How Does Herbal Medicine Treat Idiopathic Membranous Nephropathy?

Feng, Zhendong; Liu, Wenbin; Jiang, Hongbin; Dai, Haoran; Gao, Chang; Dong, Zhaocheng; Gao, Yu; Liu, Fei; Zhang, Zihan; Zhao, Qihan; Zhang, Lei; Liu, Baoli

doi:10.3389/fphar.2020.00994

Cited by 14 publications

(9 citation statements)

References 99 publications

(115 reference statements)

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“…Natural products or TCM have been used as a medical therapy for various diseases, including the prevention and treatment of renal diseases since the beginning of civilization (Chen et al, 2018a;Chen Y. Y. et al, 2019;Feng Z. et al, 2020;Hu et al, 2020;Liu et al, 2019;Newman and Cragg, 2016;Yang et al, 2019). A number of natural products such as Polyporus umbellatus, Poria cocos, and Alisma orientale have shown renoprotective properties (Chen et al, 2020;Chen et al, 2019a;Tian et al, 2014;Wang et al, 2018;Wang et al, 2013;Zhao, 2013).…”

Section: Discussionmentioning

confidence: 99%

Polyporus Umbellatus Protects Against Renal Fibrosis by Regulating Intrarenal Fatty Acyl Metabolites

Wang

Zhang

et al. 2021

Front. Pharmacol.

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Background: Chronic renal failure (CRF) results in significant dyslipidemia and profound changes in lipid metabolism. Polyporus umbellatus (PPU) has been shown to prevent kidney injury and subsequent kidney fibrosis.Methods: Lipidomic analysis was performed to explore the intrarenal profile of lipid metabolites and further investigate the effect of PPU and its main bioactive component, ergone, on disorders of lipid metabolism in rats induced by adenine. Univariate and multivariate statistical analyses were performed for choosing intrarenal differential lipid species in CRF rats and the intervening effect of n-hexane extract of PPU and ergone on CRF rats.Results: Compared with control group, decreased creatinine clearance rate indicated declining kidney function in CRF group. Based on the lipidomics, we identified 65 lipid species that showed significant differences between CRF and control groups. The levels of 12 lipid species, especially fatty acyl lipids including docosahexaenoic acid, docosapentaenoic acid (22n-3), 10,11-Dihydro-12R-hydroxy-leukotriene C4, 3-hydroxydodecanoyl carnitine, eicosapentaenoic acid, hypogeic acid and 3-hydroxypentadecanoic acid had a strong linear correlation with creatinine clearance rate, which indicated these lipid species were associated with impaired renal function. In addition, receiver operating characteristics analysis showed that 12 lipid species had high area under the curve values with high sensitivity and specificity for differentiating CRF group from control group. These changes are related to the perturbation of fatty acyl metabolism. Treatment with PPU and ergone improved the impaired kidney function and mitigated renal fibrosis. Both chemometrics and cluster analyses showed that rats treated by PPU and ergone could be separated from CRF rats by using 12 lipid species. Intriguingly, PPU treatment could restore the levels of 12 lipid species, while treatment with ergone could only reverse the changes of six fatty acids in CRF rats.Conclusion: Altered intrarenal fatty acyl metabolites were implicated in pathogenesis of renal fibrosis. PPU and ergone administration alleviated renal fibrosis and partially improved fatty acyl metabolism. These findings suggest that PPU exerted its renoprotective effect by regulating fatty acyl metabolism as a potential biochemical mechanism. Therefore, these findings indicated that fatty acyl metabolism played an important role in renal fibrosis and could be considered as an effective therapeutic avenue against renal fibrosis.

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Section: Discussionmentioning

confidence: 99%

Polyporus Umbellatus Protects Against Renal Fibrosis by Regulating Intrarenal Fatty Acyl Metabolites

Wang

Zhang

et al. 2021

Front. Pharmacol.

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“…Rituximab-treated MN patients showed a decrease in anti-PLA 2 R antibody levels in the follow-up period ( Ramachandran et al, 2018 ). However, it is worth noting that some natural products exhibit an excellent efficacy for MN treatment ( Feng et al, 2020 ; Lang et al, 2020 ; Lu et al, 2021 ).…”

Section: Treatment Of Membranous Nephropathymentioning

confidence: 99%

“…Natural products or traditional Chinese medicines have been long used in patients and considered an alternative therapeutic strategy for prevention and treatment of glomerular-associated diseases including MN ( Feng et al, 2020 ), glomerulonephritis ( Gianassi et al, 2019 ; Wang et al, 2021 ), diabetes ( Chen et al, 2020b ; Wang et al, 2020b ; Fang et al, 2021 ; Su et al, 2021 ; He et al, 2022 ), and diabetic nephropathy ( Li et al, 2020a ; Yang et al, 2020 ; Wang, 2021 ; Xuan et al, 2021 ; Yang and Wu, 2021 ; Zhou et al, 2021 ; Liu et al, 2022 ). Earlier finding have demonstrated that a 77-year-old woman with IMN was treated by Astragalus membranaceus and achieved clinical remission without using immunosuppressive therapy ( Ahmed et al, 2007 ).…”

