Urolithin B as a renoprotective agent against 5-fluorouracil-induced nephrotoxicity: Role of Nrf2/Keap1/HO-1, SIRT1/FOXO3, and NF-кB/TNF-α signaling pathways

Food Chem Toxicol. 2025 Jan:195:115129. doi: 10.1016/j.fct.2024.115129. Epub 2024 Nov 22.

Abstract

The clinical use of 5-fluorouracil (5-FU) in cancer patients has been associated with nephrotoxicity, which is greatly curbing its therapeutic application. The pathogenesis of 5-FU-induced nephrotoxicity is complex; however, oxidative stress-mediated inflammation is considered a central pathogenic factor. Urolithin B (UB), a product of ellagitannins, has recently been assigned diverse pharmacological activities due to its potent antioxidant and anti-inflammatory properties. Therefore, the current study explored the potential renoprotective effect of UB on 5-FU-induced nephrotoxicity in mice and illuminated its potential mechanistic pathways. In this study, administration of UB (50 and 100 mg/kg) mitigated 5-FU-induced elevated levels of kidney injury indices, including renal somatic index, serum creatinine, blood urea nitrogen, and serum cystatin C, that were concurrent with histopathological improvement. UB maintained renal oxidant/antioxidant balance and enhanced the nuclear factor-erythroid-2-related factor-2 (Nrf2)/heme oxygenase 1 (HO-1) as well as the silent information regulator factor 2-related enzyme 1 (SIRT1)/forkhead box O 3 (FOXO3) antioxidant protective responses. On the other hand, 5-FU-driven activation of the NF-кB/TNF-α inflammatory signaling was opposed by UB administration. Conclusively, UB protected against 5-FU-induced nephrotoxicity through dose-dependent antioxidant and anti-inflammatory effects. These effects are mediated mainly through upregulating Nrf2/HO-1 and SIRT-1/FOXO3 antioxidant responses with subsequent suppression of NF-κB inflammatory signaling.

Keywords: 5-Fluorouracil-induced nephrotoxicity; Drug discovery; Health care; Nrf2/Keap1/HO-1; SIRT1/FOXO3; Urolithin B.

MeSH terms

  • Animals
  • Coumarins* / pharmacology
  • Fluorouracil* / adverse effects
  • Fluorouracil* / toxicity
  • Forkhead Box Protein O3* / metabolism
  • Heme Oxygenase (Decyclizing) / metabolism
  • Kelch-Like ECH-Associated Protein 1* / metabolism
  • Kidney / drug effects
  • Kidney / metabolism
  • Kidney Diseases / chemically induced
  • Kidney Diseases / metabolism
  • Kidney Diseases / prevention & control
  • Membrane Proteins / metabolism
  • Mice
  • NF-E2-Related Factor 2* / metabolism
  • NF-kappa B* / metabolism
  • Oxidative Stress / drug effects
  • Protective Agents / pharmacology
  • Signal Transduction* / drug effects
  • Sirtuin 1* / metabolism
  • Tumor Necrosis Factor-alpha* / metabolism

Substances

  • Coumarins
  • Fluorouracil
  • Forkhead Box Protein O3
  • FoxO3 protein, mouse
  • Heme Oxygenase (Decyclizing)
  • Hmox1 protein, mouse
  • Keap1 protein, mouse
  • Kelch-Like ECH-Associated Protein 1
  • Membrane Proteins
  • NF-E2-Related Factor 2
  • NF-kappa B
  • Nfe2l2 protein, mouse
  • Protective Agents
  • Sirt1 protein, mouse
  • Sirtuin 1
  • Tumor Necrosis Factor-alpha
  • urolithin B