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Analysis of the Renal Protection and Antioxidative Stress Effects of Panax notoginseng Saponins in Diabetic Nephropathy Mice. J Immunol Res 2022; 2022:3610935. [PMID: 36249425 PMCID: PMC9556179 DOI: 10.1155/2022/3610935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/13/2022] [Accepted: 09/24/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Diabetic nephropathy (DN), a diabetes-induced chronic complication, is the major trigger of end-stage renal disease. As the main active ingredient of Panax notoginseng (PNG), Panax notoginseng saponins (PNS) are crucial in treating renal diseases. This study is aimed at investigating the role played by PNS in renal protection and antioxidative stress (OS) in DN mice. Methods A DN mouse model was constructed, and then low, medium, and high doses of PNS were used to intervene the model group mice. Eight weeks after intervention, the 24 h urine protein (UPro) and urinary albumin (UAlb) were quantitatively examined, and the related blood biochemical indices were measured. HE and PAS staining were performed for pathological changes of renal tissue. ELISA and western blotting were carried out to quantify the levels of OS indexes and inflammatory factors (IFs) in mouse kidney tissues and the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1), respectively. Results The weight of DN mice decreased first compared with control animals and then gradually increased after different doses of PNS treatment. Besides, DN mice presented elevated urine volume, UPro, and UAlb, all of which were reversed by PNS intervention. SOD activity and GSH content in renal tissues of the model group mice decreased markedly versus the control group, and MDA, CRP, IL-6, and TGF-β1 contents elevated statistically, while different doses of PNS effectively reduced the OS injury and IFs in mice. Compared with the model group, PNS dose-dependently increased Nrf2 and HO-1 levels in DN mice. Conclusions PNS is protective of HFF + STZ-induced DN mice against kidney tissue damage and can reduce the excretion of UPro and relieve the OS state of mice, possibly by activating Nrf2/HO-1 axis to play an antioxidant and anti-inflammatory role.
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Wu X, Li H, Wan Z, Wang R, Liu J, Liu Q, Zhao H, Wang Z, Zhang H, Guo H, Qi C, Jiao X, Li X. The combination of ursolic acid and empagliflozin relieves diabetic nephropathy by reducing inflammation, oxidative stress and renal fibrosis. Biomed Pharmacother 2021; 144:112267. [PMID: 34624679 DOI: 10.1016/j.biopha.2021.112267] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
Studies have shown that ursolic acid (UA) and empagliflozin (EM) exert therapeutic effects in the treatment of diabetic nephropathy (DN), but both drugs have disadvantages. This study explores the effect of combining these drugs compared to that of either monotherapy. A diabetic rat model was established by feeding a high-fat diet (HFD) with high-sugar content and administering a low dose of streptozotocin (STZ) via intraperitoneal injection. UA (50 mg/kg/day, po), EM (10 mg/kg/day, po) or both were administered for 8 weeks. The development of DN was determined by observing increases in urine protein, serum creatinine, urea nitrogen, and uric acid and abnormal changes in kidney morphology. UA and EM either alone or in combination can alleviate the increases in blood glucose, glycosylated haemoglobin, blood lipid levels, inflammatory factors (TNF-α, IL-1β, IL-6), oxidation factors (SOD, MDA, GSH, CAT, NO), renal fibrosis and pro-fibrosis factors (FN, E-cad, MMP-9, TIMP-1, SMA-α, TGF-β1, SMAD, MAPK). The treatments could also ameliorate DN by preventing the abnormal proliferation of glomerular mesangial cells under high-glucose conditions, aberrant apoptosis and excessive production of reactive oxygen species (ROS). In addition, UA reduces the increase in LDL-L, reverses abnormal bladder morphology and mitigates the increase in colony count caused by EM, and the combination treatment can overcome the disadvantages of the slow hypoglycaemic effect of UA. In short, UA combined with empagliflozin is more effective than either monotherapy in the treatment of DN and can cancel the adverse effects of each other. The protective effect of this regimen on the kidney may be related to reducing inflammation, oxidative stress and renal fibrosis.
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Affiliation(s)
- Xiaohan Wu
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China; Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan City, Hubei Province, China
| | - He Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan Province, China
| | - Zhijie Wan
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Ran Wang
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Jing Liu
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Qingfeng Liu
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Haiyun Zhao
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Zhehuan Wang
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Huiru Zhang
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Hui Guo
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Caihong Qi
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Xiangyue Jiao
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China
| | - Xiaotian Li
- Zhengzhou University, No. 100, Science Avenue, Zhengzhou City, Henan Province, China.
