Cisplatin-based cancer drugs and herbal remedies containing aristolochic acid offer a cruel dilemma to patients — they may fight disease and relieve the aches and pains of growing older, but they also are toxic to the kidneys.
While drug-induced acute kidney injury is expected to get worse as the population ages, a new report by Craig Brooks, PhD, and colleagues suggests there may be a way to avoid it.
In a study in mice and human tissue samples, the researchers were surprised to discover that interleukin-22 (IL-22), an infection-fighting cytokine previously thought to be secreted only by immune cells, is also released by epithelial cells lining the proximal tubules, part of the kidney’s blood-filtering apparatus.
Reporting Dec. 4 in the journal Kidney International, they found that IL-22 was essential to the overactivation of the cellular response to drug-induced DNA damage that results in severe kidney injury and cell death.
Deletion of the genes for IL-22 or its receptor in an animal model resulted in a dramatic reduction in kidney injury and a significant increase in survival.
These findings suggest that targeting IL-22 may represent a new therapeutic approach to prevent kidney injury caused by drugs or toxins, the researchers concluded.
Authors of the report include Kensei Taguchi, MD, PhD, Sho Sugahara, MD, PhD, Bertha Elias, PhD, Navjot S. Pabla, PhD, and Guillaume Canaud, MD, PhD. The research was supported by the National Institutes of Health (grants 5P30DK114809 and 5R01DK121101) and the American Heart Association (grant 20POST35200221).