1.National biological standards for antibiotics: an overview
Bufang MA ; Hui LIU ; Xuan JIN ; Yanchun FENG ; Jin LI
Journal of China Pharmaceutical University 2026;57(1):108-114
National biological standards for antibiotics are critical components of the antibiotic quality control system and serve as reference materials for measuring and calibrating the biological activity of antibiotics. This article systematically reviews the classification, definition of potency units, and current research status of commercially available national antibiotic biological standards in China. At present, these standards can be categorized based on chemical structure, number of components, and development methods. The definition of potency units has evolved from an early “arbitrarily assigned unit” to “being represented by the mass of the antibiotic salt” and, more recently, to the current mainstream approach of “being represented by the mass of the active ingredient”. This evolution reflects a shift in quality control philosophy from primarily biological analysis to a system dominated by chemical analysis supplemented by biological methods. Current research focuses on optimizing potency determination methods, studying the unification of content and potency, and implementing dual quality control of both the potency and the ratio/content of active components in multi-component antibiotics. For complex multi-component antibiotics, the microbiological assay based on biological activity remains irreplaceable in quality control. Future efforts should emphasize further method optimization, ensuring batch-to-batch consistency of standards, and advancing precision quality control as key research priorities for antibiotic biological standards.
2.Curcumin extraction and preparation and optimization of curcumin nanoparticles
Yuhang WANG ; Han ZHANG ; Chaojing ZHANG ; Xurong KOU ; Tongtong JING ; Rimei LIN ; Xinyu LIU ; Shilei LOU ; Hui YAN ; Cong SUN
Chinese Journal of Tissue Engineering Research 2026;30(2):362-374
BACKGROUND:Curcumin is the main active ingredient of turmeric and has significant medicinal value in anti-tumor,anti-inflammatory,antioxidant and other aspects.However,its poor water solubility,unstable chemical properties and easy decomposition lead to difficulty in extracting curcumin and low extraction yield.Therefore,it is particularly important to optimize the curcumin extraction method.OBJECTIVE:To enhance the extraction yield and utilization value of curcumin and optimize the curcumin extraction process and curcumin nanoparticle preparation process.METHODS:Curcumin was extracted from turmeric by ethanol extraction,ultrasonic extraction,ionic liquid extraction,enzyme extraction,and ionic liquid combined with ultrasonic assisted enzyme extraction.The curcumin extraction yield was detected by high performance liquid chromatography;the best extraction method was determined,and subsequent process optimization experiments were carried out.The curcumin extraction yield was the response value with the type of ionic liquid,reaction temperature,ultrasonic time,liquid-to-solid ratio,ionic liquid concentration,and enzyme-drug mass ratio as parameters.The optimal production process of ionic liquid combined with ultrasonic assisted enzyme extraction was determined by single factor combined response surface experiment.The optimal process for preparing curcumin nanoparticles by ionic crosslinking method was determined by single factor combined response surface experiment with acetic acid concentration,chitosan to sodium tripolyphosphate mass ratio,stirring rate,curcumin mass concentration,sodium tripolyphosphate mass concentration,and chitosan mass concentration as parameters,and drug encapsulation efficiency as response value.Curcumin nanoparticles were prepared under the optimal process,and the particle size,polydispersity index,Zata potential value,drug loading,stability,hemolysis rate,and antioxidant capacity in vivo and in vitro of the nanoparticles were detected.RESULTS AND CONCLUSION:(1)Among the five extraction methods,the curcumin yield of ionic liquid combined with ultrasound-assisted enzyme extraction was the highest,and this method was selected as the curcumin extraction method for subsequent experiments.The results of single factor combined response surface experiment showed that the optimal process for curcumin extraction was:ionic liquid selected 1-hexyl-3-methylimidazolium chloride,reaction temperature 55 ℃,liquid-to-solid ratio 40 mL/g,ultrasound time 57 minutes,ionic liquid concentration 57%,enzyme-drug mass ratio 3.5:10,and the obtained turmeric extraction yield was 3.10%.The optimal preparation process of curcumin nanoparticles was:glacial acetic acid concentration 0.5%,chitosan and sodium tripolyphosphate mass ratio 5.0:1,stirring speed 150 r/min,curcumin mass concentration 2.23 mg/mL,sodium tripolyphosphate mass concentration 1.45 mg/mL,chitosan mass concentration 3.63 mg/mL,and the obtained drug encapsulation efficiency was 90.61%.(2)The drug loading of curcumin nanoparticles was(14.49±0.23)%,the average particle size was(76.95±1.65)nm,the polydispersity coefficient was 0.15±0.02,and the Zata potential value was(32.37±1.46)mV.The curcumin nanoparticles had good stability and blood compatibility,did not induce hemolysis,and had stronger antioxidant capacity in vivo and in vitro than free curcumin.(3)The results show that the process optimization not only solves the problems of low extraction yield,poor solubility,and low bioavailability of curcumin,but also enhances its antioxidant activity in vivo and in vitro.
