顺铂是多种实体瘤的有效化疗药物，但其使用受到正常组织不良反应的限制。特别是，顺铂具有肾毒性，可引起急性肾损伤和慢性肾病。临床前研究提供了对顺铂肾毒性的细胞和分子机制的见解，其中涉及细胞内应激，包括 DNA 损伤、线粒体病理学、氧化应激和内质网应激。应激反应，包括自噬、细胞周期停滞、衰老、细胞凋亡、程序性坏死和炎症，在顺铂肾毒性的发病机制中起着关键作用。此外，新出现的证据表明表观遗传变化对顺铂诱导的急性肾损伤和慢性肾病有影响。需要进一步研究以确定这些途径是如何整合的，并确定参与顺铂肾毒性调节性坏死、炎症和表观遗传修饰的关键分子的细胞类型特异性作用。已经确定了顺铂肾毒性的许多潜在治疗靶点。然而，需要全面评估肾脏保护策略对顺铂化疗疗效的影响。使用荷瘤动物、多组学和全基因组关联研究的进一步研究将使人们能够全面了解顺铂肾毒性的复杂细胞和分子机制，并可能导致识别特定靶点以保护肾脏而不影响化疗疗效顺铂。

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Cisplatin is an effective chemotherapeutic agent for various solid tumours, but its use is limited by adverse effects in normal tissues. In particular, cisplatin is nephrotoxic and can cause acute kidney injury and chronic kidney disease. Preclinical studies have provided insights into the cellular and molecular mechanisms of cisplatin nephrotoxicity, which involve intracellular stresses including DNA damage, mitochondrial pathology, oxidative stress and endoplasmic reticulum stress. Stress responses, including autophagy, cell-cycle arrest, senescence, apoptosis, programmed necrosis and inflammation have key roles in the pathogenesis of cisplatin nephrotoxicity. In addition, emerging evidence suggests a contribution of epigenetic changes to cisplatin-induced acute kidney injury and chronic kidney disease. Further research is needed to determine how these pathways are integrated and to identify the cell type-specific roles of critical molecules involved in regulated necrosis, inflammation and epigenetic modifications in cisplatin nephrotoxicity. A number of potential therapeutic targets for cisplatin nephrotoxicity have been identified. However, the effects of renoprotective strategies on the efficacy of cisplatin chemotherapy needs to be thoroughly evaluated. Further research using tumour-bearing animals, multi-omics and genome-wide association studies will enable a comprehensive understanding of the complex cellular and molecular mechanisms of cisplatin nephrotoxicity and potentially lead to the identification of specific targets to protect the kidney without compromising the chemotherapeutic efficacy of cisplatin.