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Karmazyn M, Gan XT. Ginseng for the treatment of diabetes and diabetes-related cardiovascular complications: a discussion of the evidence 1. Can J Physiol Pharmacol 2018; 97:265-276. [PMID: 30395481 DOI: 10.1139/cjpp-2018-0440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Diabetes mellitus (DM) is a chronic metabolic disorder associated with elevated blood glucose levels due either to insufficient insulin production (type 1 DM) or to insulin resistance (type 2 DM). The incidence of DM around the world continues to rise dramatically with more than 400 million cases reported today. Among the most serious consequences of chronic DM are cardiovascular complications that can have deleterious effects. Although numerous treatment options are available, including both pharmacological and nonpharmacological, there is substantial emerging interest in the use of traditional medicines for the treatment of this condition and its complications. Among these is ginseng, a medicinal herb that belongs to the genus Panax and has been used for thousands of years as a medicinal agent especially in Asian cultures. There is emerging evidence from both animal and clinical studies that ginseng, ginseng constituents including ginsenosides, and ginseng-containing formulations can produce beneficial effects in terms of normalization of blood glucose levels and attenuation of cardiovascular complications through a multiplicity of mechanisms. Although more research is required, ginseng may offer a useful therapy for the treatment of diabetes as well as its complications.
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Liu JY, Chen XX, Tang SCW, Sze SCW, Feng YB, Lee KF, Zhang KYB. Chinese medicines in the treatment of experimental diabetic nephropathy. Chin Med 2016; 11:6. [PMID: 26913057 PMCID: PMC4765093 DOI: 10.1186/s13020-016-0075-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 01/26/2016] [Indexed: 12/22/2022] Open
Abstract
Diabetic nephropathy (DN) is a severe micro vascular complication accompanying diabetes mellitus that affects millions of people worldwide. End-stage renal disease occurs in nearly half of all DN patients, resulting in large medical costs and lost productivity. The course of DN progression is complicated, and effective and safe therapeutic strategies are desired. While the complex nature of DN renders medicines with a single therapeutic target less efficacious, Chinese medicine, with its holistic view targeting the whole system of the patient, has exhibited efficacy for DN management. This review aims to describe the experimental evidence for Chinese medicines in DN management, with an emphasis on the underlying mechanisms, and to discuss the combined use of herbs and drugs in DN treatment.
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Affiliation(s)
- Jing-Yi Liu
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Hong Kong, People's Republic of China
| | - Xiao-Xin Chen
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Hong Kong, People's Republic of China
| | - Sydney Chi-Wai Tang
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Hong Kong, People's Republic of China
| | - Stephen Cho-Wing Sze
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Hong Kong, People's Republic of China
| | - Yi-Bin Feng
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Hong Kong, People's Republic of China
| | - Kai-Fai Lee
- Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Hong Kong, People's Republic of China
| | - Kalin Yan-Bo Zhang
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Hong Kong, People's Republic of China
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Sun GD, Li CY, Cui WP, Guo QY, Dong CQ, Zou HB, Liu SJ, Dong WP, Miao LN. Review of Herbal Traditional Chinese Medicine for the Treatment of Diabetic Nephropathy. J Diabetes Res 2016; 2016:5749857. [PMID: 26649322 PMCID: PMC4662991 DOI: 10.1155/2016/5749857] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 07/22/2015] [Indexed: 02/07/2023] Open
Abstract
Diabetic nephropathy (DN) is the most serious chronic complications of diabetes; 20-40% of diabetic patients develop into end stage renal disease (ESRD). However, exact pathogenesis of DN is not fully clear and we have great difficulties in curing DN; poor treatment of DN led to high chances of mortality worldwide. A lot of western medicines such as ACEI and ARB have been demonstrated to protect renal function of DN but are not enough to delay or retard the progression of DN; therefore, exploring exact and feasible drug is current research hotspot in medicine. Traditional Chinese medicine (TCM) has been widely used to treat and control diabetes and its complications such as DN in a lot of scientific researches, which will give insights into the mechanism of DN, but they are not enough to reveal all the details. In this paper, we summarize the applications of herbal TCM preparations, single herbal TCM, and/or monomers from herbal TCM in the treatment of DN in the recent 10 years, depicting the renal protective effects and the corresponding mechanism, through which we shed light on the renal protective roles of TCM in DN with a particular focus on the molecular basis of the effect and provide a beneficial supplement to the drug therapy for DN.
