Application of Herbal Traditional Chinese Medicine in the Treatment of Acute Kidney Injury

Abstract

Acute kidney injury (AKI) is a clinical syndrome characterized by a rapid loss of renal function, which may further develop into chronic kidney damage (CKD) or even end-stage renal disease (ESRD). AKI is a global health problem associated with high morbidity and costly treatments, and there is no specific or effective strategy to treat AKI. In recent years, Traditional Chinese Medicine (TCM) has attracted more attention, with lines of evidence showing that application of TCM improved AKI, and the mechanisms of action for some TCMs have been well illustrated. However, reviews summarizing the progress in this field are still lacking. In this paper, we reviewed TCM preparations and TCM monomers in the treatment of AKI over the last 10 years, describing their renal protective effects and mechanisms of action, including alleviating inflammation, programmed cell death, necrosis, and reactive oxygen species. By focusing on the mechanisms of TCMs to improve renal function, we provide effective complementary evidence to promote the development of TCMs to treat AKI. Moreover, we also summarized TCMs with nephrotoxicity, which provides a more comprehensive understanding of TCMs in the treatment of AKI. This review may provide a theoretical basis for the clinical application of TCMs in the future.

Potential mechanisms of Chinese Herbal Medicine that implicated in the treatment of COVID-19 related renal injury

“…Inflammation and apoptosis and other immune regulation-related steps are mainly involved after making a general survey at the pharmacological effects of ingredients, classification of targets, biological processes and pathways. Studies have confirmed that CHM prescriptions and CHM monomers mainly protect the kidney and treat renal injury by reducing inflammation, inhibiting apoptosis, necrosis and inhibiting oxidative stress ( Li et al, 2019 ). Analysis of the pharmacological effects of the core herbs showed that Huang Qi is good at tonifying Qi and can play a therapeutic role in renal dysfunction and pathological changes through anti-oxidation ( Han et al, 2017 ).…”

Protective Effects of Traditional Herbal Formulas on Cisplatin‐Induced Nephrotoxicity in Renal Epithelial Cells via Antioxidant and Antiapoptotic Properties

“…Considering that a goal of drug discovery is developing optimal combinations consisting of effective compounds for treating diseases, verifying the efficacy in traditional polyherbal formulas already proven clinically can be the most efficient and fastest strategy for novel drug development in AKI treatment. Many medicinal herbs have been reported to improve the nephrotoxicity of AKI via antioxidant and anti- Evidence-Based Complementary and Alternative Medicine inflammatory properties [3,15]. Cisplatin produces excessive reactive oxygen species (ROS) and induces mitochondrial dysfunction and macrophage activation, which further increases ROS release and decreases the cellular antioxidant defense system [6].…”

“…Many medicinal herbs have been reported to improve the nephrotoxicity of AKI via antioxidant and anti-inflammatory properties [ 3 , 15 ]. Cisplatin produces excessive reactive oxygen species (ROS) and induces mitochondrial dysfunction and macrophage activation, which further increases ROS release and decreases the cellular antioxidant defense system [ 6 ].…”

“…Asian traditional herbal medicine based on Traditional Chinese Medicine (TCM) has been widely used for the treatment of kidney disease in China, Korea, and Japan for a long time. Although several herbs containing constituents such as aristolochic acids and other plant alkaloids have been found to cause side effects, including nephrotoxicity [14], increasing evidences show that some polyherbal formulas, single herbs, and their main components have significant efficacy in AKI models via anti-inflammatory, antioxidant, or antiapoptotic activities [3,15]. Notably, Xuebijing consisting of Radix Paeoniae Rubra, Chuan dome, Salvia miltiorrhiza, safflower, and Chinese angelica improves renal function in patients with scald injury-induced AKI [16].…”

Ginsenoside Rh1 Alleviates HK‐2 Apoptosis by Inhibiting ROS and the JNK/p53 Pathways

“…Renal fibrosis has been found to be improved by TCM products, including resveratrol, curcumin, berberine, and poricoic acid, among others [ 9 – 12 ]. TCM products can also improve acute kidney injury by inhibiting inflammatory response and proapoptotic transcription factors [ 13 ]. According to previous research, TCM products have the potential to alleviate kidney damage.…”