3.Choline kinase alpha silencing affects proliferation and apoptosis in glioma cells by inducing mitochondrial dysfunction
Yang ZHAO ; Jialin LI ; Xiao WU ; Yourui ZOU ; Yang LIU ; Hui MA
Chinese Journal of Tissue Engineering Research 2026;30(1):130-138
BACKGROUND:Choline kinase alpha is a key enzyme in phospholipid metabolism,involved in the synthesis of phosphatidylcholine,and plays an important role in maintaining cell membrane integrity and signal transduction.Research has shown that choline kinase alpha is highly expressed in various tumors and is closely related to cell proliferation,metabolic reprogramming,and tumor progression.As a potential therapeutic target,the role of choline kinase alpha in tumor metabolism and mitochondrial function still needs further exploration.OBJECTIVE:To evaluate the effects and the underlying mechanisms of choline kinase alpha on the proliferation and apoptosis of glioma U87MG and U251 cells.METHODS:Short hairpin RNA of choline kinase alpha and its empty vector control were transfected into U87MG and U251 glioma cells.Mitochondrial morphology was observed by transmission electron microscopy.Mitochondrial structure and functional protein levels were assessed by western blot assay.Reactive oxygen species levels in cells were measured using a reactive oxygen species fluorescent probe.Mitochondrial membrane potential was assessed with a JC-1 assay.Intracellular adenosine triphosphate levels were measured by chemiluminescence.Cell proliferation was evaluated using a CCK-8 assay.Apoptosis levels were analyzed by flow cytometry.The mitochondrial fission inhibitor Mdivi-1 was used to protect the mitochondrial function of the choline kinase α-silenced lentiviral cells.Finally,U87MG cells were subcutaneously injected to construct a subcutaneous tumor model in nude mice.The tumor growth in nude mice was observed before and after choline kinase alpha silencing and after the use of the mitochondrial fission inhibitor Mdivi-1.RESULTS AND CONCLUSION:(1)Compared with the empty control group,the mitochondria of U87MG and U251 cells in the choline kinase alpha silencing lentivirus group exhibited significant structural abnormalities in mitochondria,such as vacuolization and cristae disruption.The expressions of mitochondrial structure and function-related proteins TOM20,ACO2,and ATP5A were significantly decreased(P<0.01,P<0.001),the expression of SOD2 was significantly increased(P<0.01,P<0.000 1),the fluorescence intensity of reactive oxygen species was significantly increased(P<0.01),the mitochondrial membrane potential and adenosine triphosphate level were significantly decreased(P<0.01,P<0.001),the cell proliferation ability was reduced(P<0.01),and the apoptosis level was increased(P<0.001).(2)Following Mdivi-1 treatment,the fluorescence intensity of reactive oxygen species in U87MG and U251 cells decreased(P<0.05,P<0.01),mitochondrial membrane potential and adenosine triphosphate levels were significantly restored(P<0.05,P<0.01,P<0.001),cell proliferation ability was improved(P<0.05,P<0.01),and apoptosis level was decreased(P<0.05).(3)In addition,the in vitro subcutaneous tumor formation experiment of nude mice showed that compared with the empty control group,the mass and growth rate of subcutaneous tumors formed by U87MG cells in the choline kinase alpha silencing lentivirus group were significantly reduced(P<0.000 1).After Mdivi-1 treatment,the mass and growth rate of tumors were significantly increased(P<0.000 1).(4)The results show that choline kinase alpha silencing affects the proliferation and apoptosis of glioma cells by inducing mitochondrial dysfunction.
