Therapeutic effect and underlying mechanism of Shenkang injection against cisplatin-induced acute kidney injury in mice

Ethnopharmacological relevance: Shenkang injection (SKI), a Chinese patent medicine injection, has been approved for the treatment of chronic kidney disease (CKD) due to its definite clinical therapeutic efficacy. However, the effect and associated underlying mechanism of Shenkang injection against cisplatin (CDDP)- induced acute kidney injury (AKI) has not yet been well elucidated..Aim of the study: This study aims to investigate the therapeutic effect and associated underlying mechanism of Shenkang injection against CDDP-induced AKI.Materials and methods: We established a CDDP-induced AKI mouse model to evaluate renal function by biochemical markers measurement and to observe histopathological alterations by haemotoxylin and eosin (HE)- staining sections of renal. In addition, the distribution of representative components of SKI in the kidneys of mice was evaluated by liquid chromatography tandem mass spectrometry (LC-MS/MS). Furthermore, the degree of oxidative stress and inflammation were assessed by detecting the levels of inflammatory cytokines and oxidants, while the related mechanisms were elucidated by network pharmacology.Results: CDDP could induce excessive inflammation and severe injury to the kidneys of mice. However, SKI significantly ameliorated the kidney damages and improved the renal function by reducing the levels of renal function markers (SCr, BUN and urine protein), and inhibiting the production of inflammatory cytokines IL-34, IL-6 and TNF-alpha. SKI repaired oxidative balance through up-regulation of antioxidants SOD and GSH and down -regulated oxidants MDA. Moreover, 4 components from SKI were detected in the kidney by LC-MS/MS quan-tification. In addition, pharmacology network indicated the PI3K/AKT, TNF, MAPK, and p53 were the possible signaling pathways for the therapeutic effect of SKI against CDDP-induced AKI, which were related to inflam-mation, oxidative stress and apoptosis.Conclusion: In the present study, we for the first time demonstrated that SKI alleviates CDDP-induced nephro-toxicity by antioxidant and anti-inflammation via regulating PI3K/AKT, MAPK, TNF, and p53 signaling path-ways. The study may provide a scientific rationale for the clinical indication of SKI.