The present study explored the protective effects of DPP and Flv against H2O2-induced oxidative damage in PC12 cells. According to findings, H2O2 below 100 μM is nontoxic. Previous studies have demonstrated that H2O2 can inhibit cell growth and cause cell death; higher doses of H2O2 can lead to oxidative stress (
24). In this study, 100 μM H2O2 induced oxidative stress with less severe apoptotic effects.
The results revealed that DPP was nontoxic to PC12 cells and even induced slight cell growth at a concentration of 500 μg/mL compared to the vehicle control. While a previous study has demonstrated the neuroprotective potential of DPP (
25), research into its effects on the nervous system and the expression of neural oxidative stress-related genes remains limited. As previously reported, DPP exhibits antioxidant properties owing to the presence of phytochemical agents, including various flavonoids and unsaturated fatty acids (
26).
Date palm pollen demonstrated neuroprotection against oxidative stress and neuronal injury induced by bilateral carotid artery occlusion (
25). Recently, DPP has been shown to protect against doxorubicin-induced cardiomyopathy and hepatotoxicity, both of which are disorders associated with oxidative stress (
4,
27).
Regarding the neuroprotective effect of Flv, doses of 10 μM and 25 μM increased cell growth, but the difference between these doses was not statistically significant. Oxidative stress has been recognized as a crucial factor in depression. However, previous studies have documented the combined antioxidant and antidepressant effects of antidepressants such as fluvoxamine (
28,
29). Schlezinger et al. reported that Flv inhibits ROS generation by suppressing the cytochrome P450 family 1 subfamily A member 2 (CYP1A2) enzyme, which is responsible for metabolizing antioxidants in the body (
30).
Evaluation of the protective effects of DPP and Flv showed a significant increase in
Nrf2 expression in DPP and Flv-pretreated cells (500 μg/mL and 10 μM, respectively). H2O2 induces oxidative stress and influences adaptive responses, such as the Nrf2 pathway. Various studies have identified
Nrf2 as a guardian of redox homeostasis (
9). The expression level of
Nrf2 in the DPP group was higher than that in the H2O2 group, indicating that DPP and Flv prevent the initiation of oxidative stress primarily through the Nrf2 pathway.
Previous studies have shown that forsythiaside provided protection against neurotoxicity through the elevation of
Nrf2 levels and the upregulation of SOD and CAT (
31). In 2018, it was reported that duloxetine could protect neuroblastoma cells primarily through
Nrf2 upregulation and the expression of HO-1, a target gene of
Nrf2 (
32). Kolla et al. reported findings that amitriptyline and fluoxetine exerted neuroprotective effects on PC12 cells exposed to H2O2, which was associated with upregulation in SOD activity (
7). The sigma-1 receptor was chosen because it has been shown that fluvoxamine maleate (Flv) binds to it, so being an agonist of the sigma-1 receptor would be congruent with our antidepressant selection (
33). The sigma-1 receptor agonist's fluvoxamine, fluoxetine, and citalopram bind to the ER sigma-1 receptors and cause them to separate from the complex with BiP (GRP78). Further, dissociating the sigma-1 receptor will allow it to generate chaperone activity, resulting in neuroprotection (
15).
According to our findings, SIGMAR1 expression increased in all experimental states compared with the control. Treatment with DPP (at 500 µg/mL) significantly impacted SIGMAR1 expression compared to H2O2-exposed cells. This finding suggested that DPP could have a more significant impact on the Nrf2 pathway than the ER pathway. In contrast, Flv slightly attenuated the expression of SIGMAR1 in H2O2-exposed cells, indicating the role of Flv via regulation of ER oxidative stress.
Previous studies have demonstrated the association between sigma-1 receptor dysfunction and depression, suggesting its potential as an antidepressant target (
17). Additionally, studies have shown that sigma-1 receptor agonists can exert neuroprotection against neurotoxicity in neuronal cell lines (
34). Recently, the antifibrotic efficacy of fluvoxamine has been confirmed in a vascular disorder associated with oxidative damage (
35).
The role of oxidative stress and mitochondrial dysfunction through apoptosis in neurodegenerative disease has been studied previously (
35). It was elucidated that oxidative stress exerts ferroptosis and mitochondrial dysregulation, which lead to neuronal cell death and apoptosis (
2). The expression of
Bcl2, an antiapoptotic factor from the Bcl2 family, was found to be significantly attenuated in H2O2-treated cells compared to the control. However, pretreatment with DPP and Flv reduced
Bcl2 gene expression, but this downregulation did not show any significant difference between the experimental groups.
Nakayama et al. demonstrated the neuroprotection of ferulic acid as a phytochemical against H2O2-induced apoptosis. Ferulic acid increased the expression of BDNF, a neuroprotective factor, and regulated the activity of phosphokinases and apoptosis-related proteins (
23). Additionally, quercetin has been shown to protect PC12 cells from H2O2-induced neurotoxicity by elevating the SOD and CAT level, reducing the apoptosis markers, such as Bax and caspase-3, and upregulating the
Bcl2 (
22).
The combined suppression of oxidative stress induced by H2O2 by DPP and Flv through the Nrf2 and sigma-1 signaling pathways suggests that these pretreatment packages could be an effective modality for preventing neurodegenerative damage in an animal neurotoxicity model.