Natural Reno-Protective Agents against Cyclosporine A-Induced Nephrotoxicity: An Overview

Abstract

CA (cyclosporine A) is a powerful immunosuppressing agent that is commonly utilized for treating various autoimmune illnesses and in transplantation surgery. However, its usage has been significantly restricted because of its unwanted effects, including nephrotoxicity. The pathophysiology of CA-induced kidney injury involves inflammation, apoptosis, tubular injury, oxidative stress, and vascular injury. Despite the fact that exact mechanism accountable for CA's effects is inadequately understood, ROS (reactive oxygen species) involvement has been widely proposed. At present, there are no efficient methods or drugs for treating CA-caused kidney damage. It is noteworthy that diverse natural products have been investigated both in vivo and in-vitro for their possible preventive potential in CA-produced nephrotoxicity. Various extracts and natural metabolites have been found to possess a remarkable potential for restoring CA-produced renal damage and oxidative stress alterations via their anti-apoptosis, anti-inflammatory, and antioxidative potentials. The present article reviews the reported studies that assess the protective capacity of natural products, as well as dietary regimens, in relation to CA-induced nephrotoxicity. Thus, the present study presents novel ideas for designing and developing more efficient prophylactic or remedial strategies versus CA passive influences.

Keywords: cyclosporine A; natural products; nephrotoxicity; phenolics; reno-protective.

Figure 1

Possible mechanisms of cyclosporine A nephrotoxic effects [13,14,15].

Figure 2

Proposed mechanisms of CA oxidative stress-induced reno-toxicity.

Figure 3

Chemical structures of natural metabolites tested for reno-protective potential.

Figure 4

Different classes of natural products protect against CA-induced nephrotoxicity.