Efficacy and safety of Huaiqihuang granule as adjuvant treatment for primary nephrotic syndrome in children: a meta-analysis and systematic review

Jiao, Lin; Huang, Li-Min; Wang, Jingjing; Mao, Jianhua

doi:10.1007/s12519-020-00405-w

Cited by 4 publications

(10 citation statements)

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“…HSPN is a focal or diffuse allergic disease associated with vascular autoimmune damage. HSPN has a highly complex pathogenesis involving multiple factors, such as Gd-IgA1 [4,27] [28], complement cascade [29], and cellular immunity [30]. IgA1mediated glomerular injury manifests as mesangial cell proliferation and podocyte injury due to an immunological response.…”

Section: Discussionmentioning

confidence: 99%

Multicenter Real-World Study of Huaiqihuang Granules in the Treatment of Pediatric Henoch-Schonlein Purpura Nephritis

Tang

2023

Preprint

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Background: Henoch-Schonlein purpura nephritis (HSPN) is one of the most common secondary glomerular diseases. Effective treatment of HSPN is particularly important. The therapeutic efficacy of Huaiqihuang(HQH) granules for HSPN has only been investigated in small, single-center studies. Multicentered, large sample, real-world study is still lacking. Methods: In this real-world study, 835 children with HSPN from 21 hospitals were divided into isolated hematuria and proteinuria groups. Patients were treated with Huaiqihuang granules combined with conventional treatment (HQH group) or conventional treatment alone (control group). The remission rate of HQH group and control group were compared using life table method, factors associated with remission were identified using Cox regression analyses, and the incidence of adverse events was observed. Results: Patients were aged 8.85 ± 2.86 years on average, and 58% were male. In 154 HSPN patients with isolated hematuria. The 12th week remission rate of HQH group was 58.31 %( 95%CI, 49.38%–67.50%) while that in the control group was 26.99 %( 95%CI, 15.03%–45.52%), the hazard ratio(HR) of HQH treatment for hematuria remission was 2.77 (95% CI, 1.57–4.89; p < 0.01) in multivariate Cox regression analysis. Of 681 patients with proteinuria, those treated with HQH had 12th week remission rate of 76.81%( 95% CI,72.97%– 80.45%) while those in the control group was 67.70 %(95% CI, 60.00%–75.18%),the HR of HQH treatment for proteinuria remission was 1.23(95% CI, 1.01–1.50; p = 0.04) in multivariate Cox regression analysis.Stratified analysis indicated in patients with non-nephrotic-range proteinuria, the HR of HQH treatment for proteinuria remission were 1.26 (95% CI, 1.01–1.59; p = 0.04) The incidence of adverse reactions did not differ between the Huaiqihuang and control groups (p < 0.05). Conclusion: Huaiqihuang granules combined with conventional treatment can significantly increase the remission rate in cases of isolated hematuria HSPN and HSPN with proteinuria and be a protective factor on isolated hematuria HSPN and non-nephrotic-range proteinuria (NNRP)-type HSPN, with good safety.

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Section: Discussionmentioning

confidence: 99%

Multicenter Real-World Study of Huaiqihuang Granules in the Treatment of Pediatric Henoch-Schonlein Purpura Nephritis

Tang

2023

Preprint

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“…One meta-analysis found significantly elevated IgM level in Huaier-treated patients with hepatocellular carcinoma (61), which is in agreement with another study investigating the effects of HQH in children with severe Mycoplasma pneumonia (13). Conversely, for pediatric patients with primary nephrotic syndrome, it has been reported by meta-analysis that the regulation of HQH on IgM level was not statistically significant (74) in spite of some positive observation (82). On the other hand, coherent conclusions have been noted that Huaier promoted reduction of serum IgE level in animal models of asthma (49,80) and parasitic infection (79), indicating amelioration of diseases.…”

Section: The Effects Of Huaier On B Lymphocytesmentioning

confidence: 99%

“…Generally, Huaier has been reported to stimulate T cell proliferation and increase the quantity of T cells in peripheral blood and local tissues. Clinical studies revealed that Huaier increased the proportion of CD3+ and CD4+ T cells in peripheral blood in cancer patients receiving chemotherapy ( 37 , 61 – 63 , 72 , 73 ); HQH, the compound preparation of Huaier, has also been claimed to raise serum levels of CD3+ and CD4+ T lymphocytes in pediatric patients suffering primary nephrotic syndrome ( 74 ) and severe Mycoplasma pneumonia ( 13 ). Elevated peripheral blood CD4+ and CD8+ T cells by the administration of Huaier polysaccharides were recapitulated in rat model simulating HCC recurrence after liver transplantation ( 75 ).…”

Section: Immunomodulatory Activities Of Huaiermentioning

confidence: 99%

“…In mouse model of Echinococcus granulosus infection, oral intake of Huaier extract markedly decreased CD8+ T cells in peripheral blood of infected animals ( 79 ). For clinical studies, co-administration of Huaier or HQH as adjuvant therapy has been reported to reduce CD8+ T lymphocytes in advanced breast cancer patients ( 73 ), pediatric patients with primary nephrotic syndrome ( 74 ) and severe Mycoplasma pneumonia ( 13 ). On contrary, several animal experiments claimed that oral administration of Huaier increased CD8+ T lymphocytes in peripheral blood of a rat model of primary hepatocellular carcinoma ( 75 ) and in heart allografts of a mouse heterotopic transplantation model ( 76 ).…”

Section: Immunomodulatory Activities Of Huaiermentioning

confidence: 99%

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Immunoregulatory effects of Huaier (Trametes robiniophila Murr) and relevant clinical applications

Long

2023

Front. Immunol.

