Hydrogen sulfide: A novel nephroprotectant against cisplatin-induced renal toxicity

• Suggested natural sources of H2S disrupts the enzymatic conversion of cisplatin into nephrotoxin in proximal tubular epithelial cells.
• The antioxidant property of H2S ameliorates cisplatin-induced nephrotoxicity.
• Anti-inflammatory action of H2S limits renal proximal tubular injury induced by cisplatin administration.
• H2S interferes with the apoptotic machinery and protects renal proximal tubular cells against cisplatin-induced nephrotoxicity.
• H2S seems to be a promising nephroprotective agent against cisplatin-induced renal toxicity.

Cisplatin is a potent chemotherapeutic agent for the treatment of various solid-organ cancers. However, a plethora of evidence indicates that nephrotoxicity is a major side effect of cisplatin therapy. While the antineoplastic action of cisplatin is due to formation of cisplatin-DNA cross-links, which damage rapidly dividing cancer cells upon binding to DNA, its nephrotoxic effect results from metabolic conversion of cisplatin into a nephrotoxin and production of reactive oxygen species, causing oxidative stress leading to renal tissue injury and potentially, kidney failure. Despite therapeutic targets in several pre-clinical and clinical studies, there is still incomplete protection against cisplatin-induced nephrotoxicity. Hydrogen sulfide (H2S), the third discovered gasotransmitter next to nitric oxide and carbon monoxide, has recently been identified in several in vitro and in vivo studies to possess specific antioxidant, anti-inflammatory and anti-apoptotic properties that modulate several pathogenic pathways involved in cisplatin-induced nephrotoxicity. The current article reviews the molecular mechanisms underlying cisplatin-induced nephrotoxicity and displays recent findings in the H2S field that could disrupt such mechanisms to ameliorate cisplatin-induced renal injury.