Chinese herbal medicine for the treatment of diabetic nephropathy: From clinical evidence to potential mechanisms.

ETHNOPHARMACOLOGICAL RELEVANCE: Diabetic nephropathy (DN) is a typical chronic microvascular complication of diabetes, characterized by proteinuria and a gradual decline in renal function. At present, there are limited clinical interventions aimed at preventing the progression of DN to end-stage renal disease (ESRD). However, Chinese herbal medicine presents a distinct therapeutic approach that can be effectively combined with conventional Western medicine treatments to safeguard renal function. This combination holds considerable practical implications for the treatment of DN. AIM OF THE STUDY: This review covers commonly used Chinese herbal remedies and decoctions applicable to various types of DN, and we summarize the role played by their active ingredients in the treatment of DN and their mechanisms, which includes how they might improve inflammation and metabolic abnormalities to provide new ideas to cope with the development of DN. MATERIALS AND METHODS: With the keywords "diabetic nephropathy," "Chinese herbal medicine," "clinical effectiveness," and "bioactive components," we conducted an extensive literature search of several databases, including PubMed, Web of Science, CNKI, and Wanfang database, to discover studies on herbal formulas that were effective in slowing the progression of DN. The names of the plants covered in the review have been checked at MPNS (http://mpns.kew.org). RESULTS: This review demonstrates the superior total clinical effective rate of combining Chinese herbal medicines with Western medicines over the use of Western medicines alone, as evidenced by summarizing the results of several clinical trials. Furthermore, the review highlights the nephroprotective effects of seven frequently used herbs exerting beneficial effects such as podocyte repair, anti-fibrosis of renal tissues, and regulation of glucose and lipid metabolism through multiple signaling pathways in the treatment of DN. CONCLUSIONS: The potential of herbs in treating DN is evident from their excellent effectiveness and the ability of different herbs to target various symptoms of the condition. However, limitations arise from the deficiencies in interfacing with objective bioindicators, which hinder the integration of herbal therapies into modern medical practice. Further research is warranted to address these limitations and enhance the compatibility of herbal therapies with contemporary medical standards.

Chinese Herbal Medicines for Coronary Heart Disease: Clinical Evidence, Pharmacological Mechanisms, and the Interaction with Gut Microbiota.

Coronary heart disease (CHD) is a common type of cardiovascular disease (CVD) that has been on the rise in terms of both incidence and mortality worldwide, presenting a significant threat to human health. An increasing body of studies has shown that traditional Chinese medicine (TCM), particularly Chinese herbal medicines (CHMs), can serve as an effective adjunctive therapy to enhance the efficacy of Western drugs in treating CHD due to their multiple targets and multiple pathways. In this article, we critically review data available on the potential therapeutic strategies of CHMs in the intervention of CHD from three perspectives: clinical evidence, pharmacological mechanisms, and the interaction with gut microbiota. We identified 20 CHMs used in clinical practice and it has been found that the total clinical effective rate of CHD patients improved on average by 17.78% with the intervention of these CHMs. Subsequently, six signaling pathways commonly used in treating CHD have been identified through an overview of potential pharmacological mechanisms of these 20 CHMs and the eight representative individual herbs selected from them. CHMs could also act on gut microbiota to intervene in CHD by modulating the composition of gut microbiota, reducing trimethylamine-N-oxide (TMAO) levels, increasing short-chain fatty acids (SCFAs), and maintaining appropriate bile acids (BAs). Thus, the therapeutic potential of CHMs for CHD is worthy of further study in view of the outcomes found in existing studies.

Spatial distribution of soil cadmium and its influencing factors in peri-urban farmland: a case study in the Jingyang District, Sichuan, China.

Semi-agricultural ecosystems in peri-urban areas are susceptible to contamination. The spatial distribution and influencing factors of such pollution are unclear and poorly constrained in many areas worldwide. Therefore, studying the problems of soil pollution in peri-urban areas is critical for environmental management and agricultural production. In this paper, with cadmium (Cd) as the target pollutant, the spatiotemporal variations of soil cadmium pollution and the relative importance of the affecting factors were analyzed at a peri-urban area from the Jingyang District, Sichuan, China. Statistical results showed that the farmland in the study area could be considered moderately soil Cd-polluted, under the dual influence of natural factors and human activity. In particular, the soil Cd concentration in Tianyuan and Bajiaojing exceeded 0.5 mg kg-1, for intensive industrial enterprises are distributed in these areas. Correspondingly, the geoaccumulation index also showed that the contamination of Cd in this area was moderately polluted. Moreover, the ecological risk index was 80% in the study area, indicating that the soil Cd pollution potential risk was moderate to high. High geological background values (soil Cd = 0.29 mg kg-1), river migration, industrial enterprises, and traffic significantly influenced soil Cd pollution, with natural geological factors playing greater roles. The significant horizontal-spatial effective distances away from Shiting River, Deyang-Aba Highway, and chemical plants were 200, 400, and 100 m, respectively. These results will be useful in guiding farmland cultivation and pollution remediation effectively in the peri-urban areas.