Nephrotoxicity and Neuropathy-Associated with Acyclovir Antiviral Remedy: Toxicological Mechanism and Ameliorative Role of Rutin and Quercetin

Abstract

Background: Acyclovir is one of the most essential antiviral drugs in treating herpes virus infections like herpes simplex and herpes zoster.  However, several clinical complications limit their uses, since after recovery these serious complications deteriorate patient quality of life. The most common and dangerous complications are nephrotoxicity and neuropathy. Acyclovir induced the abovementioned disorders by disrupting several physiological functions and molecular pathways such as promoting tissue oxidative burst, inflammation, apoptosis, endoplasmic reticulum stress, fibrosis, and blocking cellular autophagy in nephrons and neural cells. Nowadays, the protective usage of various bioactive compounds extracted from several medicinal plants is growing worldwide since they possess several beneficial pharmacological activities like anti-inflammatory, antioxidant, immunomodulatory, cytoprotective, and antiapoptotic properties. Thus, the current review summarizes the mechanism by which acyclovir induces renal impairment and neuropathy and the possible ameliorative effects of many bioactive compounds in mitigating these complications.