Nephroprotective Mechanisms of Ambrette (abelmoschus Moschatus Medik.) Leaf Extracts in Adriamycin Mediated Acute Kidney Injury Model of Wistar Rats.

Ethnopharmacological relevance: Ambrette (Abelmoschus moschatus Medik., Family: Malvaceae) is a common Ayurvedic herbal medicine used in the treatment of kidney-related diseases, in the forms of tea, medicated oil, medicated wine, etc., however, its nephroprotective mechanisms remain unexploited. Aim of the study: To investigate the mechanisms by which the hexane (A-HE), ethyl acetate (A-EE), butanol (A BE), and aqueous (A-WE) leaf extracts of Ambrette protect against the adriamycin-mediated acute kidney injury in Wistar rats. Materials and methods: A-HE, A-EE, A-BE, A-WE, and fosinopril sodium were administered at therapeutically effective doses (55, 75, 60, 140, 0.09 mg/kg) to adriamycin-induced (5 mg/kg, ip) Wistar rats for 28 consecutive days. Results: Oral administration of the selected extracts of A. moschatus resulted in amelioration of kidney injury as observed by the significant changes of biomarkers of kidney function in serum and in urine, biochemical parameters of oxidative stress, and inflammation in kidney homogenates (p < 0.05). Furthermore, the administration of plant extracts caused a significant reduction in total kidney injury scores in H and E stained kidney sections (p < 0.05). The immunohistochemical expression of the inflammatory marker, COX-2, and the proapoptotic marker, Bax, were attenuated and the expression of the anti-apoptotic marker, BCL-2, was increased. A-HE exerted superior nephroprotective effects over the other three extracts and the drug reference standard. Conclusions: The findings revealed that Ambrette exerts promising protective effects against adriamycin-mediated acute kidney injury through antioxidant, anti-inflammatory, and anti-apoptosis pathways. A-HE might serve as a potential candidate for the development of therapeutic drug leads that will be beneficial in the treatment of acute kidney injury.