Chemical constituents, clinical efficacy and molecular mechanisms of the ethanol extract of Abelmoschus manihot flowers in treatment of kidney diseases

Abstract

Abelmoschus manihot, also called as “Huangkui” in Chinese, is an annual flowering herb plant in the family of Malvaceae. As a traditional Chinese medicine, the ethanol extract of the flower in Abelmoschus manihot is made as Huangkui capsule and has been used for medication of the patients with kidney diseases. Its efficacy in clinical symptoms is mainly improving renal function and reducing proteinuria among the patients with chronic kidney disease, diabetic kidney disease or IgA nephropathy. The possible mechanism of Huangkui capsule treatment in kidney diseases may include reducing inflammation and anti‐oxidative stress, improving immune response, protecting renal tubular epithelial cells, ameliorating podocyte apoptosis, glomerulosclerosis and mesangial proliferation, as well as inhibiting renal fibrosis. In this review, we first described chemical constituents and pharmacokinetic characteristics in ethanol extract of the flower of Abelmoschus manihot. We then summarized the clinical and epidemiological relevancies of kidney diseases particularly in the mainland of China and discussed the possible molecular mechanisms of Huangkui capsule in the treatment of kidney diseases. Finally, we prospected further research on cellular and molecular mechanisms and application of this Chinese natural medicine in kidney diseases.

The Therapeutic Strategies for Uremic Toxins Control in Chronic Kidney Disease

“…Medicus (A. manihot), was approved by China's State Food and Drug Administration in 1999 for treating chronic nephritis. Studies have confirmed the renal protective effect of the Huangkui capsule in vivo, in vitro, and clinically [105,140]. Flavonoids, the main chemical component of the Huangkui capsule, can be converted into glucuronic acid-sulfate conjugates in vivo, which may contribute to the nephroprotective effects [141].…”

Total Flavones of Abelmoschus manihot Remodels Gut Microbiota and Inhibits Microinflammation in Chronic Renal Failure Progression by Targeting Autophagy-Mediated Macrophage Polarization

“…The total flavones of Abelmoschus manihot (TFA) are the main components of Huangkui capsule (HKC; the local name in China), which is a modern Chinese patented medicine preparation extracted from Abelmoschus manihot (AM). This preparation has been approved by the China State Food and Drug Administration (Z19990040) for the treatment of CKD and has been used over the past two decades (Zhang et al, 2014;Li et al, 2020). Clinical evidence in China has suggested that HKC (at the safe and effective dose of 7.5 g/kg/day) can reduce urinary albumin in CKD.…”

Efficacy and safety of Huangkui capsule for diabetic nephropathy

“…Diabetic nephropathy (DN), 1 of the major complications of diabetes mellitus, [ 1 , 2 ] has become a threat to human health and mortality. [ 3 , 4 ] DN shows progressive renal damage over several years and involves many pathological changes: excessive deposition of extracellular matrix, glomerulosclerosis and renal interstitial fibrosis.…”