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2015 ; 2015
(ä): 704382
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Protective Effects of Cilastatin against Vancomycin-Induced Nephrotoxicity
#MMPMID26504822
Humanes B
; Jado JC
; Camaño S
; López-Parra V
; Torres AM
; Álvarez-Sala LA
; Cercenado E
; Tejedor A
; Lázaro A
Biomed Res Int
2015[]; 2015
(ä): 704382
PMID26504822
show ga
Vancomycin is a very effective antibiotic for treatment of severe infections.
However, its use in clinical practice is limited by nephrotoxicity. Cilastatin is
a dehydropeptidase I inhibitor that acts on the brush border membrane of the
proximal tubule to prevent accumulation of imipenem and toxicity. The aim of this
study was to investigate the potential protective effect of cilastatin on
vancomycin-induced apoptosis and toxicity in cultured renal proximal tubular
epithelial cells (RPTECs). Porcine RPTECs were cultured in the presence of
vancomycin with and without cilastatin. Vancomycin induced dose-dependent
apoptosis in cultured RPTECs, with DNA fragmentation, cell detachment, and a
significant decrease in mitochondrial activity. Cilastatin prevented apoptotic
events and diminished the antiproliferative effect and severe morphological
changes induced by vancomycin. Cilastatin also improved the long-term recovery
and survival of RPTECs exposed to vancomycin and partially attenuated vancomycin
uptake by RPTECs. On the other hand, cilastatin had no effects on
vancomycin-induced necrosis or the bactericidal effect of the antibiotic. This
study indicates that cilastatin protects against vancomycin-induced proximal
tubule apoptosis and increases cell viability, without compromising the
antimicrobial effect of vancomycin. The beneficial effect could be attributed, at
least in part, to decreased accumulation of vancomycin in RPTECs.