Palmatine ameliorates cisplatin-induced acute kidney injury through regulating Akt and NF-κB/MAPK pathways

Cisplatin-induced acute kidney injury (CIAKI) is a major dose-limiting toxicity of cisplatin treatment. The mechanisms of CIAKI involve the production of inflammation, apoptosis and oxidative stress. Palmatine, an isoquinoline alkaloid has anti-inflammatory activity. Here, we investigated the protective effect and underlying mechanism of palmatine on CIAKI by in vitro and in vivo experiments based on network pharmacology. Network pharmacology was used to analyze the relationship and potential mechanisms of palmatine and CIAKI. The protective effect of palmatine was validated in cisplatin induced 293 T cell injury model and mice model. Furthermore, the mechanism of palmatine on CIAKI was determined by detecting inflammatory factors and related signaling pathways. A total of 61 targets of palmatine against CIAKI and the closely related signaling pathways including oxidative stress, MAPK and Akt were found. Palmatine effectively protected 293 T cells and mouse kidney against CIAKI. Mechanistically, palmatine reduced CIAKI inflammation by suppressing the NF-κB/MAPK pathway. Meanwhile, palmatine inhibited apoptosis by activating the Akt pathway and reduced oxidative stress. The results of in vitro and in vivo experiments were consistent with those of network pharmacology. Furthermore, the cytotoxicity of cisplatin to H460 and HCT116 cells was slightly improved by palmatine. In conclusion, palmatine protects against CIAKI by inhibiting inflammation and apoptosis through regulation of NF-κB/MAPK and Akt pathways. Palmatine is a potential adjunctive treatment during the use of cisplatin.