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Cai H, Wang M, Zhu H, Song P, Pei K, Duan Y, Bao Y, Cao G. Phytochemical component profiling and anti-renal fibrosis effects of crude and salt-stir fried Eucommiae Cortex extracts on renal fibrosis rats caused by high-purine diet. Food Chem 2025; 464:141784. [PMID: 39476582 DOI: 10.1016/j.foodchem.2024.141784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 10/18/2024] [Accepted: 10/24/2024] [Indexed: 11/28/2024]
Abstract
A prolonged diet laden with purine-rich foods represents a significant contributor to renal fibrosis (RF). Eucommia ulmoides Oliver, a plant homologous to food and medicinal materials, has long been employed to recover kidney function. This investigation presents a strategy integrating chemistry, biochemistry, and metabolomics to evaluate bioactive components and efficiency mechanism of crude and salt-stir fried Eucommiae Cortex (EC) extracts against RF. Firstly, 155 chemical components were identified in the EC extracts and the contents of 19 and 27 compounds decreased and increased respectively after salt-stir frying. Secondly, various biochemical indicators displayed that salt-stir fried EC (SEC) extracts had the optimal anti-RF effects in adenine-induced RF model rats, which were associated with the attenuation of TGF-β signaling pathway. Finally, untargeted metabolomics analysis demonstrated that after treatments with EC and SEC extracts, 30 and 32 efficacy biomarkers were significantly restored in the RF + EC and RF + SEC groups respectively, involving five metabolic pathways.
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Affiliation(s)
- Hao Cai
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing 210023, PR China.
| | - Mengqing Wang
- School of Pharmacy, Jiangsu Food and Pharmaceutical Science College, Huaian 223001, PR China
| | - Hui Zhu
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Peixiang Song
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Ke Pei
- School of Chinese Medicine and Food Engineering, Shanxi University of Chinese Medicine, Jinzhong 030619, PR China
| | - Yu Duan
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Yini Bao
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou 310053, PR China.
| | - Gang Cao
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou 310053, PR China.
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Li M, Zheng Y, Deng S, Yu T, Ma Y, Ge J, Li J, Li X, Ma L. Potential therapeutic effects and applications of Eucommiae Folium in secondary hypertension. J Pharm Anal 2021; 12:711-718. [PMID: 36320603 PMCID: PMC9615539 DOI: 10.1016/j.jpha.2021.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 11/27/2022] Open
Abstract
Eucommiae Folium (EF), a traditional Chinese medicine, has been used to treat secondary hypertension, including renal hypertension and salt-sensitive hypertension, as well as hypertension caused by thoracic aortic endothelial dysfunction, a high-fat diet, and oxidized low-density lipoprotein. The antihypertensive components of EF are divided into four categories: flavonoids, iridoids, lignans, and phenylpropanoids, such as chlorogenic acid, geniposide acid and pinoresinol diglucoside. EF regulates the occurrence and development of hypertension by regulating biological processes, such as inhibiting inflammation, regulating the nitric oxide synthase pathway, reducing oxidative stress levels, regulating endothelial vasoactive factors, and lowering blood pressure. However, its molecular antihypertensive mechanisms are still unclear and require further investigation. In this review, by consulting the relevant literature on the antihypertensive effects of EF and using network pharmacology, we summarized the active ingredients and pharmacological mechanisms of EF in the treatment of hypertension to clarify how EF is associated with secondary hypertension, the related components, and underlying mechanisms. The results of the network pharmacology analysis indicated that EF treats hypertension through a multi-component, multi-target and multi-pathway mechanism. In particular, we discussed the role of EF targets in the treatment of hypertension, including epithelial sodium channel, heat shock protein70, rho-associated protein kinase 1, catalase, and superoxide dismutase. The relevant signal transduction pathways, the ras homolog family member A (RhoA)/Rho-associated protein kinase (ROCK) and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase/eNOS/NO/Ca2+ pathways, are also discussed. Eucommiae Folium (EF) treats secondary hypertension via the RhoA/ROCK1 and NO/sGC/cGMP pathways. EF inhibits oxidative stress and improves endothelial dysfunction to treat hypertension. EF's antihypertensive components are phenylpropanoids, flavonoids, lignans, iridoids. KEGG analysis showed EF treated hypertension through the MAPK and TNF signaling pathways.
