Total flavonoids of Astragalus protects glomerular filtration barrier in diabetic kidney disease

BACKGROUND

Diabetic kidney disease (DKD) is a prevalent complication of diabetes and the leading cause of end-stage renal disease. Recent evidence suggests that total flavonoids of Astragalus (TFA) has promising effects on diabetes; however, its influence on DKD and the underlying mechanism remains unclear.

METHODS

In this study, we induced the DKD model using streptozotocin (STZ) in male C57BL/6J mice and utilized glomerular endothelial cell (GEC) lines for in vitro investigations. We constructed a network pharmacology analysis to understand the mechanism of TFA in DKD. The mechanism of TFA action on DKD was investigated through Western blot analysis and multi-immunological methods.

RESULTS

Our findings revealed that TFA significantly reduced levels of urinary albumin (ALB). Network pharmacology and intracellular pathway experiments indicated the crucial involvement of the PI3K/AKT signaling pathway in mediating these effects. In vitro experiments showed that TFA can preserve the integrity of the glomerular filtration barrier by inhibiting the expression of inflammatory factors TNF-alpha and IL-8, reducing oxidative stress.

CONCLUSION

Our findings demonstrated that TFA can ameliorates the progression of DKD by ameliorating renal fibrosis and preserving the integrity of the kidney filtration barrier. These results provide pharmacological evidence supporting the use of TFA in the treatment of kidney diseases.

The Efficacy and Safety of Astragalus as an Adjuvant Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Objective: This meta-analysis evaluated the beneficial and potential adverse effects of Astragalus in the treatment of patients with type 2 diabetes mellitus (T2DM). Methods: The authors searched for randomized controlled trials of Astragalus treatment for patients with T2DM in the following databases: PubMed, Embase, Cochrane Library, China Knowledge Resource Integrated Database (CNKI), Wanfang Data, China Science and Technology Journal Database (CQVIP), and SinoMed. Two reviewers conducted independent selection of studies, data extraction, and coding, as well as the assessment of risk of bias in the studies included. Standard meta-analysis and, if appropriate, meta-regression were performed using the STATA, v.15.1, software. Results: This meta-analysis encompasses 20 studies and a total of 953 participants. Compared to the control group (CG), the observation group (OG) decreased fasting plasma glucose (FPG) (WMD = -0.67, 95% CI: -1.13∼-0.20, P = 0.005), 2 hours postprandial plasma glucose (2hPG) (WMD = -0.67 (95% CI: -1.13∼-0.20, P=0.005), glycated hemoglobin A1C (HbA1c) (WMD = -0.93, 95% CI: -1.22∼-0.64, P = 0.000), homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = -0.45, 95% CI: -0.99∼0.99, P = 0.104), insulin sensitive index (WMD = 0.42, 95% CI: 0.13-0.72, P = 0.004). The total effective ratio of the OG is more effective than CG (RR = 1.33, 95% CI: 1.26-1.40, P = 0.000), the significant effective ratio (RR = 1.69, 95% CI: 1.48-1.93, P = 0.000). Conclusions: Astragalus may provide specific benefits for T2DM patients as an adjuvant treatment. Nonetheless, the certainty of the evidence and risk of bias fell short of optimal performance, indicating the need for additional clinical research to ascertain potential effects. PROSPERO REGISTRATION NUMBER CRD42022338491.

Intake of flavonoids from Astragalus membranaceus ameliorated brain impairment in diabetic mice via modulating brain-gut axis

Background

Brain impairment is one of a major complication of diabetes. Dietary flavonoids have been recommended to prevent brain damage. Astragalus membranaceus is a herbal medicine commonly used to relieve the complications of diabetes. Flavonoids is one of the major ingredients of Astragalus membranaceus, but its function and mechanism on diabetic encepholopathy is still unknown.

Methods

Type 2 diabetes mellitus (T2DM) model was induced by high fat diet and STZ in C57BL/6J mice, and BEnd.3 and HT22 cell lines were applied in the in vitro study. Quality of flavonoids was evaluated by LC–MS/MS. Differential expressed proteins in the hippocampus were evaluated by proteomics; influence of the flavonoids on composition of gut microbiota was analyzed by metagenomics. Mechanism of the flavonoids on diabetic encepholopathy was analyzed by Q-PCR, Western Blot, and multi-immunological methods et al.

Results

We found that flavonoids from Astragalus membranaceus (TFA) significantly ameliorated brain damage by modulating gut-microbiota-brain axis: TFA oral administration decreased fasting blood glucose and food intake, repaired blood brain barrier, protected hippocampus synaptic function; improved hippocampus mitochondrial biosynthesis and energy metabolism; and enriched the intestinal microbiome in high fat diet/STZ-induced diabetic mice. In the in vitro study, we found TFA increased viability of HT22 cells and preserved gut barrier integrity in CaCO₂ monocellular layer, and PGC1α/AMPK pathway participated in this process.

Conclusion

Our findings demonstrated that flavonoids from Astragalus membranaceus ameliorated brain impairment, and its modulation on gut-brain axis plays a pivotal role. Our present study provided an alternative solution on preventing and treating diabetic cognition impairment.

Mandibular lengthening by distraction osteogenesis in children--a one-year follow-up study

OBJECTIVE

The present study was undertaken to document whether mandibular length could be increased by distraction osteogenesis in children and what happens to the mandibular position 1 year after the distraction.

METHODS

Five patients with hemifacial microsomia (four unilateral, one bilateral) had distraction osteogenesis performed to lengthen the mandible. All patients had cephalometric and panoramic radiographs obtained before and 3, 6, and 12 months after the distraction osteogenesis.

RESULTS

The total mandibular length (Co-Gn) on the affected side was increased by 11.2 mm after the distraction and remained stable during a 1-year observation period. However, the increased mandibular length tended to move the chin downward (8 mm) more than forward (2 mm) during the same period.

CONCLUSIONS

Distraction osteogensis can be used to lengthen the hypoplastic mandible. However, most of the increased mandibular length moved the chin downward more than forward.

Low prevalence of hepatitis C virus and infrequent perinatal or spouse infections in pregnant women in Taiwan

To assess the prevalence of hepatitis C virus (HCV) infection in the pregnant women in Taiwan, we investigated two groups of pregnant women, 944 women without serum alanine aminotransferase (ALT) screening (group A) and 197 women with abnormal ALT (greater than 45 IU/L) (group B). They were checked for anti-HCV (anti-C100-3) with HCV EIA kit (Abbott Lab., North Chicago, IL). The results showed that 21 (2.2%) in group A and 5 (2.5%) in group B were anti-HCV-positive. However, 15 out of 21 in group A had an optical density (O.D.) of anti-HCV less than 1.0, were negative by recombinant immunoblot assay (RIBA), and were regarded as false-positive. Nine infants delivered by those 11 cases were negative for anti-HCV at 6 months of age, while none of the 8 husbands were anti-HCV-positive. It is concluded that the prevalence of anti-HCV in pregnant women in Taiwan is low (6/944, 0.63%), even in the cases with abnormal ALT (5/197, 2.5%). There was no serologic evidence for perinatal transmission or spouse infection.