4.Mechanisms by which aerobic and resistance exercises improve obesity-related cognitive impairment
Yu LIU ; Senlin LEI ; Jintao ZHOU ; Hui LIU ; Xianhui LI
Chinese Journal of Tissue Engineering Research 2026;30(5):1171-1183
BACKGROUND:Obesity is not only related to metabolic diseases such as diabetes and cardiovascular disease,but also closely related to the increased risk of cognitive decline,dementia and other neurodegenerative diseases.Studies have found that aerobic exercise and resistance exercise can help improve obesity-related cognitive impairment,but their therapeutic effects and related mechanisms of action are still unclear.OBJECTIVE:To explore the protective effects of aerobic and resistance exercises on the nervous center of obesity-related cognitive impairment mice.METHODS:Forty-eight 8-week-old C57BL/6J wild-type male mice were randomly divided into four groups:a control group was fed normally for 20 weeks;a high fat group was fed with high fat diet(60%fat energy)for 20 weeks;an aerobic exercise group was fed with 12 weeks of high-fat diet followed by 8 weeks of aerobic exercise;and a resistance exercise group was fed with 12 weeks of high-fat diet followed by 8 weeks of resistance exercise.After the exercise intervention,body mass was weighed,insulin tolerance and glucose tolerance were tested to evaluate insulin resistance,and cognitive function of mice in each group was detected by new object recognition experiment and Y-maze experiment.The morphology of hippocampal and cortical tissue cells was observed by hematoxylin-eosin staining.The mRNA relative expression levels of tumor necrosis factor-α and interleukin-6 were detected by real-time fluorescence quantitative PCR,and the protein expressions of Bax,Bcl-2,nuclear factor-κB,Cleaved Caspase-1,Caspase-3,synapsin 1 and brain-derived neurotrophic factor were detected by western blot.RESULTS AND CONCLUSION:(1)Compared with the control group,the body mass of mice increased in the high-fat group(P<0.05),accompanied by insulin resistance and cognitive dysfunction,the expression levels of nuclear factor-κB,Bax,Caspase-3,Cleaved Caspase-1 in the hippocampus were significantly increased(P<0.05),the expression levels of brain-derived neurotrophic factor,synapsin 1and Bcl-2 proteins were significantly decreased(P<0.05),Bcl-2/Bax ratio was significantly decreased(P<0.05),and the mRNA levels of inflammatory cytokines,tumor necrosis factor-α and interleukin-6,were significantly up-regulated(P<0.05).(2)Compared with the high-fat group,the above indexes were significantly improved in the aerobic exercise group(P<0.05),while in the resistance exercise group,the body mass of mice was significantly decreased,the levels of inflammatory cytokines tumor necrosis factor-α and interleukin-6 mRNA were significantly decreased(P<0.05),the protein expression of Caspase-3 was significantly decreased(P<0.05),and the protein expression of brain-derived neurotrophic factor was significantly up-regulated(P<0.05),but no significant changes were observed in the other indexes(P>0.05).In conclusion,long-term exercise can reduce insulin resistance,down-regulate the expression of nuclear factor-κB pathway,weaken inflammatory response,inhibit neuronal apoptosis and improve synaptic plasticity,resulting in neuroprotective effects,and effectively alleviate obesity-related cognitive dysfunction in obese mice.The therapeutic effect of aerobic exercise is superior to that of resistance exercise.