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Affiliation(s)
- Guang-dong Sun
- Department of Nephrology, Second Hospital of Jilin University, Changchun 130041, China
- *Guang-dong Sun: and
| | - Chao-yuan Li
- Department of Nephrology, Second Hospital of Jilin University, Changchun 130041, China
| | - Wen-peng Cui
- Department of Nephrology, Second Hospital of Jilin University, Changchun 130041, China
| | - Qiao-yan Guo
- Department of Nephrology, Second Hospital of Jilin University, Changchun 130041, China
| | - Chang-qing Dong
- Department of Nephrology, Second Hospital of Jilin University, Changchun 130041, China
| | - Hong-bin Zou
- Department of Nephrology, Second Hospital of Jilin University, Changchun 130041, China
| | - Shu-jun Liu
- Department of Nephrology, Second Hospital of Jilin University, Changchun 130041, China
| | - Wen-peng Dong
- Department of Nephrology, Second Hospital of Jilin University, Changchun 130041, China
| | - Li-ning Miao
- Department of Nephrology, Second Hospital of Jilin University, Changchun 130041, China
- *Li-ning Miao:
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Du YG, Wang LP, Qian JW, Zhang KN, Chai KF. Panax notoginseng saponins protect kidney from diabetes by up-regulating silent information regulator 1 and activating antioxidant proteins in rats. Chin J Integr Med 2015; 22:910-917. [PMID: 26712211 DOI: 10.1007/s11655-015-2446-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To explore the mechanism of the protective effects of Panax notoginseng saponins (PNS) on kidney in diabetic rats. METHODS Diabetic rat model was obtained by intravenous injection of alloxan, and the rats were divided into model, PNS-100 mg/(kg day) and PNS-200 mg/(kg day) groups, 10 each. Another 10 rats injected with saline were served as control. Periodic acid-Schiff staining and immunological histological chemistry were used to observe histomorphology and tissue expression of bone morphogenetic protein-7 (BMP-7). Silent information regulator 1 (SIRT1) was silenced in rat mesangial cells by RNA interference. The mRNA expressions of SIRT-1, monocyte chemoattractant protein-1 (MCP-1), transforming growth factor β1 (TGF-β1) and plasminogen activator inhibitor-1 (PAI-1) were analyzed by reverse transcription polymerase chain reaction. The protein expressions of SIRT1 and the acetylation of nuclear factor κB (NF-κB) P65 were determined by western blotting. The concentration of MCP-1, TGF-β1 and malondialdehyde (MDA) in culture supernatant were detected by enzyme-linked immuno sorbent assay. The activity of superoxide dismutase (SOD) was detected by the classical method of nitrogen and blue four. RESULTS In diabetic model rats, PNS could not only reduce blood glucose and lipid (P<0.01), but also increase protein level of BMP-7 and inhibit PAI-1 expression for suppressing fibrosis of the kidney. In rat mesangial cells, PNS could up-regulate the expression of SIRT1 (P<0.01) and in turn suppress the transcription of TGF-β1 (P<0.05) and MCP-1 (P<0.05). PNS could also reverse the increased acetylation of NF-κB p65 by high glucose. In addition, redox regulation factor MDA was down-regulated (P<0.05) and SOD was up-regulated (P<0.01), which were both induced by SIRT1 up-regulation. CONCLUSIONS PNS could protect kidney from diabetes with the possible mechanism of up-regulating SIRT1, therefore inhibiting inflammation through decreasing the induction of inflammatory cytokines and TGF-β1, as well as activating antioxidant proteins.
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Affiliation(s)
- Yue-Guang Du
- Department of Pathyology, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Li-Pei Wang
- Department of Pathyology, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Jun-Wen Qian
- National Clinical Research Center of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Ke-Na Zhang
- Department of Pathyology, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Ke-Fu Chai
- National Clinical Research Center of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
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Liu JY, Chen XX, Tang SCW, Lao LX, Sze SCW, Lee KF, Zhang KYB. Edible plants from traditional Chinese medicine is a promising alternative for the management of diabetic nephropathy. J Funct Foods 2015. [DOI: 10.1016/j.jff.2015.01.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Ancient records and modern research on the mechanisms of chinese herbal medicines in the treatment of diabetes mellitus. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:747982. [PMID: 25815039 PMCID: PMC4359835 DOI: 10.1155/2015/747982] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 06/25/2014] [Indexed: 12/14/2022]
Abstract
Over the past decades, Chinese herbal medicines (CHM) have been extensively and intensively studied through from both clinical and experimental perspectives and CHM have been proved to be effective in the treatment of diabetes mellitus (DM). This study, by searching ancient records and modern research papers, reviewed CHM in terms of their clinical application and principal mechanism in the treatment of DM. We summarized the use of CHM mentioned in 54 famous ancient materia medica monographs and searched papers on the hypoglycemic effect of several representative CHM. Main mechanisms and limitations of CHM and further research direction for DM were discussed. On the basis of the study, we were led to conclude that TCM, as a main form of complementary and alternative medicine (CAM), was well recorded in ancient literatures and has less adverse effects as shown by modern studies. The mechanisms of CHM treatment of DM are complex, multilink, and multitarget, so we should find main hypoglycemic mechanism through doing research on CHM monomer active constituents. Many CHM monomer constituents possess noteworthy hypoglycemic effects. Therefore, developing a novel natural product for DM and its complications is of much significance. It is strongly significant to pay close attention to CHM for treatment of DM and its complications.
