1.Effects of Intestinal Flora and Local Renin-angiotensin System on Diabetic Nephropathy and Traditional Chinese Medicine Intervention: A Review
Chaomao YANG ; Yuanyuan LI ; Shunxiao ZHANG ; Jiandong GAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(15):242-248
Diabetic nephropathy (DN) is a common clinical complication of diabetes, the main cause of end-stage renal disease (ESRD), and a key determinant of survival in diabetic patients. The pathogenesis of DN is complex, and it is currently believed to be associated with hemodynamic abnormalities, intestinal flora disturbances, glucose and lipid metabolism disorders, oxidative stress, genetic susceptibility, and protein non-enzymatic glycosylation. The local renin-angiotensin system (RAS) has always been the core of the pathogenic and progressive changes of DN. Once activated, it will induce the massive release of oxygen free radicals in the blood vessels, damage the endothelial function, and affect the microcirculation of the body. The recent studies demonstrate that intestinal flora and its metabolites may affect the occurrence and development of DN by activating or antagonizing the local RAS. Compared with western medicine treatment, traditional Chinese medicine (TCM) has the advantages of multiple targets and little toxic and side effects. Many TCM scholars have found that single herbs, their active ingredient extracts, and TCM compound prescriptions can improve kidney function by regulating the local RAS or intestinal flora. Specifically, the Chinese medicinal materials tonifying spleen (Codonopsis Radix, Dioscoreae Rhizoma, Atractylodis Macrocephalae Rhizoma, and Poria), replenishing kidney (Rehmanniae Radix Praeparata, Corni Fructus, and Pseudostellariae Radix), and activating blood, resolving stasis, and dredging collaterals (Hirudo, Salviae Miltiorrhizae Radix et Rhizoma, and Angelicae Sinensis Radix) have the regulatory effect. This article summarizes the roles of intestinal flora and local RAS in the occurrence and development of DN, and analyzes the animal experiments or clinical trials of TCM intervention in DN in recent years, aiming to provide more therapies and a theoretical basis for the treatment of DN with integrated TCM and Western medicine.
2.Modified Liuwei Dihuangtang Combined with Losartan Potassium Regulates ACE1/AngⅡ/AT1R Axis and Intestinal Flora in Rat Model of Diabetic Kidney Disease
Chaomao YANG ; Shunxiao ZHANG ; Yuanyuan LI ; Jiandong GAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):1-9
ObjectiveTo explore the mechanism of modified Liuwei Dihuangtang in preventing and treating renal injury in diabetic kidney disease (DKD) via the angiotensin-converting enzyme 1 (ACE1)/angiotensin Ⅱ (AngⅡ)/angiotensin Ⅱ type 1 receptor (AT1R) axis. MethodFifty male SD rats were randomized into a normal group (n=8) and a modeling group (n=42). The rats in the modeling group were fed with a high-sugar and high-fat diet for 6 weeks and intraperitoneally injected with 35 mg