5.Reporting Status of Clinical Practice Guideline Protocols: A Systematic Analysis
Huayu ZHANG ; Xufei LUO ; Hui LIU ; Qi ZHOU ; Yishan QIN ; Ye WANG ; Yuanyuan YAO ; Haodong LI ; Xiaohui WANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(1):255-262
To systematically analyzed the reporting status of core elements in publicly available clinical practice guideline(hereafter referred to as "guideline") protocols published domestically and internationally over the past decade, identified existing problems, and provided evidence to inform the standardized writing and publication of future guideline protocols. A systematic search was conducted in Chinese and English databases for clinical practice guideline protocols published during the past ten years. The basic characteristics and reporting of core elements—including registration information, conflict of interest management, evidence grading, development process and timeline planning, as well as dissemination and implementation—were extracted and analyzed. Chi-square tests were performed to explore associations between protocol characteristics and the reporting of core elements. A total of 94 guideline protocols were included, of which 67 were in Chinese(71.28%) and 27 were in English(28.72%). Overall, 82.98% of the guideline protocols were registered, 92.55% reported management of conflicts of interest, 97.87% reported evidence searching, 88.30% reported evidence grading, and 89.36% described dissemination and implementation strategies. However, only 55.32% reported the guideline development process, and merely 23.40% reported timeline planning. Further analysis indicated that the reporting of registration, evidence searching, development process, and timeline planning was associated with year of publication. Differences were observed between domestic and international guidelines in reporting registration, conflict of interest management, development process, time planning, and dissemination and implementation. Guidelines intended for development exhibited higher reporting rates for registration, development process, and dissemination and implementation compared to those planned for updating or adaptation. Although current guideline protocols demonstrate relatively adequate reporting of methodological elements, deficiencies remain in development process and timeline planning. Future efforts should focus on promoting the publication and standardized reporting of guideline protocols, enhancing the international recognition of registration platforms, and strengthening the development process and timeline planning to advance the scientific rigor and transparency of guideline development.
6.Standardization Challenges in Outcome Evaluation Systems of Animal Experiments and Considerations for Core Outcome Set Construction Strategies
Qingyong ZHENG ; Yongjia ZHOU ; Tengfei LI ; Jianguo XU ; Chen TIAN ; Hui LIU ; Min TIAN ; Ziyu ZHOU ; Caihua XU ; Yating CUI ; Junfei WANG ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2026;46(1):138-148
Animal experimentation constitutes a critical link between basic research and clinical application, making its research quality and translational efficiency paramount. Although considerable progress has been made in standardizing operational procedures and ethical guidelines, the standardization of outcome evaluation systems has significantly lagged, creating a key bottleneck that constrains the quality of biomedical research and evidence synthesis. This deficiency is manifested by pronounced heterogeneity in outcome selection across similar studies, incomplete methodological reporting, and disparate criteria for result interpretation, which severely impairs the comparability of findings and the evidence integration. To cope with this challenge, this paper systematically introduces a mature methodological tool from clinical research–the core outcome set (COS)–and explores its construction strategies and application potential in the field of animal experimentation. Given the extensive diversity of animal experiments, a pragmatic strategy of "focusing on key areas, implementing phased pilots, and promoting gradual expansion" should be adopted. This approach prioritizes the development of domain-specific COS for disease areas characterized by high research volume, urgent translational needs, and well-established animal models. A multi-source integration pathway for COS development is detailed, comprising systematic literature searches, methodological appraisals, and expert consensus, with the feasibility of leveraging artificial intelligence (AI) to enhance efficiency also being examined. The development and promotion of such COS are not intended to restrict scientific exploration; rather, they aim to establish a new, tiered evaluation paradigm consisting of "core outcomes" (mandatory), "recommended outcomes" (encouraged), and "exploratory outcomes" (optional). This framework is expected not only to enhance research quality through standardization and to adhere to the "3R" principles but also to accelerate the accumulation of high-quality evidence. This, in turn, provides a solid foundation for higher-level evidence synthesis, ultimately facilitating the effective translation of basic research findings into clinical practice and providing an essential methodological framework for scientific advancement in relevant disciplines.
