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Literature Review

Doxorubicin has always been shown to cause major tissue damage by reactive oxygen species. It’s being researched for a way to protect tissue, more specifically the kidneys, from these free radicals.

Doxorubicin is proven to cause reactive oxygen species that can be very damaging to the kidney. Discussed in the article, (Ayla, et al., 2011). The article goes over how rats being injected with doxorubicin (DOX), the kidney is damaged by oxidative stress, specifically a free radical gas Nitric oxide. It goes into detail of DOX being proven as a formation of free radicals, and the author proves within the test that rat kidney tissue shows oxidation stress. It shows a different appproach of protecting against the toxicity of DOX using Nicotinamide. Within a different article, (Ozbek, 2012), it goes into detail of oxidative stress in the kidneys. The article talks about several diseases that can cause oxidative stress in the kidney, such as radiation, diabetes, and nephrotoxins. It goes to state that doxorubicin, a nephrotoxic anticancer agent, can lead to oxidative stress which, as stated the kidney is very vulnerable to damage. The author includes details of how Mitochondria are also scavenging reactive oxygen species.

Creatine has been a possible positive antioxidant against reactive oxygen spices.  The article (Riesberg, Weed, McDonald, Eckerson, & Drescher, 2016) discuss the role of creatine in the human bodies and how it’s been used in history. It covers how current creatine supplement, creatine monohydrate, has a low bioavailability, or an active effect on the body. Then covers how creatine should have farther studies on neurological disease, such as in the article, traumatic brain injury, Huntington's disease, Parkinson's disease, and more. The authors also presented a case for creatine as an anti-inflammatory agent. There is also a section on creatine having antioxidant properties that helps understand my research. The article (Sestili, et al., 2011) goes into proof that creatine has antioxidant properties. The authors explain how creatine has many beneficial factors including as an antioxidant. Within the article it supports that test against the hypothesis, of being a possible antioxidant, proved that creatine could act as a radical scavenger. It suggests that the antioxidant ability is from less muscle fatigue, such as in athletes using creatine supplements. The author Sestili went testing for antioxidant properties of creatine and found that oxidative stressors causing cytotoxicity, with creatine preloading, found that the creatine was able to be cytoprotective. The article also goes on to summarize its findings, stating that creatine can protect RNA and DNA from oxidative stress on an array of reactive oxygen species.

With each of these articles it’s stated a problem with doxorubicin causing reactive oxygen species, to creatine being a possible solution being an antioxidant. With the kidney being a sensitive organ to free radicals and having little support against doxorubicin damaging muscle and tissue having multiple different antioxidants can help with the future of chemotherapy. It could be seen for the future to have creatine or other antioxidants tested for properties of advancing protecting against reactive oxygen species, free radicals.

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