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Wang JY, Gao YB, Zhang N, Zou DW, Xu LP, Zhu ZY, Li JY, Zhou SN, Cui FQ, Zeng XJ, Geng JG, Yang JK. Tongxinluo ameliorates renal structure and function by regulating miR-21-induced epithelial-to-mesenchymal transition in diabetic nephropathy. Am J Physiol Renal Physiol 2013; 306:F486-95. [PMID: 24370587 DOI: 10.1152/ajprenal.00528.2013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Diabetic nephropathy (DN) is one of the most important diabetic microangiopathies. The epithelial-to-mesenchymal transition (EMT) plays an important role in DN. The physiological role of microRNA-21 (miR-21) was closely linked to EMT. However, it remained elusive whether tongxinluo (TXL) ameliorated renal structure and function by regulating miR-21-induced EMT in DN. This study aimed to determine the effect of TXL on miR-21-induced renal tubular EMT and to explore the relationship between miR-21 and TGF-β1/smads signals. Real-time RT-PCR, cell transfection, in situ hybridization (ISH), and laser confocal microscopy were used, respectively. Here, we revealed that TXL dose dependently lowered miR-21 expression in tissue, serum, and cells. Overexpression of miR-21 can enhance α-smooth muscle actin (SMA) expression and decrease E-cadherin expression by upregulating smad3/p-smad3 expression and downregulating smad7 expression. Interestingly, TXL also increased E-cadherin expression and decreased α-SMA expression by regulating miR-21 expression. More importantly, TXL decreased collagen IV, fibronectin, glomerular basement membrane, glomerular area, and the albumin/creatinine ratio, whereas it increased the creatinine clearance ratio. The results demonstrated that TXL ameliorated renal structure and function by regulating miR-21-induced EMT, which was one of the mechanisms to protect against DN, and that miR-21 may be one of the therapeutic targets for TXL in DN.
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Affiliation(s)
- Jin-yang Wang
- Metabolic Disease Center, School of Traditional Chinese Medicine, Capital Medical Univ. 10, Youanmenwai Xitoutiao, Fengtai District, Beijing, 100069, People's Republic of China.
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Yuan HD, Kim JT, Kim SH, Chung SH. Ginseng and diabetes: the evidences from in vitro, animal and human studies. J Ginseng Res 2013; 36:27-39. [PMID: 23717101 PMCID: PMC3659569 DOI: 10.5142/jgr.2012.36.1.27] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 12/02/2011] [Accepted: 12/02/2011] [Indexed: 01/09/2023] Open
Abstract
Panax ginseng exhibits pleiotropic beneficial effects on cardiovascular system, central nervous system, and immune system. In the last decade, numerous preclinical findings suggest ginseng as a promising therapeutic agent for diabetes prevention and treatment. The mechanism of ginseng and its active components is complex and is demonstrated to either modulate insulin production/secretion, glucose metabolism and uptake, or inflammatory pathway in both insulin-dependent and insulin-independent manners. However, human studies are remained obscure because of contradictory results. While more studies are warranted to further understand these contradictions, ginseng holds promise as a therapeutic agent for diabetes prevention and treatment. This review summarizes the evidences for the therapeutic potential of ginseng and ginsenosides from in vitro studies, animal studies and human clinical trials with a focus on diverse molecular targets including an AMP-activated protein kinase signaling pathway.
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Affiliation(s)
- Hai-Dan Yuan
- Department of Pharmacology and Clinical Pharmacy, College of Pharmacy, Kyung Hee University, Seoul 130-701, Korea
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