Section: Treatment Of Membranous Nephropathymentioning

confidence: 99%

Recent Advances in Clinical Diagnosis and Pharmacotherapy Options of Membranous Nephropathy

et al. 2022

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Membranous nephropathy (MN) is the most common cause of nephrotic syndrome among adults, which is the leading glomerular disease that recurs after kidney transplantation. Treatment for MN remained controversial and challenging, partly owing to absence of sensitive and specific biomarkers and effective therapy for prediction and diagnosis of disease activity. MN starts with the formation and deposition of circulating immune complexes on the outer area in the glomerular basement membrane, leading to complement activation. The identification of autoantibodies against the phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing protein 7A (THSD7A) antigens illuminated a distinct pathophysiological rationale for MN treatments. Nowadays, detection of serum anti-PLA2R antibodies and deposited glomerular PLA2R antigen can be routinely applied to MN. Anti-PLA2R antibodies exhibited much high specificity and sensitivity. Measurement of PLA2R in immune complex deposition allows for the diagnosis of PLA2R-associated MN in patients with renal biopsies. In the review, we critically summarized newer diagnosis biomarkers including PLA2R and THSD7A tests and novel promising therapies by using traditional Chinese medicines such as Astragalus membranaceus, Tripterygium wilfordii, and Astragaloside IV for the treatment of MN patients. We also described unresolved questions and future challenges to reveal the diagnosis and treatments of MN. These unprecedented breakthroughs were quickly translated to clinical diagnosis and management. Considerable advances of detection methods played a critical role in diagnosis and monitoring of treatment.

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“…The herbs can effectively improve membranous nephropathy ( Ahmed et al, 2007 ; Liu et al, 2019 ; Tian et al, 2019 ) via this multi-target treatment of membranous nephropathy. Herein, it is possible to treat MN by repairing the function of podocytes ( Feng et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The Ameliorative Effect of Mahuang Fuzi and Shenzhuo Decoction on Membranous Nephropathy of Rodent Model is Associated With Autophagy and Wnt/β-Catenin Pathway

et al. 2022

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The increased incidence of membranous nephropathy (MN) has made it the most common pathological type of primary nephrotic syndrome in adults in China. According to the theory of Traditional Chinese Medicine (TCM), Mahuang Fuzi (Chinese ephedra and Radix Aconiti Lateralis Preparata) and Shenzhuo Decoction (MFSD) could be used to treat such diseases. We treated patients of MN with MFSD, and observed comparable efficacy to glucocorticoid and/or immunosuppressants. In this study, we observed the therapeutic effect of MFSD on the rat model of passive Heymann nephritis (PHN), a classical MN model. Our results showed that MFSD treatment significantly reduced urinary protein level and podocyte injury in PHN rats, and correspondingly improved renal pathology, with the improvement effect on MN comparable to that of Cyclosporine A (CsA) alone. To explore the potential therapeutical mechanism of MFSD, the main chemical components of MFSD were determined by High-performance liquid chromatography-mass spectrometry (HPLC-MS). There were about 30 active components of MFSD. Next, based on network pharmacology methods, we screened related targets of MSFD on MN, which provided a preliminary understanding of the MFSD bioactive compounds. The clustering analysis showed that its active site might be in the autophagy-related protein and Wnt/β-catenin pathway, which was related to podocyte injury. Finally, we observed an improvement in renal autophagy and a down-regulation of the Wnt/β-catenin pathway after MSFD treatment in a PHN rat model. According to this study, autophagy and Wnt/β-catenin pathway may be potential targets for MFSD in the treatment of MN.

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How Does Herbal Medicine Treat Idiopathic Membranous Nephropathy?

Cited by 14 publications

References 99 publications

Polyporus Umbellatus Protects Against Renal Fibrosis by Regulating Intrarenal Fatty Acyl Metabolites

Polyporus Umbellatus Protects Against Renal Fibrosis by Regulating Intrarenal Fatty Acyl Metabolites

Recent Advances in Clinical Diagnosis and Pharmacotherapy Options of Membranous Nephropathy

The Ameliorative Effect of Mahuang Fuzi and Shenzhuo Decoction on Membranous Nephropathy of Rodent Model is Associated With Autophagy and Wnt/β-Catenin Pathway

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