The Efficacy and Mechanism of Chinese Herbal Medicine on Diabetic Kidney Disease

Abstract

Diabetic kidney disease (DKD) is the most common microvascular complication of diabetes and is one of the main causes of end-stage renal disease (ESRD) in many countries. The pathological features of DKD are the hypertrophy of mesangial cells, apoptosis of podocytes, glomerular basement membrane (GBM) thickening, accumulation of extracellular matrix (ECM), glomerular sclerosis, and tubulointerstitial fibrosis. The etiology of DKD is very complicated and many factors are involved, such as genetic factors, hyperglycemia, hypertension, hyperlipidemia, abnormalities of renal hemodynamics, and metabolism of vasoactive substances. Although some achievements have been made in the exploration of the pathogenesis of DKD, the currently available clinical treatment methods are still not completely effective in preventing the progress of DKD to ESRD. CHM composed of natural products has traditionally been used for symptom relief, which may offer new insights into therapeutic development of DKD. We will summarize the progress of Chinese herbal medicine (CHM) in the treatment of DKD from two aspects. In clinical trials, the Chinese herbal formulas were efficacy and safety confirmed by the randomized controlled trials. In terms of experimental research, studies provided evidence for the efficacy of CHM from the perspectives of balancing metabolic disorders, reducing inflammatory response and oxidative stress, antifibrosis, protecting renal innate cells, and regulating microRNA and metabolism. CHM consisting of different ingredients may play a role in synergistic interactions and multiple target points in the treatment of DKD.

Magnoflorine Ameliorates Inflammation and Fibrosis in Rats With Diabetic Nephropathy by Mediating the Stability of Lysine-Specific Demethylase 3A

“…The incidence and pervasiveness of diabetes mellitus have grown remarkably throughout the world, and the global increase in the amount of people with diabetes contributed a lot to the surge of diabetic kidney disease ( Tuttle et al, 2014 ). The etiology of diabetic kidney disease is complicated and involved many factors, including genetic factors, hypertension, abnormalities of renal hemodynamics, as well as metabolism of vasoactive substances ( Lu et al, 2019 ). Diabetic nephropathy (DN), the major cause of chronic kidney disease, is characterized by albuminuria, lowered glomerular filtration rate, hypertension, and mesangial matrix expansion in addition to tubulointerstitial fibrosis ( Giralt-Lopez et al, 2020 ).…”

Jian-Pi-Yi-Shen Formula Ameliorates Oxidative Stress, Inflammation, and Apoptosis by Activating the Nrf2 Signaling in 5/6 Nephrectomized Rats

“…As a consequence, Nrf2 can assemble the RNA polymerase machinery and then initiate transcription by combining with small Maf proteins (sMaf) and antioxidant responsive elements (ARE) in the promoters of its target genes ( Hirotsu et al, 2012 ). Many Chinese herbs have been demonstrated to promote the accumulation of Nrf2 and translocation into the nucleus ( Zhang et al, 2017 ) and reinforce gene expression of other antioxidative-related factors ( Lu et al, 2019 ), but whether the possible mechanism of the JPYS formula associates with activation of Nrf2 signaling pathway remains unknown.…”

A Network Pharmacology-Based Strategy for Predicting Active Ingredients and Potential Targets of Shuilu Erxian Dan in Treating Diabetic Kidney Disease

“…In China, Chinese herbal medicine is a way for physicians to against DKD, and there is growing evidence to prove that Chinese herbal medicine has its unique advantages in treating DKD [16][17][18][19]. Shuilu Erxian Dan (SED) is a traditional Chinese medicine compound, which is composed of two herbs, Fructus Rosae Laevigatae and Semen Euryales.…”