A Review of Traditional Chinese Medicine on Treatment of Diabetic Nephropathy and the Involved Mechanisms

Abstract

Diabetic nephropathy (DN) is a common microvascular complication of diabetes mellitus (DM), which can lead to renal failure in diabetic patients. At present, the first-line drugs for DN are mainly the renin–angiotensin system (RAS) inhibitors or angiotensin receptor blockers, and the latest approved aldosterone receptor antagonist finerenone, which delay the progression of DN to end-stage renal disease (ESRD), but the therapeutic effect is still not ideal. With a history of thousands of years, traditional Chinese medicine (TCM) has rich experience in the treatment of DN. Based on the theory of TCM, the clinical treatment of DN mainly focuses on generating fluid and nourishing blood, nourishing Qi and Yin, detoxifying and detumescent. In recently years, the therapeutic effects and mechanisms of TCM prescription, Chinese herbal medicine, and its active components on DN have received extensive attention in new drug development. This paper reviews the research progress of the mechanism of TCM on DN.

Characteristics of elderly diabetes patients: focus on clinical manifestation, pathogenic mechanism, and the role of traditional Chinese medicine

“…TCM had the effect of modulating gut microbiota and improving glucose metabolisms in T2DM patients and pre-clinical experiments ( Zheng et al, 2021b ). Numerous studies reviewed the efficacy and mechanisms of Chinese herbal medicine on DKD, DR, and DPN, which have been reported to be critical for diabetes in the elderly ( Lu et al, 2019 ; Ai et al, 2020 ; Chen et al, 2022b ; Liu et al, 2022 ). Whlie TCM could give full play to the advantages of multiple targets and intervene in many important mechanisms of elderly diabetes.…”

A review of therapeutic impacts of saffron (Crocus sativusL.) and its constituents

“…Although pathogenesis of DN is complex and multifactorial, inflammation, and oxidative stress have been demonstrated to have a key role to the induction and progression of DN (Winiarska et al, 2021). The results of numerous of studies emphasize the herbal medicines which have positive effects on diabetes mellitus could alleviate DN symptoms (Liu et al, 2022). It has been reported that, daily oral administration of 20 mg/kg of crocin for 8 weeks improved DN in diabetic rats.…”

(+)-Catechin ameliorates diabetic nephropathy injury by inhibiting endoplasmic reticulum stress-related NLRP3-mediated inflammation

“…1,2 Currently, renin-angiotensin system inhibitors (RASis) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) remain the primary treatment options for patients with DN. 3,4 However, patients with high levels of potassium and serum creatinine (Scr) are restricted in the use of RASis, and patients receiving SGLT2is are prone to urinary tract and genital infections. [5][6][7] Accordingly, there is an urgent clinical need to develop multitargeted therapeutic interventions for DN.…”