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Melatonin ameliorates the drug induced nephrotoxicity: Molecular insights

Zohaib Raza¹, Zainab Naureen²

¹Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan.

|November 19, 2019

Abstract

Background:

Drug-induced nephrotoxicity is a frequent adverse event that can lead to acute or chronic kidney disease and increase the healthcare expenditure. It has high morbidity and mortality incidence in 40-70% of renal injuries and accounts for 66% cases of renal failure in elderly population.

Objective:

Amelioration of drug-induced nephrotoxicity has been long soughed to improve the effectiveness of therapeutic drugs. This study was conducted to review the melatonin potential to prevent the pathogenesis of nephrotoxicity induced by important nephrotoxic drugs.

Methods:

We analyzed the relevant studies indexed in Pubmed, Medline, Scielo and Web of science to explain the molecular improvements following melatonin co-administration with special attention to oxidative stress, inflammation and apoptosis as key players of drug-induced nephrotoxicity.

Results:

A robust consensus among researchers of these studies suggested that melatonin efficiently eradicate the chain reaction of free radical production and induced the endogenous antioxidant enzymes which attenuate the lipid peroxidation of cellular membranes and subcellular oxidative stress in drug-induced nephrotoxicity. This agreement was further supported by the melatonin role in disintegration of inflammatory process through inhibition of principle pro-inflammatory or apoptotic cytokines such as TNF-α and NF-κB. These studies highlighted that alleviation of drug-induced renal toxicity is a function of melatonin potential to down regulate the cellular inflammatory and oxidative injury process and to stimulate the cellular repair or defensive mechanisms.

Conclusion:

The comprehensive nephroprotection and safer profile suggests the melatonin to be a useful adjunct to improve the safety of nephrotoxic drugs.

Insights

Melatonin effectively combats drug-induced nephrotoxicity by reducing oxidative stress and inflammation. This antioxidant and anti-inflammatory potential makes melatonin a promising adjunct for improving the safety of nephrotoxic drugs.

Area of Science:

Pharmacology
Nephrology
Toxicology

Background:

Drug-induced nephrotoxicity is a significant cause of kidney disease, increasing morbidity, mortality, and healthcare costs.
It affects 40-70% of acute kidney injury cases and contributes to 66% of renal failure in the elderly.

Purpose of the Study:

To review the potential of melatonin in preventing drug-induced nephrotoxicity.
To explore melatonin's molecular mechanisms against nephrotoxic agents.

Main Methods:

Systematic review of studies indexed in major scientific databases (PubMed, Medline, Scielo, Web of Science).
Analysis focused on molecular pathways including oxidative stress, inflammation, and apoptosis.

Main Results:

Melatonin neutralizes free radicals and enhances endogenous antioxidant enzymes, reducing lipid peroxidation and oxidative stress.
Melatonin inhibits inflammatory cytokines (e.g., TNF-α, NF-κB) and apoptotic processes.
It downregulates cellular inflammatory and oxidative injury while promoting repair mechanisms.

Conclusions:

Melatonin demonstrates comprehensive nephroprotection against drug-induced toxicity.
Its safety profile suggests it as a valuable adjunct to enhance the safety of nephrotoxic medications.

Read full analysis

Keywords:

Anti-inflammatory Antiinflamatorio Drug-induced nephrotoxicity Eliminación de radicales libres Free radical scavenging Melatonin Melatonina Nefroprotección Nefrotoxicidad inducida por medicamentos Nephroprotection

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