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Huang L, Lyu Q, Zheng W, Yang Q, Cao G. Traditional application and modern pharmacological research of Eucommia ulmoides Oliv. Chin Med 2021; 16:73. [PMID: 34362420 PMCID: PMC8349065 DOI: 10.1186/s13020-021-00482-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/29/2021] [Indexed: 12/18/2022] Open
Abstract
As a Traditional Chinese Medicine, Eucommia ulmoides Oliv. has been used for the treatment of various diseases since ancient times, involving lumbar pain, knee pain, osteoporosis, hepatoprotection, paralysis, intestinal haemorrhoids, vaginal bleeding, abortion, spermatorrhoea, foot fungus, anti-aging etc. With the developing discovery of E. ulmoides extracts and its active components in various pharmacological activities, E. ulmoides has gained more and more attention. Up to now, E. ulmoides has been revealed to show remarkable therapeutic effects on hypertension, hyperglycemia, diabetes, obesity, osteoporosis, Parkinson's disease, Alzheimer's disease, sexual dysfunction. E. ulmoides has also been reported to possess antioxidant, anti-inflammatory, neuroprotective, anti-fatigue, anti-aging, anti-cancer and immunoregulation activities etc. Along these lines, this review summarizes the traditional application and modern pharmacological research of E. ulmoides, providing novel insights of E. ulmoides in the treatment of various diseases.
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Affiliation(s)
- Lichuang Huang
- School of Pharmacy, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China
| | - Qiang Lyu
- School of Pharmacy, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China
| | - Wanying Zheng
- School of Pharmacy, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China
| | - Qiao Yang
- School of Pharmacy, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China
| | - Gang Cao
- School of Pharmacy, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, China.
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Huang Q, Ouyang DS, Liu Q. Isoeucommin A attenuates kidney injury in diabetic nephropathy through the Nrf2/HO-1 pathway. FEBS Open Bio 2021. [PMID: 34228907 PMCID: PMC8329780 DOI: 10.1002/2211-5463.13251] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetic nephropathy (DN) is a common complication in patients with diabetes and a leading cause of mortality. The management of DN in the clinic still remains a challenge. Therefore, the identification of novel compounds for DN treatment and their characterization in preclinical DN models are crucial. Isoeucommin A is a lignan compound isolated from Eucommia ulmoides Oliv, which has not been studied in detail. Our aim was to investigate the effect of Isoeucommin A in DN and to elucidate the molecular mechanisms though which Isoeucommin A acts in vitro and in vivo. We first isolated and purified Isoeucommin A by microporous resin column chromatography and studied the mass spectrogram, as well as the structure of Isoeucommin A, by high‐resolution electrospray ionization mass spectroscopy and NMR, respectively. We further established an in vivo rat DN model and measured the changes of blood glucose, body weight, kidney index (KI), blood urea nitrogen, creatinine (CRE), glutathione, malondialdehyde (MDA), SOD, albumin (ALB) and urinary ALB to CRE ratios on treatment with Isoeucommin A. In addition, we measured SOD, MDA, glycogen synthase kinase‐3β (GSK‐3β), phosphorylated (p)‐GSK‐3β, nuclear factor erythroid‐derived 2‐related factor 2 (Nrf2) and heme oxygenase‐1 (HO‐1) levels by quantitative real‐time PCR and western blot, and estimated cell viability by a 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl‐tetrazolium bromide assay. After Isoeucommin A treatment, body weight, as well as SOD, glutathione, HO‐1 and Nrf2 expression levels, in DN rats increased in a dose‐dependent manner. In contrast, the levels of blood glucose, KI, blood urea nitrogen, CRE, urinary ALB to CRE ratio, tumor necrosis factor‐α, interleukin‐1β, interleukin‐6 and MDA decreased significantly. In addition, Isoeucommin A protected H2O2‐stimulated renal tubular epithelial cells from oxidative stress and activated the Nrf2/HO‐1 signaling pathway in high‐glucose‐stimulated human renal mesangial cells. In conclusion, Isoeucommin A could alleviate inflammation and oxidative stress in in vitro and in vivo DN models and thus attenuate kidney injury by activating the Nrf2/HO‐1 signaling pathway. Isoeucommin A could have the potential to be used as an effective drug for the treatment of DN.
