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Ye Y, Li M, Chen W, Wang H, He X, Liu N, Guo Z, Zheng C. Natural polysaccharides as promising reno-protective agents for the treatment of various kidney injury. Pharmacol Res 2024; 207:107301. [PMID: 39009291 DOI: 10.1016/j.phrs.2024.107301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/13/2024] [Accepted: 07/07/2024] [Indexed: 07/17/2024]
Abstract
Renal injury, a prevalent clinical outcome with multifactorial etiology, imposes a substantial burden on society. Currently, there remains a lack of effective management and treatments. Extensive research has emphasized the diverse biological effects of natural polysaccharides, which exhibit promising potential for mitigating renal damage. This review commences with the pathogenesis of four common renal diseases and the shared mechanisms underlying renal injury. The renoprotective roles of polysaccharides in vivo and in vitro are summarized in the following five aspects: anti-oxidative stress effects, anti-apoptotic effects, anti-inflammatory effects, anti-fibrotic effects, and gut modulatory effects. Furthermore, we explore the structure-activity relationship and bioavailability of polysaccharides in relation to renal injury, as well as investigate their utility as biomaterials for alleviating renal injury. The clinical experiments of polysaccharides applied to patients with chronic kidney disease are also reviewed. Broadly, this review provides a comprehensive perspective on the research direction of natural polysaccharides in the context of renal injury, with the primary aim to serve as a reference for the clinical development of polysaccharides as pharmaceuticals and prebiotics for the treatment of kidney diseases.
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Affiliation(s)
- Yufei Ye
- Department of Chinese Medicine Authentication, Faculty of Pharmacy, Second Military Medical University/Naval Medical University, 325 Guohe Road, Shanghai 200433, China; Department of Nephrology, Changhai Hospital, Second Military Medical University/Naval Medical University, 168 Changhai Road, Shanghai 200433, China
| | - Maoting Li
- Department of Chinese Medicine Authentication, Faculty of Pharmacy, Second Military Medical University/Naval Medical University, 325 Guohe Road, Shanghai 200433, China; Department of Nephrology, Naval Medical Center of PLA, Second Military Medical University/Naval Medical University, 338 West Huaihai Road, Shanghai 200052, China
| | - Wei Chen
- Department of Nephrology, Changhai Hospital, Second Military Medical University/Naval Medical University, 168 Changhai Road, Shanghai 200433, China
| | - Hongrui Wang
- Department of Chinese Medicine Authentication, Faculty of Pharmacy, Second Military Medical University/Naval Medical University, 325 Guohe Road, Shanghai 200433, China
| | - Xuhui He
- Department of Chinese Medicine Authentication, Faculty of Pharmacy, Second Military Medical University/Naval Medical University, 325 Guohe Road, Shanghai 200433, China
| | - Nanmei Liu
- Department of Nephrology, Naval Medical Center of PLA, Second Military Medical University/Naval Medical University, 338 West Huaihai Road, Shanghai 200052, China.
| | - Zhiyong Guo
- Department of Nephrology, Changhai Hospital, Second Military Medical University/Naval Medical University, 168 Changhai Road, Shanghai 200433, China.
| | - Chengjian Zheng
- Department of Chinese Medicine Authentication, Faculty of Pharmacy, Second Military Medical University/Naval Medical University, 325 Guohe Road, Shanghai 200433, China.
