Layered Double Hydroxide-Loaded Dl-3-n-Butylphthalide Alleviates Renal Ischemia-Reperfusion Injury by Regulating the PI3K-AKT-Nrf2 Signaling Pathway

Purpose: This study aims to address the issues that limit the clinical application of Dl-3-n-butylphthalide (NBP) due to its poor water solubility and low bioavailability, and to explore its therapeutic potential in renal ischemia-reperfusion (I/R) injury. We attempted to utilize layered double hydroxide (LDH) to construct a novel nano-drug delivery system to enhance the stability and efficacy of NBP, and to deeply investigate its potential mechanism of action. Methods: By loading NBP onto LDH, LDHs-NBP nanocomplexes were successfully constructed. Subsequently, the effects of LDHs-NBP on renal function, tissue pathology, cell apoptosis, oxidative stress and mitochondrial function were systematically evaluated in rat renal ischemia-reperfusion injury models and HK-2 cell hypoxia/reoxygenation models. The molecular mechanism of the PI3K-AKT-Nrf2 signaling pathway was analyzed through immunohistochemistry and Western Blot. Results: The experimental results show that the drug loading capacity of LDHs-NBP nanocomplexes is 24.26%. Compared with pure NBP, LDHs-NBP more effectively improve renal function in rats, reduces serum creatinine (SCr) and blood urea nitrogen (BUN), decreases inflammatory infiltration and structural damage in renal tissues, and exhibits stronger antioxidant capacity-evidenced by decreased malondialdehyde (MDA) levels and increased superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) activities. At the cellular level, LDHs-NBP significantly inhibits apoptosis and ROS production in HK-2 cells, alleviates mitochondrial dysfunction, and its protective effect is closely associated with activation of the PI3K-AKT-Nrf2 signaling pathway. Conclusion: This study successfully constructed an NBP nano-complex based on LDH, and confirmed that LDHs-NBP has significant therapeutic advantages in renal ischemia-reperfusion injury. The mechanism may be related to the activation of the PI3K-AKT-Nrf2 pathway. This study provides experimental evidence for the application of LDHs-NBP in the treatment of renal ischemia-reperfusion injury, and shows a promising translational prospect and clinical value.