1. Clinical efficacies, underlying mechanisms and molecular targets of Chinese medicines for diabetic nephropathy treatment and management
- Author
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Hai-Yong Chen, Yibin Feng, Cheng Zhang, Ning Wang, Sha Li, and Guoyi Tang
- Subjects
LOX1, lectin-like oxidized LDL receptor 1 ,BUN, blood urea nitrogen ,TGBM, thickness of glomerular basement membrane ,NQO1, NAD(P)H:quinone oxidoreductase 1 ,STAT, signal transducers and activators of transcription ,N/O, not observed ,p62, sequestosome 1 protein ,p-IRS1, phospho-IRS1 ,Review ,NOX-4, nicotinamide adenine dinucleotide phosphate-oxidase-4 ,OCP, oxidative carbonyl protein ,Traditional Chinese medicine ,AGEs, advanced glycation end-products ,N/A, not applicable ,TRAF5, tumor-necrosis factor receptor-associated factor 5 ,Health problems ,0302 clinical medicine ,ESRD, end-stage renal disease ,LDL, low-density lipoprotein ,BMP-7, bone morphogenetic protein-7 ,TGFβR-I/II, TGF-β receptor I/II ,Medicine ,P70S6K, 70-kDa ribosomal protein S6 kinase ,General Pharmacology, Toxicology and Pharmaceutics ,SOCS, suppressor of cytokine signaling proteins ,HO-1, heme oxygenase-1 ,0303 health sciences ,TG, triglyceride ,BW, body weight ,HDL-C, high density lipoprotein-cholesterol ,RASI, renin-angiotensin system inhibitor ,ATK, protein kinase B ,TBARS, thiobarbituric acid-reactive substance ,BCL-XL, B-cell lymphoma-extra large ,Gαq, Gq protein alpha subunit ,GCK, glucokinase ,PI3K, phosphatidylinositol 3 kinases ,Systematic review ,TLR-2/4, toll-like receptor 2/4 ,IR, insulin receptor ,PERK, protein kinase RNA-like eukaryotic initiation factor 2A kinase ,030220 oncology & carcinogenesis ,CRP, C-reactive protein ,IRS, insulin receptor substrate ,AM, mesangial area ,JAK, Janus kinase ,FBG, fasting blood glucose ,ETAR, endothelium A receptor ,LDL-C, low density lipoprotein-cholesterol ,CD2AP, CD2-associated protein ,eIF2α, eukaryotic initiation factor 2α ,RM1-950 ,mTOR, mammalian target of rapamycin ,CHOP, C/EBP homologous protein ,STZ, streptozotocin ,03 medical and health sciences ,ADE, adverse event ,PKC, protein kinase C ,LC3, microtubule-associated protein light chain 3 ,ORP150, 150-kDa oxygen-regulated protein ,PGE2, prostaglandin E2 ,IL-1β/6, interleukin 1β/6 ,Diabetic kidney disease ,IGF-1, insulin-like growth factor 1 ,EP, E-prostanoid receptor ,FN, fibronectin ,eGFR, estimated GFR ,MDA, malondialdehyde ,Chinese medicine ,MMP-2, matrix metallopeptidase 2 ,XBP-1, spliced X box-binding protein 1 ,TGF-β, tumor growth factor β ,GRB 10, growth factor receptor-bound protein 10 ,medicine.disease ,Clinical trial ,GRP78, glucose-regulated protein 78 ,UP, urinary protein ,IGF-1R, insulin-like growth factor 1 receptor ,ACEI, angiotensin-converting enzyme inhibitor ,BCL-2, B-cell lymphoma 2 ,EMT, epithelial-to-mesenchymal transition ,MAPK, mitogen-activated protein kinase ,MYD88, myeloid differentiation primary response 88 ,PBG, postprandial blood glucose ,RCT, randomized clinical trial ,N/R, not reported ,COL-I/IV, collagen I/IV ,PINK1, PTEN-induced putative kinase 1 ,UACR, urinary albumin to creatinine ratio ,C, control group ,Diabetic nephropathy ,GPX, glutathione peroxidase ,ICAM-1, intercellular adhesion molecule-1 ,Bioinformatics ,VCAM-1, vascular cell adhesion molecule-1 ,AMPKα, adenosine monophosphate-activated protein kinase α ,DM, diabetes mellitus ,TFEB, transcription factor EB ,TNF-α, tumor necrosis factor α ,Molecular target ,IKK-β, IκB kinase β ,Signaling pathway ,GLUT4, glucose transporter type 4 ,BAX, BCL-2-associated X