RESUMO
Chronic kidney disease （CKD） has become a public health problem worldwide with renal interstitial fibrosis （RIF） serving as the important pathological feature and pathological outcome of various CKD. Therefore， anti-fibrosis therapy has important practical significance for delaying the progression of CKD and improving the prognosis of CKD patients. The Wnt/β-catenin signaling pathway is a conserved signaling pathway through evolution， which plays a vital role in organ formation， tissue homeostasis， and disease progression during embryonic development. A growing body of research has confirmed that the Wnt/β-catenin signaling pathway is one of the key signaling pathways in a variety of kidney diseases and its activation is closely related to RIF. RIF is aggravated by the specific regulation of the expression of downstream target genes， such as fibroblasts， zinc finger transcription factor 1 （Snail1）， M2 macrophages， matrix metalloproteinase-7 （MMP-7）， plasminogen activator inhibitor-1 （PAI-1）， and renin-angiotensin system（RAS）， and relieved by targeting the signaling pathways， such as Klotho， Dickkopf-related protein 1 （DKK1）， secreted frizzled-related protein 1 （Sfrp1）， and indocyanine green-001. In addition，the pathological view of RIF in traditional Chinese medicine （TCM） coincides with that in western medicine. Based on the etiology and pathogenesis of TCM in the combination of deficiency and excess， TCM regulates fibrosis-promoting mediators by tonifying deficiency， eliminating turbidity， removing the toxin， resolving stasis， and treating both symptoms and root causes in a multi-target， multi-layer， and multi-pathway manner to inhibit the Wnt/β-catenin signaling pathway and play an important role in renal protection. Therefore， this study reviewed the regulatory mechanism of the Wnt/β-catenin signaling pathway in RIF and the protective effect of targeting this signaling pathway on renal function and discussed the potential role of TCM in delaying the progression of RIF， which is expected to provide new targets and strategies for the prevention and treatment of RIF.
RESUMO
As common and frequently-occurring disorders in clinic practice，renal diseases are characterized by the impairment of kidney structure and function due to a variety of reasons and can be divided into primary，secondary， and hereditary types. Clinically，the impairment of kidney structure and function is usually a chronic progressive process，and the resulting chronic renal diseases have become a major public health problem endangering human health worldwide. Notch signaling pathway affects cell proliferation，differentiation，migration，growth， and apoptosis and determines the fate of cells. Abnormal expression or gene mutation of Notch will cause tissue damage， followed by the occurrence and development of a variety of renal diseases. Traditional Chinese medicine （TCM）， as an important means to prevent and treat renal diseases，has the characteristics of acting on multiple targets and signaling pathways with multiple components，and is often used as a routine or potential complementary therapy for the treatment of chronic renal diseases and also a source of new drug discovery. In recent years， considering the limitations of western medicine in treating renal diseases，more and more scholars have begun to take Notch signaling pathway as the breakthrough point for exploring TCM prevention and treatment of renal diseases. They have conducted clinical and experimental studies on the regulation of Notch signaling pathway by a variety of individual Chinese herbs or their extracts，Chinese patent medicines， and Chinese medicinal compounds，and found that TCM exerted the renal protective effects by inhibiting the Notch signaling pathway. By collecting relevant literatures on TCM prevention and treatment of various renal diseases，especially those concerning TCM regulation of Notch signaling pathway for preventing and treating such chronic renal diseases as diabetic nephropathy，immunoglobulin A （IgA） nephropathy，renal fibrosis，membranous nephropathy，focal segmental glomerulosclerosis， and renal cell carcinoma，this paper summarized the current research status，in order to provide reference for clinical prevention and treatment of various renal diseases and build up the factual basis for the universal application of TCM.