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Zhang L, Liu Y, Zhang Q, Yao W, Zhao Z, Wang X, Bao Y, Shi W. Salvia miltiorrhiza polysaccharide mitigates AFB1-induced liver injury in rabbits. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 276:116344. [PMID: 38636259 DOI: 10.1016/j.ecoenv.2024.116344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
Aflatoxin B1 (AFB1) is one of the common dietary contaminants worldwide, which can harm the liver of humans and animals. Salvia miltiorrhiza polysaccharide (SMP) is a natural plant-derived polysaccharide with numerous pharmacological activities, including hepatoprotective properties. The purpose of this study is to explore the intervention effect of SMP on AFB1-induced liver injury and its underlying mechanisms in rabbits. The rabbits were administered AFB1 (25 μg/kg/feed) and or treatment with SMP (300, 600, 900 mg/kg/feed) for 42 days. The results showed that SMP effectively alleviated the negative impact of AFB1 on rabbits' productivity by increasing average daily weight gain (ADG) and feed conversion rate (FCR). SMP reduced aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) levels in serum, ameliorating AFB1-induced hepatic pathological changes. Additionally, SMP enhanced superoxide dismutase (SOD), catalase (CAT) and glutathione (GSH) activity, and inhibited reactive oxygen species (ROS), malondialdehyde (MDA), 4-Hydroxynonenal (4-HNE), interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) expression, thus mitigating AFB1-induced oxidative stress and inflammatory responses. Moreover, SMP upregulated the expression of nuclear factor E2 related factor 2 (Nrf2), heme oxygenase 1 (HO-1), NADPH quinone oxidoreductase 1 (NQO1) and B-cell lymphoma 2 (Bcl2) while downregulating kelch like ECH associated protein 1 (Keap1), cytochrome c (cyt.c), caspase9, caspase3, and Bcl-2-associated X protein (Bax) expression, thereby inhibiting AFB1-induced hepatocyte apoptosis. Consequently, our findings conclude that SMP can mitigate AFB1-induced liver damage by activating the Nrf2/HO-1 pathway and inhibiting mitochondria-dependent apoptotic pathway in rabbits.
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Affiliation(s)
- Lu Zhang
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding 071001, China
| | - Ying Liu
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding 071001, China
| | - Qiongyi Zhang
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding 071001, China
| | - Weiyu Yao
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding 071001, China
| | - Zenghui Zhao
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding 071001, China
| | - Xiao Wang
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding 071001, China
| | - Yongzhan Bao
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding 071001, China; Hebei Provincial Veterinary Biotechnology Innovation Center, Baoding 071001, China
| | - Wanyu Shi
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding 071001, China; Hebei Provincial Veterinary Biotechnology Innovation Center, Baoding 071001, China.
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Li Z, Zhu JF, Ouyang H. Progress on traditional Chinese medicine in improving hepatic fibrosis through inhibiting oxidative stress. World J Hepatol 2023; 15:1091-1108. [PMID: 37970620 PMCID: PMC10642434 DOI: 10.4254/wjh.v15.i10.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/26/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Hepatic fibrosis is a common pathological process that occurs in the development of various chronic liver diseases into cirrhosis and liver cancer, characterized by excessive deposition of the extracellular matrix. In the past, hepatic fibrosis was thought to be a static and irreversible pathological process. In recent years, with the rapid development of molecular biology and the continuous in-depth study of the liver at the microscopic level, more and more evidence has shown that hepatic fibrosis is a dynamic and reversible process. Therefore, it is particularly important to find an effective, simple, and inexpensive method for its prevention and treatment. Traditional Chinese medicine (TCM) occupies an important position in the treatment of hepatic fibrosis due to its advantages of low adverse reactions, low cost, and multi-target effectiveness. A large number of research results have shown that TCM monomers, single herbal extracts, and TCM formulas play important roles in the prevention and treatment of hepatic fibrosis. Oxidative stress (OS) is one of the key factors in the occurrence and development of hepatic fibrosis. Therefore, this article reviews the progress in the understanding of the mechanisms of TCM monomers, single herbal extracts, and TCM formulas in preventing and treating hepatic fibrosis by inhibiting OS in recent years, in order to provide a reference and basis for drug therapy of hepatic fibrosis.
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Affiliation(s)
- Zhen Li
- Department of Liver, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jun-Feng Zhu
- Department of Liver, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Department of Liver, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Hao Ouyang
- Department of Liver, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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Luo L, Xue J, Shao Z, Zhou Z, Tang W, Liu J, Hu H, Yang F. Recent developments in Salvia miltiorrhiza polysaccharides: Isolation, purification, structural characteristics and biological activities. Front Pharmacol 2023; 14:1139201. [PMID: 36937857 PMCID: PMC10020221 DOI: 10.3389/fphar.2023.1139201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
In recent years, natural polysaccharides have attracted more and more attention and research because of their value in the medicine, beauty and food fields. Salvia miltiorrhiza is a traditional Chinese herb that has been used for thousands of years and has antidiabetic, antifibrotic, neuroprotective, antioxidation, anti-inflammatory and other effects. It mainly includes rosmarinic acid, tanshinone I, tanshinone IIA, tanshinone IIB, procatechualdehyde, polysaccharide and salvianolic acids. Salvia miltiorrhiza polysaccharide is a polysaccharide extracted and isolated from Salvia miltiorrhiza and has diverse biological functions, including antioxidation, anti-tumor, hepatoprotective, anti-inflammatory, immune regulatory and cardioprotective effect. In this review, the extraction, purification, structural characterization and biological activity of SMPs are summarized and new perspectives for the future work of SMPs were also proposed, we hope our research can provide a reference for further research on SMPs.