protein ,NF-κB, nuclear factor kappa-light-chain-enhancer of activated B cells ,PARP, poly(ADP-Ribose) polymerase ,SMURF-2, SMAD ubiquitination regulatory factor 2 ,AREs, antioxidant response elements ,MD, mean difference ,SMAD, small mothers against decapentaplegic ,MCP-1, monocyte chemotactic protein-1 ,VEGF, vascular endothelial growth factor ,cAMP, cyclic adenosine monophosphate ,ARB, angiotensin receptor blocker ,PAI-1, plasminogen activator inhibitor-1 ,SMD, standard mean difference ,JNK, c-Jun N-terminal kinase ,NRF2, nuclear factor erythroid 2-related factor 2 ,IκB-α, inhibitory protein α ,Herbal medicine ,TCM, traditional Chinese medicine ,DG, glomerular diameter ,GSK-3, glycogen synthase kinase 3 ,SIRT1, sirtuin 1 ,D, duration ,HbA1c, glycosylated hemoglobin ,WMD, weight mean difference ,CTGF, connective tissue growth factor ,ER, endoplasmic reticulum ,DN, diabetic nephropathy ,ROS, reactive oxygen species ,CCR, creatinine clearance rate ,SOD, superoxide dismutase ,Diabetes mellitus ,PGC-1α, peroxisome proliferator-activated receptor gamma coactivator 1α ,ET-1, endothelin-1 ,UMA, urinary microalbumin ,SCr, serum creatinine ,IRE-1α, inositol-requiring enzyme-1α ,030304 developmental biology ,TII, tubulointerstitial injury index ,RAGE, receptors of AGE ,business.industry ,GFR, glomerular filtration rate ,PTEN, phosphatase and tensin homolog ,CI, confidence interval ,TC, total cholesterol ,SD-rat, Sprague–Dawley rat ,UAER, urinary albumin excretion rate ,DKD, diabetic kidney disease ,T, treatment group ,Molecular targets ,Therapeutics. Pharmacology ,α-SMA, α smooth muscle actin ,SD, standard deviation ,business ,DAG, diacylglycerol ,GCLC, glutamate-cysteine ligase catalytic subunit ,Kidney disease - Abstract
Diabetic nephropathy (DN) has been recognized as a severe complication of diabetes mellitus and a dominant pathogeny of end-stage kidney disease, which causes serious health problems and great financial burden to human society worldwide. Conventional strategies, such as renin-angiotensin-aldosterone system blockade, blood glucose level control, and bodyweight reduction, may not achieve satisfactory outcomes in many clinical practices for DN management. Notably, due to the multi-target function, Chinese medicine possesses promising clinical benefits as primary or alternative therapies for DN treatment. Increasing studies have emphasized identifying bioactive compounds and molecular mechanisms of reno-protective effects of Chinese medicines. Signaling pathways involved in glucose/lipid metabolism regulation, antioxidation, anti-inflammation, anti-fibrosis, and podocyte protection have been identified as crucial mechanisms of action. Herein, we summarize the clinical efficacies of Chinese medicines and their bioactive components in treating and managing DN after reviewing the results demonstrated in clinical trials, systematic reviews, and meta-analyses, with a thorough discussion on the relative underlying mechanisms and molecular targets reported in animal and cellular experiments. We aim to provide comprehensive insights into the protective effects of Chinese medicines against DN., Graphical abstract Diabetic nephropathy is one of the most severe complications of diabetes mellitus. Chinese medicines have been intensively studied in treating diabetic nephropathy. This review comprehensively summarizes and discusses the clinical efficacies and underlying mechanisms of Chinese medicines for diabetic nephropathy, providing deep insights and profound perspectives into this field.Image 1
- Published
- 2021