Résumé
Objective:To investigate the protective effects and mechanism of Shenyan 1 Prescription on renal fibrosis of unilateral ureteral obstruction (UUO) rats through TGF- β 1/Smad homologous 3 (Smad3) pathway regulating ferroptosis.Methods:Totally 48 male SD rats were divided into four groups: sham-operation group, UUO model group, and Shenyan 1 Prescription low-(10 drug/kg) , and high-dosage (20 crude drug/kg) groups according to random number table method, with 12 rats in each group. The UUO model was induced by the method of unilateral ureteral obstruction except for those sham-operation group. After modeling, rats received corresponding drugs or normal saline by gavage for 4 weeks, once per day. After 4 weeks, the body mass and the left kidney weight were measured. The 24 h urine protein and the levels of serum albumin (ALB), alanine aminotransferase (ALT), serum creatinine (SCr) and blood urea nitrogen (BUN) were detected by biochemical analysis method; the ROS level in renal tissue was measured using a chemical fluorescence assay kit, and the SOD and MDA levels in left renal tissue of rats were measured using ELISA method; the morphology of renal tissue and the specific blue staining of hemosiderin were observed using HE and Prussian blue staining methods, respectively; the expressions of transforming growth factor-β1 (TGF-β1), Smad3, glutathione peroxidase 4 (GPX4), and solute carrier family 1 member 5 (SLC1A5) were detected by Western blot.Results:Compared with the model group, the 24 h urinary protein excretion in Shenyan 1 Prescription high-dosage group decreased ( P<0.05), the serum ALB level increased ( P<0.05), the ALT level decreased ( P<0.05), and the expression of SLC1A5 in renal tissue decreased ( P<0.05); the left kidney weight/body decreased in Shenyan 1 Prescription low- and high-dosage groups ( P<0.05); the levels of serum ROS and MDA decreased ( P<0.05), and the activity of SOD significantly increased ( P<0.05); the expressions of TGF-β1 and Smad3 in renal tissue decreased ( P<0.05), and the expression of GPX4 increased ( P<0.05), and the renal pathological injury and ion deposition were improved. Conclusion:Shenyan 1 Prescription has a protective effect on the structure and function of renal tissues in UUO rats through regulating ferroptosis via inhibition of the TGF-β1/ Smad3 pathway to inhibit renal fibrosis of UUO rats.
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This article aimed to explore the theoretical connotation and mechanism of clearing damp-heat method in the treatment of chronic kidney disease (CKD), provide theoretical support for clearing damp-heat method in the treatment of chronic kidney disease, and further explain the modern scientific connotation of "damp-heat impairing kidney". Modern Traditional Chinese Medicine (TCM) believes that damp-heat is an important pathogenesis of kidney damage. Clearing damp-heat method plays a key role in inhibiting CKD immune inflammatory response, improving oxidative stress and antagonizing renal fibrosis. The mechanism is mainly related to the regulation of TNF-α level, blocking NF-κB signaling pathway, inhibiting inflammatory cytokines, antagonizing TGF-β1 secretion and other pathways.
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Objective:To evaluate the clinical curative effect of self-made Lishi Qufeng Juanbi Decoction combined with Febuxostat tablet on uric acid nephropathy (UAN).Methods:Randomized controlled trial. A total of 150 patients with UAN in Yixing Hospital of Traditional Chinese Medicine were enrolled as the observation objects between October 2019 to October 2021. According to random number table method, they were divided into two groups, 75 in each group. The control group was treated with Febuxostat tablets on basis of routine diet intervention, while the observation group was treated with self-made Lishi Qufeng Juanbi Decoction on basis of control group. All were continuously treated for 6 months. TCM syndromes were scored before and after treatment. The levels of serum uric acid (SUA) and creatinine (SCr) were detected by full-automatic biochemical analyzer, and levels of serum CRP, IL-6 and IL-8 were detected by ELISA. The 24h urine was collected to detect 24 h urine protein quantitation. The adverse events were recorded, and clinical curative effect was evaluated.Results:There were significant differences in total response rate between observation group and control group [93.33% (70/75) vs. 80.00% (60/75); χ2=5.77, P=0.016]. After treatment, scores of waist soreness-fatigue and frequent nocturia in observation group were significantly lower than those in the control group ( t=9.17, 2.67, P<0.01), and frequency of joint swelling pain was significantly lower than that of the control group ( t=9.49, P<0.01). The levels of serum SUA and SCr, and 24 h urine protein quantitation in observation group were significantly lower than those in the control group ( t=3.38, 2.49, 12.55, P<0.01 or P<0.05), and levels of CRP, IL-6 and IL-8 were significantly lower than those in the control group ( t=5.44, 4.15, 9.61, P<0.01). There was no significant difference in incidence of adverse reactions between observation group and control group [4.00% (3/75) vs. 10.67% (8/75); χ2=2.45, P=0.117]. Conclusion:The self-made Lishi Qufeng Juanbi Decoction combined with Febuxostat tablets can promote uric acid metabolism, improve high uric acid environment, protect renal function, inhibit the release of inflammatory factors, improve curative effect and reduce adverse reactions in UAN patients.
Résumé
Theory of Shen-Xu Pang-Guang-Re (SXPGR) is an important part of the theory of zang-fu in traditional Chinese medicine (TCM). And it is the generalization for etiology and pathogenesis of Lin-Zheng (LZ). In immunology, mucosal immune system is composed of mucosal-associated lymphoid tissues and immune cells, which can resist the invasion of microorganisms. Mucosal immune plays an important role in the occurrence of urinary tract infection. This paper, which was based on SIgA and homing mechanism, was to investigate the relevance between mucosal immunity and the theory of SXPGR, in order to study the connotation of SXPGR in TCM.