Neferine mitigates cisplatin-induced acute kidney injury in mice by regulating autophagy and apoptosis

Clin Exp Nephrol. 2023 Feb;27(2):122-131. doi: 10.1007/s10157-022-02292-z. Epub 2022 Nov 3.


Purpose: The nephrotoxicity caused by cisplatin severely limits the application and affects related platinum-based therapeutics. Neferine is a dibenzylisoquinoline alkaloid extracted from a Chinese medicinal herb (Nelumbo nucifera Gaertn), which can decrease cisplatin-induced apoptosis of NRK-52E cells by activating autophagy in vitro in our previous study. In this article, we aimed to further investigate the protective effect of neferine, against to the cispltain-induced kidney damage in mice.

Methods: Six groups were designed in our study. Renal index, mice serum creatinine and blood urea nitrogen levels were detected after the mice were killed. HE staining was used to observe the pathological changes of each group. The apoptosis of mouse kidney tissue was detected by TUNEL. Immunofluorescence and Western blot were used to detect the expression of cleaved-caspase3 and LC3. The transmission electron microscope was used to reveal the changes of apoptosis and autophagy of renal tubular epithelial cells in different groups.

Results: In our findings, the pathological changes of acute kidney injury were easily observed in cisplatin-treated mice while those in the neferine-pretreated groups were significantly alleviated. The apoptosis induced by cisplatin in mice increased evidently compared with the control group, which was decreased in the mice with neferine pretreatment. What' more, we found that autophagy increased obviously in mice pretreated by neferine contrast to the cisplatin-treated mice.

Conclusion: In our study, neferine can effectively alleviate cisplatin-induced renal injury in mice, as well act as an autophagy-regulator in kidney protection.

Keywords: Acute kidney injury (AKI); Apoptosis; Autophagy; Cisplatin; Neferine.

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / drug therapy
  • Acute Kidney Injury* / prevention & control
  • Animals
  • Apoptosis* / drug effects
  • Autophagy* / drug effects
  • Cell Line
  • Cisplatin* / adverse effects
  • Cisplatin* / toxicity
  • Drugs, Chinese Herbal / pharmacology
  • Kidney / pathology
  • Mice


  • Cisplatin
  • neferine
  • Drugs, Chinese Herbal