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Affiliation(s)
- Qi Huang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, Changsha, China.,Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Changsha, China.,Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha Duxact Biotech Co., Ltd., China
| | - Dong-Sheng Ouyang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Changsha, China.,Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha Duxact Biotech Co., Ltd., China
| | - Qiong Liu
- National Clinical Research Center for Geriatric Disorders, Changsha, China.,Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
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Guo F, Zhang W, Su J, Xu H, Yang H. Prediction of Drug Positioning for Quan-Du-Zhong Capsules Against Hypertensive Nephropathy Based on the Robustness of Disease Network. Front Pharmacol 2019; 10:49. [PMID: 30809144 PMCID: PMC6379470 DOI: 10.3389/fphar.2019.00049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/16/2019] [Indexed: 12/24/2022] Open
Abstract
Hypertensive nephropathy (HN) is a medical condition in which chronic high blood pressure causes different kidney damage, including vascular, glomerular and tubulointerstitial lesions. For HN patients, glomerular and tubulointerstitial lesions occur in different renal structure with distinct mechanisms in the progression of renal damage. As an extraction of Eucommia ulmoides, Quan-du-zhong capsule (QDZJN) has the potential to treat HN due to antihypertensive and renal protective activities. Complicated mechanism of HN underlying various renal lesions and the “multi-component and multi-target” characteristics of QDZJN make identifying drug positioning for various renal lesions of HN complex. Here, we proposed an approach based on drug perturbation of disease network robustness, that is used to assess QDZJN positioning for various HN lesions. Topological characteristics of drug-attacked nodes in disease network were used to evaluated nodes importance to network. To evaluate drug attack on the whole disease network of various HN lesions, the robustness of disease networks before/after drug attack were assessed and compared with null models generated from random networks. We found that potential targets of QDZJN were specifically expressed in the kidneys and tended to participate in the “inflammatory response,” “regulation of blood pressure,” and “response to LPS and hypoxia,” and they were also key factors of HN. Based on network robustness assessment, QDZJN may specifically target glomeruli account to the stronger influence on glomerular network after removal of its potential targets. This prediction strategy of drug positioning is suitable for multi-component drugs based on drug perturbation of disease network robustness for two renal compartments, glomeruli and tubules. A stronger influence on the disease network of glomeruli than of tubules indicated that QDZJN may specifically target glomerular lesion of HN patients and will provide more evidence for precise clinical application of QDZJN against HN. Drug positioning approach we proposed also provides a new strategy for predicting precise clinical use of multi-target drugs.
