New Insights Into the Effects of Individual Chinese Herbal Medicines on Chronic Kidney Disease.

Minghai Shao,Shougang Zhuang,Chaoyang Ye,George Bayliss

doi:10.3389/fphar.2021.774414

Abstract

The clinical and experimental study into the effects of Chinese herbal medicines on chronic kidney disease has evolved over the past 40 years with new insight into their mechanism and evidence of their clinical effects. Among the many traditional Chinese herbs examined in chronic renal disease, five were found to have evidence of sufficient clinical efficacy, high frequency of use, and well-studied mechanism. They are: Abelmoschus manihot and Huangkui capsule, Salvia miltiorrhiza and its components (tanshinone II A, salvianolic acid A and B); Rhizoma coptidis and its monomer berberine; Tripterygium wilfordii and its components (triptolide, tripterygium glycosides); Kudzu root Pueraria and its monomer Puerarin. These Chinese herbal medications have pharmaceutical effects against fibrosis, inflammation and oxidative stress and also promote renal repair and regeneration. This article reviews their clinical efficacy, anti-fibrotic effects in animal models, and molecular mechanism of action.

Highlights

Chronic kidney disease (CKD) is a global public health issue, affecting more than 10% of the world’s population (Glassock et al, 2017; Ruiz-Ortega et al, 2020)
We review the therapeutic effect of these five medicinal herbs in animal models of CKD (Table 1) and their clinical efficacy in CKD patients (Table 2) as well as molecular mechanism of their actions
In a murine model of diabetic nephropathy, puerarin exhibits a potent renoprotective and anti-fibrotic effect through a mechanism associated with suppression of NOX4 and miRNA-140-5p expression (Li, et al, 2017a; Xu, et al, 2020c), promotion of podocyte autophagy (Li, et al, 2020b), downregulation of MMP9 (Zhong, et al, 2014), and activation of the PERK/eIF2α/ATF4 signaling pathway (Xu, et al, 2020b)

Summary

Introduction

Chronic kidney disease (CKD) is a global public health issue, affecting more than 10% of the world’s population (Glassock et al, 2017; Ruiz-Ortega et al, 2020).

Results

Conclusion