Effect of infliximab on renal injury due to methotrexate in rat
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Updated: Apr 12, 2026

Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
Published on: August 9, 2013
Aynur Kirbas, Medine Cumhur Cure, Yildiray Kalkan
1Department of Internal Medicine, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey. erkancure@yahoo.com.
Introduction:
Methotrexate, an antagonist of folic acid used in the treatment of many cancers and inflammatory diseases, is associated with side effects that limit its usage. Infliximab has been reported to have a protective effect against nephrotoxicity induced by some drugs and ischemic reperfusion. We aimed to investigate whether infliximab has a protective effect against methotrexate-induced nephrotoxicity.
Materials And Methods:
We administered methotrexate at a dose of 20 mg/kg as a single intraperitoneal injection in 10 rats (methotrexate group). Another group of 10 rats received a single dose of infliximab, 7 mg/kg, intraperitoneally (infliximab group). The methotrexate and infliximab group received a similar single injection of infliximab 72 hours prior to methotrexate injection. After 72 hours a single dose of methotrexate, 20 mg/kg, was administered intraperitoneally. Five days after methotrexate injection, blood samples were collected and the kidney tissues were removed for biochemical and histological examination.
Results:
The methotrexate group had significantly higher tissue levels of tumor necrosis factor-α (P = .008), interleukin-1β (P = .04), nitric oxide (P < .001), and adenosine deaminase (P < .001) than the methotrexate and infliximab group after the 5-day study. The methotrexate group also had significantly higher total histological scores (P < .001) and carbonic anhydrase-II activity (P < .001) when compared to the methotrexate and infliximab group.
Conclusions:
Infliximab has a strong protective effect against methotrexate-induced nephrotoxicity by suppressing cytokines release. It may decrease methotrexate-induced nephrotoxicity by regulating carbonic anhydrase-II enzyme activities and slowing down purine metabolism.
Insights
Infliximab protects against kidney damage caused by methotrexate, a common cancer and autoimmune drug. This study shows infliximab reduces inflammation and preserves kidney function when co-administered with methotrexate.
Area of Science:
- Nephrology
- Pharmacology
- Immunology
Background:
- Methotrexate (MTX) is a vital antifolate drug for treating cancers and inflammatory conditions.
- MTX use is limited by dose-dependent nephrotoxicity.
- Infliximab (IFX) is an anti-tumor necrosis factor-alpha biologic with potential protective effects against drug-induced organ damage.
Purpose of the Study:
- To evaluate the protective effect of infliximab against methotrexate-induced nephrotoxicity in a rat model.
- To investigate the impact of infliximab on key inflammatory markers and kidney function following methotrexate administration.
Main Methods:
- Rats received either methotrexate (20 mg/kg, IP) or methotrexate with a prior dose of infliximab (7 mg/kg, IP).
- Kidney tissues and blood samples were collected 5 days post-methotrexate administration.
- Biochemical assays measured inflammatory cytokines (TNF-α, IL-1β), nitric oxide, adenosine deaminase, and carbonic anhydrase-II activity.
- Histological examination assessed kidney damage.
Main Results:
- Methotrexate administration significantly increased kidney levels of TNF-α, IL-1β, nitric oxide, and adenosine deaminase compared to the infliximab co-treated group.
- Histological damage scores and carbonic anhydrase-II activity were significantly lower in rats that received infliximab prior to methotrexate.
- These findings indicate suppressed cytokine release and altered enzyme activity in the presence of infliximab.
Conclusions:
- Infliximab demonstrates a significant protective effect against methotrexate-induced nephrotoxicity.
- This protection is mediated by the suppression of pro-inflammatory cytokines such as TNF-α and IL-1β.
- Infliximab may also mitigate kidney damage by modulating carbonic anhydrase-II activity and influencing purine metabolism.
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