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Affiliation(s)
- Feifei Guo
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wen Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China.,College of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jin Su
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Haiyu Xu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hongjun Yang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
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Wang J, Li Y, Huang WH, Zeng XC, Li XH, Li J, Zhou J, Xiao J, Xiao B, Ouyang DS, Hu K. The Protective Effect of Aucubin from Eucommia ulmoides Against Status Epilepticus by Inducing Autophagy and Inhibiting Necroptosis. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2017; 45:557-573. [PMID: 28387136 DOI: 10.1142/s0192415x17500331] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Eucommia ulmoides Oliv. is a famous traditional Chinese medicine which exhibits anti-oxidative stress ability and neuro-protective effects. Aucubin is the predominant component of Eucommia ulmoides Oliv. Our present study is intended to investigate aucubin's potential protective effects on neurons against epilepsy in the hippocampus by establishing the lithium-pilocarpine induced status epilepticus (SE) rat model in vivo. Aucubin (at a low dose and a high dose of 5[Formula: see text]mg/kg and 10[Formula: see text]mg/kg, respectively) was administered through gavage for two weeks before lithium-pilocarpine injection. Rats were sacrificed at 4, 24 and 72[Formula: see text]h after SE induction. Pretreatment with both low-dose and high-dose aucubin significantly reduced the number of death neurons ([Formula: see text]) and increased the number of surviving neurons ([Formula: see text]) in DG, Hilus, CA1 and CA3 hippocampal regions post SE. Meanwhile, it significantly inhibited necroptosis proteins (MLKL and RIP-1) ([Formula: see text] or [Formula: see text]) and enhanced autophagy protein (Beclin-1 and LC3BII/LC3BI) prevalence in the hippocampus ([Formula: see text] or [Formula: see text]). In conclusion, aucubin appeared to ameliorate damages in lithium-pilocarpine induced SE in hippocampus, reduce the number of apoptotic neurons, and increased the number of survival neurons by inducing autophagy and inhibiting necroptosis. These original findings might provide an important basis for the further investigation of the therapeutic role of aucubin in treatment or prevention of epilepsy-related neuronal damages.
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Affiliation(s)
- Jin Wang
- ** Department of Pharmacology, School of Pharmaceutical Science, Central South University, Changsha 410000, P.R. China
| | - Ying Li
- †† Department of Healthy Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, P.R. China
| | - Wei-Hua Huang
- † Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, P.R. China.,∥ Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, Changsha 410078, P.R. China
| | - Xiang-Chang Zeng
- † Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, P.R. China.,∥ Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, Changsha 410078, P.R. China
| | - Xiao-Hui Li
- ** Department of Pharmacology, School of Pharmaceutical Science, Central South University, Changsha 410000, P.R. China
| | - Jian Li
- ‡ Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha 410008, P.R. China
| | - Jun Zhou
- § Medical Science Research Center, Xiangya Hospital, Central South University, Changsha 410008, P.R. China
| | - Jian Xiao
- ¶ Department of Pharmacy, Xiangya Hospital, Central South University, Changsha 410008, P.R. China
| | - Bo Xiao
- * Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, P.R. China
| | - Dong-Sheng Ouyang
- † Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, P.R. China.,∥ Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, Changsha 410078, P.R. China
| | - Kai Hu
- * Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, P.R. China
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Pinoresinol Diglucoside Alleviates oxLDL-Induced Dysfunction in Human Umbilical Vein Endothelial Cells. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3124519. [PMID: 28042303 PMCID: PMC5155123 DOI: 10.1155/2016/3124519] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/11/2016] [Accepted: 10/19/2016] [Indexed: 01/12/2023]
Abstract
Atherosclerotic cardiovascular diseases are the leading causes of morbidity and mortality worldwide. Deposition of oxidized low-density lipoprotein (oxLDL) is one of the initiators and promoters of atherosclerosis. Eucommia lignans were shown to possess antihypertensive effects. This study aimed to investigate the effects of pinoresinol diglucoside (PD), a Eucommia lignan, on oxLDL-induced endothelial dysfunction. HUVECs were treated with oxLDL and/or PD followed by assessing radical oxygen species (ROS), apoptosis, nitrogen oxide (NO), malondialdehyde (MDA), and superoxide dismutase (SOD) activity with specific assays kits, mRNA levels with quantitative real-time polymerase chain reaction (PCR), and protein levels with western blot. PD abolished oxLDL-induced ROS and MDA production, apoptosis, upregulation of lectin-like oxidized LDL recptor-1 (LOX-1), intercellular Adhesion Molecule 1 (ICAM-1), and nuclear factor kappa-light-chain-enhancer of activated B-cells (NF-κB), and activation of p38MAPK (mitogen-activated protein kinases)/NF-κB signaling. Meanwhile, PD alleviated oxLDL-caused inhibition of SOD activity, eNOS expression, and NO production. These data demonstrated that PD was effective in protecting endothelial cells from oxLDL-caused injuries, which guarantees further investigation on the clinical benefits of PD on cardiovascular diseases.
