The Protective Effect of Dandelion Hydroalcoholic Extract on Vancomycin-Induced Nephrotoxicity

Background: Vancomycin is the most commonly used glycopeptide antibiotic against gram-positive bacteria, and 5 - 25% of users experience vancomycin-induced nephrotoxicity. Dandelion has been used in traditional medicine since ancient times. Previous studies have indicated the protective effects of dandelion on kidneys in vivo. Objectives: In this study, the mechanism of this protective effect was investigated in vitro. Methods: After treatment of Vero cells with vancomycin and hydroalcoholic extract, cell viability was measured using the MTT technique. Untreated cells were considered as controls. Then, in three programs of pre-treatment, simultaneous treatment, and post-treatment, the protective effect was measured. Finally, the effect of dandelion extract on vancomycin-induced apoptosis was tested by diphenylamine assay and Annexin V staining. The expression of apoptotic markers was evaluated by real-time PCR technique. Results: The extract reduced the viability of the cells significantly at 100 and 200 µg/mL (P < 0.05) and at lower concentrations was not toxic to cells. Vancomycin reduced cell viability in a dose-dependent manner. In combination treatment, the extract protected Vero cells against the cytotoxic action of vancomycin. Also, apoptosis was significantly induced by vancomycin (P < 0.05), and the extract prevented apoptosis induced by vancomycin. Conclusions: Dandelion extract ameliorates vancomycin-induced toxicity. Therefore, the use of dandelion in combination with vancomycin may be a promising approach to the prevention of nephrotoxicity.