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Huaier (Trametes robiniophila Murr) is a medicinal fungus of traditional Chinese medicine with more than 1000 years of history of clinical application. Its remarkable anticancer activities has led to its application in treating diverse malignancies. In recent years, the immunomodulatory effects of Huaier have been uncovered and proved to be beneficial in a plethora of immune-related diseases including cancer, nephropathy, asthma, etc. In this review, we comprehensively summarized the active components of Huaier, its regulatory activities on multifaceted aspects of the immune system, its application in various clinical settings as well as toxicologic evidence. Based on currently available literature, Huaier possesses broad-spectrum regulatory activities on various components of the innate and adaptive immune system, including macrophages, dendritic cells, natural killer cells, T and B lymphocytes, etc. Versatile immunologic reactions are under the regulation of Huaier from expression of damage-associated molecular patterns, immune cell activation and maturation to cell proliferation, differentiation, antibody production, expression of cytokines and chemokines and terminal intracellular signal transduction. Moreover, some modulatory activities of Huaier might be context-dependent, typically promoting the restoration toward normal physiological status. With excellent efficacy and minimal side effects, we foresee more extensive application of Huaier for treating immune-related disorders.

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“…Therefore, the combined treatment of nephrotic syndrome with Chinese and Western medicine has become a hot topic in the field of pediatric nephrotic syndrome research to achieve the best outcome for children with nephrotic syndrome, effectively control proteinuria, reduce recurrence, smoothly withdraw immunosuppressive drugs, and promote remission. There is increasing evidence that plants used in traditional Chinese medicine (TCM) and compounds isolated from medicinal plants have beneficial effects and that TCMs can improve clinical remission rates and reduce the frequency of relapses and infections in children with PNS as an adjunct to Western medical treatment [ 10 ]. Therefore, this retrospective study aimed to investigate the efficacy of adjuvant therapy with traditional Chinese medicine in children with primary nephrotic syndrome.…”

Section: Introductionmentioning

confidence: 99%

Clinical Efficacy of Adjuvant Treatment of Primary Nephrotic Syndrome in Pediatric Patients with Chinese Medicine

Zhang

Liu

et al. 2022

Journal of Healthcare Engineering

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Objective. Current study aimed to investigate the benefits of adjuvant therapy with traditional Chinese medicine on the pediatric primary nephrotic syndrome. Methods. A total of 455 patients with PNS admitted to our hospital from January 2010 to January 2019 were divided into the traditional Chinese medicine group (n = 217) and the control group (n = 238). The control group received conventional Western medical treatment, and the traditional Chinese medicine group was treated with traditional Chinese medicine supplemented with Western medical treatment. The differences in remission rate, recurrence rate, and recurrence-free survival between the two groups were evaluated. Results. The differences in clinical parameters between the two groups were not statistically significant. Compared with the control group, adjuvant treatment with traditional Chinese medicine increased the clinical remission rate ( p = 0.037 ), decreased the relapse rate ( p = 0.015 ), prolonged relapse-free survival ( p ≤ 0.01 ), and was an independent protective factor for relapse-free survival in children with PNS (HR = 0.55, 95% CI 0.49–0.63, p ≤ 0.01 ). In a subgroup analysis of the traditional Chinese medicine formulations, Yuebi Jiazhu Tang, Ganlu Xiaodu Dan, and Yupingfeng granules significantly reduced the risk of recurrence in children ( p ≤ 0.01 , p ≤ 0.01 , p = 0.003 ). Conclusion. Adjuvant treatment of pediatric primary nephrotic syndrome with traditional Chinese medicine could benefit the children.

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Efficacy and safety of Huaiqihuang granule as adjuvant treatment for primary nephrotic syndrome in children: a meta-analysis and systematic review

Cited by 4 publications

References 24 publications

Multicenter Real-World Study of Huaiqihuang Granules in the Treatment of Pediatric Henoch-Schonlein Purpura Nephritis

Multicenter Real-World Study of Huaiqihuang Granules in the Treatment of Pediatric Henoch-Schonlein Purpura Nephritis

Immunoregulatory effects of Huaier (Trametes robiniophila Murr) and relevant clinical applications

Clinical Efficacy of Adjuvant Treatment of Primary Nephrotic Syndrome in Pediatric Patients with Chinese Medicine

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