Management of Diabetes Mellitus with Puerarin, a Natural Isoflavone FromPueraria lobata

Abstract

Diabetes mellitus (DM) has become one of the most challenging public health problems globally. The increasing prevalence and mortality rates call for more effective therapeutic agents, especially for DM complications. Traditional herbs have a long clinical application history for DM treatment. Puerarin is a natural isoflavone from Pueraria lobata (Wild.) Ohwi which has been consumed both as a functional food and herb in Eastern Asia countries. Documented data has shown that puerarin has cardio-protective, neuroprotective, anti-oxidative, anti-inflammatory and many other effects. In this review, we will summarize the beneficial effects and underlying mechanisms of puerarin on DM and complications. Puerarin may directly benefit DM by decreasing blood glucose levels, improving insulin resistance, protecting islets, inhibiting inflammation, decreasing oxidative stress and inhibiting Maillard reaction and advanced glycation end products (AGEs) formation. Furthermore, puerarin may also benefit DM indirectly by retarding and improving a series of DM complications, such as cardiovascular complications, diabetic nephropathy, diabetic retinopathy, diabetic neuropathy, etc. However, comprehensive studies of its effect and mechanisms are needed. In addition, its efficacy is relatively low, which is partially due to its pharmacokinetics profiles. Though puerarin shows low toxicity to experimental animals, its safety on human remains to be clarified. Collectively, we suggest that puerarin might be a potential adjuvant agent for the treatment of DM and DM complications in future.

Exploring the Potential of Traditional Herbs in the Management of Diabetic Retinopathy: An Overview

“…Panax notoginseng Araliaceae Saponin Ginsenoside Inhibition in VEGF induced and age induced retinal Endothelial permeability [39,40] Salvia miltiorrhiza Lamiaceae Flavonoid Salvianolic acid Inhibition of ang-ii-Induced NADPH oxidase-4 (nox4) [44] Lycium barbarum Solanaceae Flavonoid Proteoglycans Downregulates VEGF mRNA expression and prevents retinal angiogenesis [48] Astragalus membranaceus Fabaceae Flavonoid Astragaloside [50,51] Anisodus tanguticus Solanaceae Alkaloid Anisodamine Inhibiting the production of TNF-a [53,54] Scrophularia ningpoensis Scrophulariaceae Flavonoid Syringic acid Inhibiting the production of TNF-a [55] Puerariae lobata Fabaceae Isoflaone Tectoridin Age-induced oxidative stress by downregulating RAGE Expression [57] Ginkgo biloba Ginkgoaceae Flavonoid Ginkgolide Downregulate the expression of PAF [59,60] Pinus pinaster Pinaceae Flavonoid Proanthocyanid Improve capillary resistance [61] Azadirachta indica Meliaceae Flavonoid Nimbinin Anti-serotonin activity [62,63] Stephania tetrandra Menispermaceae Alkaloid Tetrandrine Activation of Protein kinase [64] Gymnema sylvestre Asclepiadaceae Saponin Triterpenoid Downregulates VEGF mRNA expression and prevents retinal angiogenesis [65] ide. Due to this it increases the ratio of Bcl2/Bax which is important for the cell survival.…”

“…Puerarin, also known as Gegen in China and isolated from the dried root (Puerariae radix) of P. lobata, possesses a huge range of beneficial properties such as vasodilator, cardioprotective, neuroprotective, hepatoprotective, analgesic, antipyretic, antioxidant, antiangiogenic, antiinflammatory, antinociceptive, hypoglycaemic, hypocholesterolaemic, antithrombotic and osteoblastic. Due to these beneficial pharmacological properties, it has been widely used as dietary supplement for maintenance of general health and as a medicine for the treatment of various disorders [59,60]. Puerarin may directly benefit in diabetes by decreasing blood glucose levels, improving insulin resistance, protecting islets, inhibiting inflammation, decreasing oxidative stress and inhibiting Maillard reaction and advanced glycation end products (AGEs) formation [59].…”

“…Due to these beneficial pharmacological properties, it has been widely used as dietary supplement for maintenance of general health and as a medicine for the treatment of various disorders [59,60]. Puerarin may directly benefit in diabetes by decreasing blood glucose levels, improving insulin resistance, protecting islets, inhibiting inflammation, decreasing oxidative stress and inhibiting Maillard reaction and advanced glycation end products (AGEs) formation [59].…”

Puerarin alleviates liver fibrosis via inhibition of the ERK1/2 signaling pathway in thioacetamide‑induced hepatic fibrosis in rats

“…Puerarin is a Chinese herb, which is known to possess several physiological activities, including anti-oxidative and anti-inflammatory activity (19,20). Puerarin has been widely used in the treatment of various diseases, including ischemic stroke (21), renal fibrosis (22), myocardial ischemia and hypertension (23).…”

Puerarin Relieved Compression-Induced Apoptosis and Mitochondrial Dysfunction in Human Nucleus Pulposus Mesenchymal Stem Cells via the PI3K/Akt Pathway

“…Similarly, PUR, a potential antioxidant, could also relieve cadmium-mediated cytotoxicity in primary rat proximal tubular cells through restoring autophagy and inhibiting Nrf2 pathway [42]. Besides, PUR has also been found to be effective in diabetes mellitus [43] and cardiovascular or neurological disorder [12,44]. Since PUR is largely related to cell viability restoration and antioxidation, it was hypothesized that PUR might remit compression-induced apoptosis of NPMSCs.…”