7.Preliminary application of histological evaluation of donor pancreas biopsy tissue in simultaneous pancreas-kidney transplantation
Jiao WAN ; Hui GUO ; Jiali FANG ; Guanghui LI ; Luhao LIU ; Yunyi XIONG ; Wei YIN ; Tong YANG ; Junjie MA ; Zheng CHEN
Organ Transplantation 2026;17(2):250-256
Objective To preliminarily investigate the safety and efficacy of donor pancreas needle biopsy in simultaneous pancreas-kidney transplantation. Methods Clinical data of 7 cases undergoing donor pancreas biopsy were collected retrospectively. All cases underwent donor pancreas biopsy before or during simultaneous pancreas-kidney transplantation. Frozen section or paraffin sectioning techniques were used for tissue preparation, and hematoxylin-eosin and Masson staining were performed to histologically evaluate the donor pancreas. The quality of donor pancreas was comprehensively assessed by combining histological findings with the donor's clinical data. Postoperative follow-up data of 5 simultaneous pancreas-kidney transplant recipients were collected to summarize the safety of donor pancreas biopsy and the prognosis of transplant recipients. Results The 7 pancreas donors were aged 28 to 62 years, with a body mass index ranging from 20.76 to 27.68 kg/m2. Liver ultrasound indicated fatty liver in 3 cases, while pancreatic ultrasound did not reveal any significant abnormalities. Among them, biopsy was performed on 2 donors after completion of pancreatic procurement and processing, and the frozen section histology showed moderate acute pancreatitis changes (edema of acinar cells, necrosis and inflammatory cell infiltration). Combined with a serum amylase level elevated more than 3 times the upper limit of normal value, these two donor pancreases were finally discarded. The remaining 5 cases underwent biopsy immediately after pancreatic vascular anastomosis during simultaneous pancreas-kidney transplantation, and histological evaluation was performed on paraffin-embedded sections. No biopsy-related complications (such as bleeding, pancreatic fistula, etc.) occurred after transplantation. One recipient died of severe infection 2 months after transplantation, while the other 4 recipients were followed up for more than 5 years, with well-functioning transplant kidneys and pancreases. Conclusions Donor pancreas biopsy is relatively safe, and the risk of biopsy-related complications after transplantation is controllable. Comprehensive assessment of donor pancreas quality by combining histological evaluation with the donor's clinical indicators is conducive to improving the accuracy of donor pancreas selection and organ utilization.
8.Exploring Mechanism of Modified Banxia Xiexintang in Ameliorating Metabolic Disorders and Reproductive Function in PCOS-IR Rats Based on Metabolomics and Transcriptomics
Donghan BAI ; Ruying TANG ; Longfei LIN ; Yuling LIU ; Dongxue ZHENG ; Qiling ZHANG ; Xinmin LIU ; Hui LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):140-149
ObjectiveTo evaluate the therapeutic effects of modified Banxia Xiexintang(MBXT) on polycystic ovary syndrome with insulin resistance(PCOS-IR) rats and reveal its potential mechanisms based on the integrated analysis of transcriptomics and metabolomics. MethodsFemale SD rats were selected, and a PCOS-IR model was established by intragastric administration of letrozole combined with a high-fat diet for 21 days. The modeled rats were randomly divided into the model group, MBXT low-, medium-, and high-dose groups(6.62, 13.23, 26.46 g·kg-1), and metformin group(0.158 g·kg-1), with a normal group set up separately. After 14 days of administration, the estrous cycle was observed, ovarian morphology was examined by hematoxylin-eosin(HE) staining, and the levels of testosterone(T), estradiol(E2), follicle-stimulating hormone(FSH), and luteinizing hormone(LH) in serum were detected by enzyme-linked immunosorbent assay(ELISA). Serum metabolites and ovarian tissue gene expression were detected using ultra-performance liquid