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Wang Y, Yu M, Mo L, Li Z, Wang J, Zhou HH, Ouyang DS. Aldose reductase C-106T polymorphism is associated with the risk of essential hypertension. Gene 2016; 591:65-68. [DOI: 10.1016/j.gene.2016.06.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 06/07/2016] [Accepted: 06/21/2016] [Indexed: 01/28/2023]
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Niu HS, Liu IM, Niu CS, Ku PM, Hsu CT, Cheng JT. Eucommia bark (Du-Zhong) improves diabetic nephropathy without altering blood glucose in type 1-like diabetic rats. DRUG DESIGN DEVELOPMENT AND THERAPY 2016; 10:971-8. [PMID: 27041999 PMCID: PMC4780717 DOI: 10.2147/dddt.s98558] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background Eucommia bark, Eucommia ulmoides Oliver barks (Du-Zhong in Mandarin), is an herb used for renal dysfunction in Chinese traditional medicine. In an attempt to develop this herb as a treatment for diabetic nephropathy (DN), we investigated the effects of Du-Zhong on renal dysfunction in type 1-like diabetic rats. Methods Streptozotocin (STZ) was used to induce type 1-like diabetes in rats (STZ-diabetic rats). In addition to hyperglycemia, STZ-diabetic rats showed significant nephropathy, including higher plasma levels of blood urea nitrogen, creatinine, and renal fibrosis. Western blot analysis of renal cortical tissue was applied to characterize the changes in potential signals related to nephropathy. Results Oral administration of Du-Zhong (1 g/kg/day) to STZ-diabetic rats for 20 days not only decreased the plasma levels of blood urea nitrogen and creatinine but also improved renal fibrosis, whereas the plasma glucose level was not changed. The higher expressions of protein levels of transforming growth factor-beta (TGF-β) and connective tissue growth factor in diabetic rats were markedly attenuated by Du-Zhong. The increased phosphorylation of Smad2/3 in STZ-diabetic rats was also reduced by Du-Zhong. However, Du-Zhong cannot reverse the hyperglycemia-induced overproduction of signal transducers and activators of transcription 3 in the diabetic kidney. Conclusion Oral administration of Du-Zhong improves STZ-induced DN in rats by inhibiting TGF-β/Smad signaling and suppressing TGF-β/connective tissue growth factor expression. Therefore, active principle from Du-Zhong is suitable to develop as new agent for DN in the future.
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Affiliation(s)
- Ho-Shan Niu
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien City, Taiwan
| | - I-Min Liu
- Department of Pharmacy & Graduate Institute of Pharmaceutical Technology, Tajen University, Pingtung County, Taiwan
| | - Chiang-Shan Niu
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien City, Taiwan
| | - Po-Ming Ku
- Department of Cardiology, Chi-Mei Medical Center, Yong Kang, Tainan City, Taiwan; Department of Medical Research, Chi-Mei Medical Center, Yong Kang, Tainan City, Taiwan
| | - Chao-Tien Hsu
- Department of Pathology, E-DA Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Juei-Tang Cheng
- Department of Medical Research, Chi-Mei Medical Center, Yong Kang, Tainan City, Taiwan; Institute of Medical Science, College of Health Science, Chang Jung Christian University, Guei-Ren, Tainan City, Taiwan
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