Qingshen Granules improves renal function of patients with chronic kidney disease damp-heat syndrome by activating the miR-23b and Nrf2 pathway.
10.12122/j.issn.1673-4254.2025.09.07
- Author:
Qin HU
1
;
Hua JIN
2
Author Information
1. First Clinical Medical College of Anhui University of Chinese Medicine, Hefei 230000, China.
2. Institute of Xin'an Medicine and Modernization of Traditional Chinese Medicine, Institute of Health, Hefei Comprehensive National Science Center, Hefei 230031, China.
- Publication Type:Journal Article
- Keywords:
Nrf2 pathway;
Qingshen Granules;
chronic kidney disease;
microRNA;
network pharmacology
- MeSH:
Humans;
Renal Insufficiency, Chronic/metabolism*;
Drugs, Chinese Herbal/therapeutic use*;
NF-E2-Related Factor 2/metabolism*;
MicroRNAs/genetics*;
Signal Transduction;
Male;
Medicine, Chinese Traditional;
Adult;
Middle Aged;
Female
- From:
Journal of Southern Medical University
2025;45(9):1867-1879
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the therapeutic mechanism of Qingshen Granules (QSG) in patients with chronic kidney disease (CKD) damp-heat syndrome.
METHODS:The regulatory targets of QSG were retrieved and mapped using TCMSP and UniProt. Small RNA sequencing technology was used to screen the target genes of chronic renal failure damp-heat syndrome to construct the "active ingredients-intersection targets-diseases" network, followed by KEGG pathway enrichment analysis and molecular docking of the core targets. Sixty patients with CKD (stage 3-5) presenting with damp-heat syndrome and not undergoing dialysis were randomized equally into two groups for conventional Western medicine treatment (control group) and additional treatment with QSG (observation group) for 8 weeks, with 20 healthy individuals as the normal control group. The expression levels of miR-23b-5p, Nrf2 and HO-1 protein in peripheral blood mononuclear cells (PBMC), renal function indicators (Scr and eGFR), and serum ROS, AOPP and PON-1 levels were compared among the 3 groups after the treatments.
RESULTS:Six main active ingredients of QSG were identified, and their key targets included ACTB, JUN, PTEN, ESR1, GSK3B, PPARG, PIK3CA, APP, PIK3R1, and BECN1. MiR-23b-5p expression was significantly up-regulated in CKD damp-heat syndrome, in which the Nrf2 pathway abnormality played an important pathogenic role. Molecular docking results suggested good binding activity of the core targets with the active ingredients of QSG, and NFE2L2 had the strongest binding with luteolin. In patients with CKD damp-heat syndrome, QSG treatment significantly decreased serum Scr, ROS and AOPP levels, obviously improved eGFR, and increased serum PON-1 levels, expression levels of Nrf2 and HO-1 proteins in PBMCs, and the expression level of miR-23b-5p.
CONCLUSIONS:QSG can improve the renal function in patients with CKD damp-heat syndrome possibly by up-regulating miR-23b expression, activating the Nrf2 antioxidant pathway, and reducing oxidative stress levels.