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Affiliation(s)
- Lei Luo
- Department of Health Management Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Juan Xue
- Department of Gastroenterology, Hubei Provincial Hospital of Traditional Chinese and Western Medicine, Wuhan, China
- School of Clinical Medical, Hubei University of Chinese Medicine, Wuhan, China
| | - Zheng Shao
- Department of Health Management Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Zhang Zhou
- Department of Anesthesiology, Wuhan Fourth Hospital, Wuhan, China
| | - Wenqian Tang
- Department of Health Management Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Jinxin Liu
- School of Clinical Medical, Hubei University of Chinese Medicine, Wuhan, China
| | - Hongfei Hu
- School of Clinical Medical, Hubei University of Chinese Medicine, Wuhan, China
| | - Fan Yang
- Department of Health Management Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- *Correspondence: Fan Yang,
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Luo JH, Li J, Shen ZC, Lin XF, Chen AQ, Wang YF, Gong ES, Liu D, Zou Q, Wang XY. Advances in health-promoting effects of natural polysaccharides: Regulation on Nrf2 antioxidant pathway. Front Nutr 2023; 10:1102146. [PMID: 36875839 PMCID: PMC9978827 DOI: 10.3389/fnut.2023.1102146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Natural polysaccharides (NPs) possess numerous health-promoting effects, such as liver protection, kidney protection, lung protection, neuroprotection, cardioprotection, gastrointestinal protection, anti-oxidation, anti-diabetic, and anti-aging. Nuclear factor erythroid 2-related factor 2 (Nrf2) antioxidant pathway is an important endogenous antioxidant pathway, which plays crucial roles in maintaining human health as its protection against oxidative stress. Accumulating evidence suggested that Nrf2 antioxidant pathway might be one of key regulatory targets for the health-promoting effects of NPs. However, the information concerning regulation of NPs on Nrf2 antioxidant pathway is scattered, and NPs show different regulatory behaviors in their different health-promoting processes. Therefore, in this article, structural features of NPs having regulation on Nrf2 antioxidant pathway are overviewed. Moreover, regulatory effects of NPs on this pathway for health-promoting effects are summarized. Furthermore, structure-activity relationship of NPs for health-promoting effects by regulating the pathway is preliminarily discussed. Otherwise, the prospects on future work for regulation of NPs on this pathway are proposed. This review is beneficial to well-understanding of underlying mechanisms for health-promoting effects of NPs from the view angle of Nrf2 antioxidant pathway, and provides a theoretical basis for the development and utilization of NPs in promoting human health.
