Tetramethylpyrazine: An Active Ingredient of Chinese Herbal Medicine With Therapeutic Potential in Acute Kidney Injury and Renal Fibrosis.

Jun Li,Xuezhong Gong

doi:10.3389/fphar.2022.820071

Abstract

As an increasing public health concern worldwide, acute kidney injury (AKI) is characterized by rapid deterioration of kidney function. Although continuous renal replacement therapy (CRRT) could be used to treat severe AKI, effective drug treatment methods for AKI are largely lacking. Tetramethylpyrazine (TMP) is an active ingredient of Chinese herb Ligusticum wallichii (Chuan Xiong) with antioxidant and anti-inflammatory functions. In recent years, more and more clinical and experimental studies suggest that TMP might effectively prevent AKI. The present article reviews the potential mechanisms of TMP against AKI. Through search and review, a total of 23 studies were finally included. Our results indicate that the undergoing mechanisms of TMP preventing AKI are mainly related to reducing oxidative stress injury, inhibiting inflammation, preventing apoptosis of intrinsic renal cells, and regulating autophagy. Meanwhile, given that AKI and chronic kidney disease (CKD) are very tightly linked by each other, and AKI is also an important inducement of CKD, we thus summarized the potential of TMP impeding the progression of CKD through anti-renal fibrosis.

Highlights

Acute kidney injury (AKI) is characterized by an abrupt loss of renal function, mainly manifested by increased serum creatinine levels and decreased urine output
In a study on CI-acute kidney injury (AKI), we found that the mechanism by which TMP protected the kidney from contrast agent damage was partly related to the inhibition of autophagy (Gong et al, 2019)
The present study mainly focuses on the experimental research of TMP in preventing AKI, and aims to synthesize the current knowledge in this field, concurrently, this study briefly sums up the effects of TMP against renal fibrosis and chronic kidney disease (CKD)

Summary

Introduction

Acute kidney injury (AKI) is characterized by an abrupt loss of renal function, mainly manifested by increased serum creatinine (sCr) levels and decreased urine output. The results reported that the combined morbidity and related mortality of AKI in adults were 21.6% and 23.9%, respectively, and 33.7% and 13.8% in children, respectively (Susantitaphong et al, 2013). In high-income countries, AKI is mostly hospital-acquired, mainly in elderly patients with multiple organ failure. In low- and middle-income countries, AKI mainly occurs as a complication of a single disease, and approximately 77% of AKI is community-acquired (Mehta et al, 2015; Hoste et al, 2018). The global burden of AKI-related mortality has exceeded the burden of breast cancer, heart failure or diabetes, and its medical burden is increasing (Lewington et al, 2013). AKI is associated with progressive chronic kidney disease (CKD) and the following end-stage renal

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Conclusion