chromatography-quadrupole-electrostatic orbitrap mass spectrometry(UPLC-Q-Orbitrap-MS) and RNA-Seq technology, respectively, followed by multi-omics integrated analysis. ResultsPharmacodynamic findings revealed that all MBXT dose groups could reversed abnormal estrous cycles in PCOS-IR rats, improve polycystic ovarian lesions, and normalize dysregulated serum hormone levels(T, LH, E2, FS, P<0.05, P<0.01). Metabolomic analysis revealed that compared with the model group, MBXT reversed 278 differential metabolites such as estrone and S-formylglutathione, mainly involving pathways such as steroid hormone biosynthesis, glutathione metabolism, and lipid peroxidation regulation. Transcriptomic analysis identified 434 differentially expressed genes, and enrichment analysis revealed that MBXT significantly regulated lipid peroxidation defense systems, including glutathione metabolism, peroxisome function, and fatty acid metabolism, thereby intervening in ferroptosis processes. It also engaged in inflammation-related pathways such as the chemokine signaling pathway. Integrated analysis revealed that both metabolomics and transcriptomics co-enriched metabolic pathways associated with ferroptosis and fatty acid metabolism. And key Hub genes[such as Ras-related C3 botulinum toxin substrate 2 gene(Rac2) and Fas ligand gene(Faslg)] showed significant correlations with differential metabolites. ConclusionMBXT can effectively ameliorate reproductive dysfunction and metabolic disorders in PCOS-IR rats. Its mechanism may be related to remodeling the immune-metabolism network, particularly by regulating MHC-mediated immune responses, inhibiting local ovarian ferroptosis, and enhancing steroid hormone synthesis pathways.
9.Investigation on Mechanism of Modified Banxia Xiexintang in Improving Ovarian Dysfunction of PCOS-IR Rats by Inhibiting Ferroptosis via AMPK/FASN/GPX4 Signaling Pathway
Donghan BAI ; Ruying TANG ; Longfei LIN ; Yuling LIU ; Dongxue ZHENG ; Qiling ZHANG ; Xinmin LIU ; Hui LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):150-160
ObjectiveTo investigate the mechanism of modified Banxia Xiexintang(MBXT) in improving ovarian dysfunction in polycystic ovary syndrome with insulin resistance(PCOS-IR) rats by inhibiting ferroptosis through the adenosine monophosphate(AMP)-activated protein kinase(AMPK)/fatty acid synthase(FASN)/glutathione peroxidase 4(GPX4) signaling pathway. MethodsSeventy-six female SD rats were randomly divided into a normal group(n=13) and a modeling group(n=63). The modeling group established a PCOS-IR model by intragastric administration of letrozole combined with a high-fat diet for 21 days. After successful modeling, these rats were randomly divided into the model group, MBXT low-, medium-, and high-dose groups(6.62, 13.23, 26.46 g·kg-1), metformin group(0.158 g·kg-1), and high-dose of MBXT combined with ferroptosis inducer Erastin group(15 mg·kg-1), with 10 rats in each group. After 14 days of intervention, ovarian pathological morphology was observed by hematoxylin-eosin(HE) staining, the mitochondrial ultrastructure of granulosa cells was observed by transmission electron microscopy(TEM), ovarian reactive oxygen species(ROS) levels were detected by dihydroethidium(DHE) probe, biochemical methods were used to detect Fe2+, malondialdehyde(MDA), glutathione(GSH) and other indicators in ovarian tissues, serum sex hormone and insulin levels were measured by enzyme-linked immunosorbent assay(ELISA), and the protein expressions of AMPK, FASN, acyl-CoA synthetase long-chain family member 4(ACSL4), GPX4, and solute carrier family 7 member 11(SLC7A11) in ovarian tissues were detected by Western blot. ResultsCompared with the normal group, the model group showed polycystic changes in the ovaries, with atrophy of mitochondria in granulosa cells and increased membrane density. Serum levels of testosterone(T), luteinizing hormone(LH), and insulin were significantly increased(P<0.01). The levels of ROS, MDA, 4-hydroxynonenal(4-HNE), and Fe2+ in ovarian tissues were