Oligonucleotides have shifted drug discovery into a new paradigm due to their ability to silence the genes and inhibit protein translation. Importantly, they can drug the un-druggable targets from the conventional small-molecule perspective. Unfortunately, poor cellular permeability and susceptibility to nuclease degradation remain as major hurdles for the development of oligonucleotide therapeutic agents. Studies of safe and effective delivery technique with lipid bioconjugates gains attention to resolve these issues. Our review article summarizes the physicochemical effect of well-studied hydrophobic moieties to enhance the cellular entry of oligonucleotides. The structural impacts of fatty acids, cholesterol, tocopherol, and squalene on cellular internalization and membrane penetration in vitro and in vivo were discussed first. The crucial assays for delivery evaluation within this section were analyzed sequentially. Next, we provided a few successful examples of lipid-conjugated oligonucleotides advanced into clinical studies for treating patients with different medical backgrounds. Finally, we pinpointed current limitations and outlooks in this research field along with opportunities to explore new modifications and efficacy studies.

Nephrotoxicity is a significant adverse effect of many cancer chemotherapies, often limiting treatment success and complicating clinical management. The kidneys are essential for removing antineoplastic drugs and their metabolites through glomerular filtration and tubular secretion. Unfortunately, both traditional cytotoxic agents and newer targeted therapies can harm various parts of the nephron, including the renal vasculature. This damage can present clinically as proteinuria, hypertension, electrolyte imbalances, glomerulopathies, acute and chronic interstitial nephritis, acute kidney injury (AKI), and often progression to chronic kidney disease (CKD). Among cytotoxic drugs, anthracyclines, potent natural antibiotics, are widely used to treat a broad range of cancers. Doxorubicin (DOX), the most common anthracycline, is particularly effective but also linked to notable nephrotoxic effects. Doxorubicin-induced kidney damage is multifactorial, involving oxidative stress, inflammation, and apoptosis, which collectively impair renal structure and function. This review discusses the mechanisms behind doxorubicin-induced nephrotoxicity and emphasizes the urgent need for nephroprotective strategies. It also reviews current therapies under investigation to reduce renal damage caused by DOX, including natural compounds and pharmacological agents that target oxidative and inflammatory pathways, aiming to preserve renal function and improve the safety of chemotherapy treatments.

Background: This study investigates how sorafenib induces toxicity in glomerular cells and examines the protective role of 8,9-epoxyeicosatrienoic acid (8,9-EET) analogs in reducing this kidney damage. Methods: Human renal mesangial cells (HRMCs) and podocytes were treated with no treatment, sorafenib alone, or sorafenib combined with 8,9-EET analogs. Cell viability and apoptosis were measured in both cell types. Results: Sorafenib (1–10 µM) lowered cell viability and increased caspase 3/7 activity in a dose-dependent way in HRMCs and podocytes. Five of twenty 8,9-EET analogs significantly enhanced cell survival and decreased apoptosis. RNA sequencing showed that sorafenib altered 1244 genes, including those involved in cell cycle and the Raf/MEK/ERK pathway. The 8,9-EET analog MDB-52a raised ANGPTL4 levels, linked to metabolism and vascular health, and reduced ACTA2, which could activate protective pathways. Nephroseq data correlated these gene changes with glomerulosclerosis. Conclusions: MDB-52 appears to counteract gene disruptions and protect against sorafenib-induced kidney damage. Overall, 8,9-EET analogs targeting glomerular cells could be potential therapeutic agents to lessen sorafenib-related nephrotoxicity.