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Affiliation(s)
- Jiang-Hong Luo
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Jing Li
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Zi-Chun Shen
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiao-Fan Lin
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Ao-Qiu Chen
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Yi-Fei Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Er-Sheng Gong
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China.,Key Laboratory of Environment and Health of Ganzhou, Gannan Medical University, Ganzhou, China
| | - Dan Liu
- Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang, College of Biology and Environmental Engineering, Zhejiang Shuren University, Hangzhou, China
| | - Qi Zou
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China.,Key Laboratory of Environment and Health of Ganzhou, Gannan Medical University, Ganzhou, China
| | - Xiao-Yin Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China.,Key Laboratory of Environment and Health of Ganzhou, Gannan Medical University, Ganzhou, China.,State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
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Wei YY, Zhang YN, Wang H, Ga Y, Fan Y, Wang Q, Gu JH, Zhang XY, Gong XH, Hao ZH. Mori fructus aqueous extracts attenuate carbon tetrachloride-induced renal injury via the Nrf2 pathway and intestinal flora. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 245:114118. [PMID: 36174321 DOI: 10.1016/j.ecoenv.2022.114118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
Mori fructus aqueous extracts (MFAEs) have been used as a traditional Chinese medicine for thousands of years with the function of strengthening the liver and tonifying the kidney. However, its inner mechanism to alleviative renal injury is unclear. To investigate the attenuation of MFAEs on nephrotoxicity and uncover its potential molecular mechanism, we established a nephrotoxicity model induced by carbon tetrachloride (CCl4). The mice were randomly divided into control group, CCl4 model group (10% CCl4), CCl4 + low and high MFAEs groups (10% CCl4 + 100 mg/kg and 200 mg/kg MFAEs). We found that MFAEs decreased the kidney index of mice, restored the pathological changes of renal structure induced by CCl4, reduced cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (Kim-1) blood urea nitrogen and creatinine contents in serum, promoted the nuclear transportation of Nrf2 (nuclear factor erythroid derived 2 like 2), elevated the expression of HO-1 (heme oxygenase 1), GPX4 (glutathione peroxidase 4), SLC7A11 (solute carrier family 7 member 11), ZO-1 (zonula occludens-1) and Occludin, suppressed the expression of Keap1 (kelch-like ECH-associated protein 1), HMGB1 (High Mobility Group Protein 1), ACSL4 (acyl-CoA synthetase long chain family member 4) and TXNIP (thioredoxin interacting protein), upregulated the flora of Akkermansia, Anaerotruncus, Clostridium_sensu_stricto, Ihubacter, Alcaligenes, Dysosmobacter, and downregulated the flora of Clostridium_XlVa, Helicobacter, Paramuribaculum. Overlapped with Disbiome database, Clostridium_XlVa, Akkermansia and Anaerotruncus may be the potential genera treated with renal injury. It indicated that MFAEs could ameliorate kidney injury caused by CCl4 via Nrf2 signaling.
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Affiliation(s)
- Yuan-Yuan Wei
- Innovation Centre of Chinese Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China; Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China
| | - Yan-Nan Zhang
- Innovation Centre of Chinese Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China; Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China
| | - Huiru Wang
- Innovation Centre of Chinese Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China; Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China
| | - Yu Ga
- Innovation Centre of Chinese Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China; Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China
| | - Yimeng Fan
- Innovation Centre of Chinese Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China; Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China
| | - Qingtao Wang
- Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China
| | - Jin-Hua Gu
- Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China; China Institute of Veterinary Drug Control, Beijing 100193, China
| | - Xiu-Ying Zhang
- Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China; China Institute of Veterinary Drug Control, Beijing 100193, China
| | - Xu-Hao Gong
- Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China; China Institute of Veterinary Drug Control, Beijing 100193, China
| | - Zhi-Hui Hao
- Innovation Centre of Chinese Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China; Key Biology Laboratory of Chinese Veterinary Medicine, Ministry of Agriculture and Rural Affairs, China.
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Wang X, Liu W, Liu Y, Jiao Y, Rong C, Liu Q, Shi W. Florfenicol induced renal inflammatory response and apoptosis via cell adhesion molecules signaling pathway. Poult Sci 2022; 101:102152. [PMID: 36152436 PMCID: PMC9508351 DOI: 10.1016/j.psj.2022.102152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/02/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022] Open
Abstract
Early use of florfenicol (FFC) can adversely affect the health of broilers. Our previous studies showed that FFC caused kidney injury in broilers. However, the mechanism by which FFC causes nephrotoxicity remains unclear. In order to further explore the regulatory effect of FFC on specific signal pathway in the injured kidneys and the interaction between genes and proteins in this signal pathway, the transcriptome and proteome sequencing were performed on the chick kidneys in the control group and the FFC treatment group. Then, the sequencing data were analyzed, and the screened genes and proteins were verified by real-time quantitative PCR (qPCR) and parallel reaction monitoring (PRM), respectively. The results of sequencing showed that FFC exposure altered significantly the expression levels of 657 genes and 477 proteins in chick kidneys. Among them, 9 significantly differentially expressed genes (including CD28, ICOS, BLB1, BLB2, DMB2, CLDN8, CLDN18, CLDN19, and NEGR1) and 3 significantly differentially expressed proteins (including CD28, ICOS, and CLDN8) were involved in the cell adhesion molecules signaling pathway. Further analysis found that, the changes of the above genes and proteins were related to inflammation and apoptosis of the tissues and histiocytes in chick kidneys. Therefore, the structure and morphology of renal tissues, the expression levels of inflammatory and apoptotic factors, and the apoptotic rate of renal histocytes were detected. It was found that compared with the control group, there was obvious inflammatory cell infiltration in renal tissues of the FFC treatment group. At the same time, the levels of pro-inflammatory factors and pro-apoptotic factors raised significantly, and the apoptotic rate of renal histocytes increased significantly. The above results confirmed that FFC induced inflammatory reaction and apoptosis in chick kidneys by activating the cell adhesion molecules signaling pathway.