significantly elevated(P<0.01), while adenosine triphosphate(ATP), GSH, and reduced nicotinamide adenine dinucleotide phosphate (NADPH) levels were significantly decreased(P<0.01). The phosphorylation levels of AMPK and acetyl-CoA carboxylase (ACC), as well as the protein expressions of SLC7A11, GPX4, and ferroptosis suppressor protein 1(FSP1) were significantly downregulated(P<0.01), whereas the expressions of FASN, ACSL4, and nuclear receptor coactivator 4(NCOA4) were significantly upregulated(P<0.01). Compared with the model group, MBXT intervention at various doses improved the above pathological changes and biochemical indicators in a dose-dependent manner, with the high-dose group showing the most significant effect(P<0.01). Compared with the MBXT high-dose group, the high-dose of MBXT combined with ferroptosis inducer Erastin group restored ovarian ferroptosis characteristics in rats, with increased ROS and lipid peroxidation products, and altered expressions of key proteins(P<0.05, P<0.01). ConclusionMBXT can effectively improve ovarian function and metabolic disorders in PCOS-IR rats. Its mechanism may be related to activating the AMPK/ACC signaling pathway, downregulating FASN and ACSL4 to reduce lipid peroxidation substrates, and restoring glucose-6-phosphate dehydrogenase/phosphoglycerate dehydrogenase(G6PD/PHGDH) metabolic flux to enhance the GPX4/FSP1 antioxidant defense system, thereby inhibiting ferroptosis in ovarian granulosa cells.
10.Flavonoids Intervene in Diabetic Nephropathy by Regulating TGF-β/Smad Signaling Pathway: A Review
Qihui QIU ; Chang LIU ; Xiaotong YAN ; Jinwei HAN ; Hui SUN ; Fengting YIN ; Yuhang WANG ; Mengmeng WANG ; Xijun WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):300-309
Diabetic nephropathy (DKD), as a common microvascular complication of diabetes mellitus (DM), is a major cause of end-stage renal disease (ESRD). Its clinical manifestations include increased urinary protein excretion, thickening of the glomerular basement membrane, and renal tubulointerstitial fibrosis. The pathogenesis of DKD is complex and involves multiple factors, including disordered glucose metabolism, hemodynamic alterations, and oxidative stress. Although modern medical approaches can alleviate certain symptoms, they still have limitations such as insufficient therapeutic targeting and prominent adverse effects. The transforming growth factor-β/Smad (TGF-β/Smad) signaling pathway is not only a tissue fibrosis pathway that has attracted considerable attention in recent years, but also regulates multiple protein molecules, including the glomerular podocyte slit diaphragm protein Podocin, interleukin-1β (IL-1β), and superoxide dismutase (SOD), thereby participating in various pathological processes and ultimately mediating renal injury. Flavonoid compounds, owing to their sustained pharmacological effects, broad spectrum of action, and high safety profile, have become ideal candidates for targeted therapy research in DKD. Existing studies have shown that these compounds can exert inhibitory effects on renal fibrosis, alleviate inflammatory responses, protect podocytes, and reduce oxidative stress by regulating the interactions between the TGF-β/Smad signaling pathway and the aforementioned protein molecules, thereby maintaining renal structure and function, reducing proteinuria, and significantly improving DKD lesions. This review briefly outlines the composition and functions of the TGF-β/Smad signaling pathway, elucidates the mechanisms by which this pathway regulates DKD, and focuses on summarizing major studies from the past decade on flavonoid-based interventions in DKD through targeted inhibition of the TGF-β/Smad signaling pathway. Furthermore, it discusses the considerable therapeutic potential of flavonoids in the treatment of this disease, aiming to provide a scientific basis for future clinical prevention and treatment of DKD and to promote the development of targeted drugs.

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