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An integrated view of cisplatin-induced nephrotoxicity, hepatotoxicity, and cardiotoxicity: characteristics, common molecular mechanisms, and current clinical management

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Abstract

Cisplatin (CP) is a chemotherapy drug widely prescribed to treat various neoplasms. Although fundamental for the therapeutic action of the drug, its cytotoxic mechanisms trigger adverse effects in several tissues, such as the kidney, liver, and heart, which limit its clinical use. In this sense, studies point to an essential role of damage to nuclear and mitochondrial DNA associated with oxidative stress, inflammation, and apoptosis in the pathophysiology of tissue injuries. Due to the limitation of effective preventive and therapeutic measures against CP-induced toxicity, new strategies with potential cytoprotective effects have been studied. Therefore, this article is timely in reviewing the characteristics and main molecular mechanisms common to renal, hepatic, and cardiac toxicity previously described, in addition to addressing the main validated strategies for the current management of these adverse events in clinical practice. We also handle the main promising antioxidant substances recently presented in the literature to encourage the development of new research that consolidates their potential preventive and therapeutic effects against CP-induced cytotoxicity.

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Funding

This work was supported by the Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB), grant number: BOL0472/2021 and BOL0766/2023 and Institutional Program of Scientific Initiation Scholarship (PIBIC) from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), grant number: 01/2023 and Universidade Federal da Bahia (UFBA), grand number: 01/2022.

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  1. Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Bahia, 45029-094, Brazil

    Caroline Assunção Oliveira, Érika Azenathe Barros Mercês, Fernanda Santos Portela, Lara Fabiana Luz Malheiro, Henrique Bruno Lopes Silva, Laís Mafra De Benedictis, Júlia Mafra De Benedictis, Clara Cotta d’Ávilla e Silva, Alberto Christian Luz Santos, Helloisa Souza Velozo, Telma de Jesus Soares & Liliany Souza de Brito Amaral

  2. Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Bahia, 45029-094, Brazil

    Caroline Assunção Oliveira, Telma de Jesus Soares & Liliany Souza de Brito Amaral

  3. Programa de Pós-Graduação em Biociências, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Bahia, 45029-094, Brazil

    Érika Azenathe Barros Mercês, Fernanda Santos Portela, Lara Fabiana Luz Malheiro, Telma de Jesus Soares & Liliany Souza de Brito Amaral

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Oliveira, C.A., Mercês, É.A.B., Portela, F.S. et al. An integrated view of cisplatin-induced nephrotoxicity, hepatotoxicity, and cardiotoxicity: characteristics, common molecular mechanisms, and current clinical management. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02490-x

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