Pharmacokinetics and nephrotoxicity of cisplatin modulated by combination therapy with brusatol

Ethnopharmacological Relevance: , significantly increases the intracellular concentration of cisplatin and reduces tumor size by inhibiting the Nrf2 pathway. However, the underlying mechanism remains unclear. Objective: This study focuses on the effects of brusatol on plasma pharmacokinetics, tissue distribution, and nephrotoxicity of cisplatin. Materials and Methods: pharmacokinetic interaction. In the nephrotoxicity study, 30 Kunming mice were randomly divided into groups to receive cisplatin (10 mg/kg) alone or brusatol pretreatment (1 mg/kg or 2 mg/kg). Two control groups received brusatol (1 mg/kg) or solvent. Blood samples and kidney tissues were collected to investigate the underlying mechanisms of toxicity. Results: The developed HPLC-MS method demonstrated high precision and accuracy, meeting the requirements for biological sample analysis. Brusatol reduced the plasma concentration of cisplatin, increased the apparent volume of distribution (Vd), and significantly increased cisplatin concentrations in the kidney and lung, particularly in the kidney. Combined with brusatol, serum levels of blood urea nitrogen and creatinine increased, antioxidant indices in kidney tissue decreased, and inflammatory factors increased. Pathological findings revealed increased tubular congestion. Discussion and Conclusion: Brusatol increases renal cisplatin concentrations by altering its pharmacokinetics, intensifying dose-dependent nephrotoxicity. Further development as a chemotherapy sensitizer requires understanding the mechanisms of this effect and optimizing the combined dose.