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Affiliation(s)
- Xiao Wang
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding, 071001, China
| | - Wei Liu
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding, 071001, China
| | - Ying Liu
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding, 071001, China
| | - Yulan Jiao
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding, 071001, China; Veterinary Biotechnology Innovation Center of Hebei Province, Baoding, 071001, China; Ringpu (Baoding) Biological Pharmaceutical Co., Ltd., Baoding, 071001, China
| | - Chang Rong
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding, 071001, China
| | - Qi Liu
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding, 071001, China
| | - Wanyu Shi
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding, 071001, China; Veterinary Biotechnology Innovation Center of Hebei Province, Baoding, 071001, China.
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Efficacy and Safety of Salvia miltiorrhiza for Treating Chronic Kidney Diseases: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2117433. [PMID: 35747383 PMCID: PMC9213127 DOI: 10.1155/2022/2117433] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/17/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022]
Abstract
Objective This meta-analysis evaluated the effects and potential harms of Salvia miltiorrhiza or its extracts Salvianolate and Tanshinone for the treatment of population with a chronic kidney disease (CKD). Methods We searched for the randomized clinical trials (RCTs) through databases including the Cochrane Library, PubMed, Embase, Web of Science, Current Controlled Trials, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang Data), China Biology Medicine Disc (SinoMed), and Chinese Clinical Trial Registry (ChiCTR). Meta-analysis was performed with STATA 16 software after data extraction. The risk of bias was assessed with the Cochrane risk-of-bias tool (RoB 2.0), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was employed to evaluate the quality of evidence. Result A total of 32 studies were included involving 2264 participants. Compared to the control group, the treatment group significantly decreased serum creatinine (SCr) (SMD −0.60, 95% CI −0.79 to −0.41, P < 0.0001), blood urea nitrogen (BUN) (SMD −0.66, 95% CI −0.81 to −0.50, P < 0.0001), Cystatin C (CysC) (SMD −5.16, 95% CI −14.84 to 4.53, P=0.297), 24 hour urine protein (24 h UPE) (SMD −0.70, 95% CI −1.21 to −0.19, P=0.008), time to initiation of dialysis (Log RR 0.43, 95% CI 0.23 to 0.81, P=0.0089), serum total cholesterol (TC) (SMD −0.53, 95% CI −0.88 to −0.17, P=0.0042, P=0.0035), plasma fibrinogen (FIB) (SMD −0.79, 95% CI −1.12 to −0.46, P < 0.0001), C-reactive protein (CRP) (SMD −0.56, 95% CI −0.93 to −0.19, P=0.0029); increased creatinine clearance (Ccr) (SMD 0.92, 95% CI 0.43 to 1.41, P=0.0002), glomerular filtration rate (GFR) (SMD 0.56, 95% CI 0.30 to 0.83, P < 0.001), effective rate (Log RR 0.30, 95% CI 0.23 to 0.37, P < 0.0001), and hemoglobin (Hb) (SMD 0.42, 95% CI 0.13 to 0.71, P=0.0042). Moreover, the incidences of adverse effects were similar between the two groups. Conclusions Salvia miltiorrhiza or its extracts Salvianolate and Tanshinone, as a complementary therapy to conventional medicine, presents potential impacts to improve kidney functions and delay the progression of CKD without obvious adverse effects. However, the certainty of the evidence and the risk of bias are suboptimal and further clinical studies are still required to determine the underlying effects.
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