The in vitro assay demonstrated that KG-KH ($50{\mu}g/mL$) significantly increased cell viability (4.6-fold), superoxide dismutase activity (2.8-fold), and glutathione reductase activity (1.5-fold), but reduced reactive oxygen species generation (56%) compared to cisplatin control cells. KG-KH (6 mg/kg, per os) also significantly inhibited renal edema (87% kidney index) and dysfunction (71.4% blood urea nitrogen, 67.4% creatinine) compared to cisplatin control rats. Of note, KG-KH significantly recovered the kidney levels of catalase (1.2-fold) and superoxide dismutase (1.5-fold). Conclusion: Considering the oxidative injury as an early trigger of cisplatin nephrotoxicity, our findings suggest that ginsenosides Rk3 and Rh4 protect the kidney from cisplatin-induced oxidative injury and help to recover renal function by restoring intrinsic antioxidant defenses.