Cilostazol and verapamil are widely used cardiovascular drugs, explored a beneficial effect on different organs-induced toxicities. We investigated whether the Nrf2 (nuclear erythroid factor 2) and its downstream pathway are involved in the protective role of these drugs against TAA-induced renal damage. Renal biomarkers (creatinine and urea) and histopathology were observed. Antioxidant and oxidant indicators; superoxide dismutase (SOD), reduced glutathione (GSH), malondialdehyde (MDA) and total nitrite (NO) were also measured. Antioxidant markers like; Nrf2/hemoxegenase-1 (HO-1) and NADPH quinone oxidoreductase-1 (NQO-1) expressions were determined by ELISA and immunohistochemistry. Cilostazol and verapamil pretreatment improved serum creatinine and urea elevation. Examined drugs also have an ameliorative effect on TAA-induced elevation in MDA and NO activities and antioxidant enzymes; SOD and GSH. Additionally, the pretreated drugs significantly up-regulated Nrf2/HO-1/NQO-1 expression levels. In conclusion, cilostazol and verapamil exerted their protective effects partially via a Nrf2/HO-1/NQO-1 activation pathway with anti-oxidant roles.

Doxorubicin (DOX) cardiotoxicity remains an obstacle to clinical use. The current study examined the possible role of montelukast (ML), which is a cysteinyl leukotrienes receptor antagonist against DOX-induced cardiotoxicity. Male Wistar rats were divided into five groups. The control group, ML group, DOX-challenged group, and DOX/ML-treated groups received ML10 and 20 mg/kg/day for 14 days. Cardiac enzymes; lactate dehydrogenase (LDH); and creatine kinase MB (CK-MB) isoenzymes in serum were measured. Cardiac oxidative/antioxidative parameters were also measured. Cardiac samples were examined for histological images and immunohistochemical expression of tumor necrosis factor alpha (TNF-α)/survivin. Quantitative real-time-polymerase chain reaction was used to detect levels of interleukin (IL)-1β/caspase-3 mRNA. The levels of P-glycoprotein (P-gp), nuclear factor-kappa B , and reactive oxygen species were estimated by enzyme-linked immunosorbent assay. DOX increased serum cardiac enzymes along with oxidative, inflammatory, and apoptotic markers. Both doses of ML significantly ameliorated cardiac enzymes and attenuated all oxidative stress parameters with the enhancement of P-gp activity. It was concluded that ML may be a valuable cardioprotective adjuvant during DOX use.

Purpose: Pulmonary fibrosis (PF) is an inescapable problem. Diacerein, a chondro-protective drug, has antioxidant and anti-inflammatory effects. Its effect on PF injury has not yet been fully clarified. Therefore, the current study aimed to detect its protective effect on lung tissue with the explanation of possible underlying mechanisms. Methods: Adult male albino rats were assigned to four groups: control group, diacerein control group, PF non-treated group, and PF diacerein pretreated group. Lung tissue oxidative stress parameters, inflammatory biomarkers mainly Toll-like receptors-4 (TLR4), and myeloid differentiation factor 88 (MyD88) levels were determined. Histopathological examination of lung tissue and immunohistochemical studies of nuclear factor-kappa B (NF-κB), and transforming growth factor- β (TGF-β) were also done. Results: Diacerein pretreatment has the ability to restore the PF damaging effect, proved by the reduction of the oxidative stress and lung tissue inflammation via downregulation of TLR4/NF-κB signaling pathway together with the restoration of TGF-β level and improvement of the histopathological and immunohistochemical study findings in the lung tissue. Conclusion: These results suggested the protective effect of diacerein on PF relies on its antioxidant and anti-inflammatory effects reducing TLR4/NF-κB signaling pathway.