Herbal Antioxidants nyob rau hauv Dialysis Cov Neeg Mob: Kev Ntsuam Xyuas Ntawm Cov Txheej Txheem Muaj Peev Xwm thiab Kev Kho Mob
Feb 23, 2022
Emailtina.xiang@wecistanche.comyog xav paub ntxiv
TSAB NTAWVKev noj ntawm exogenous antioxidants cais los ntawm herbal extracts tau pom muaj txiaj ntsig zoo ntawm kev ua kom lub cev lim ntshav cuam tshuam los ntawm kev debilitating.oxidative kev nyuaj siabthiabmobtxheej txheem. Ntau cov kev tshawb fawb soj ntsuam muaj nyob rau hauv cov ntaub ntawv pej xeem tau tshaj tawm txog kev txhim kho ntawm kev lim ntshav hauv cov neeg mob ntxiv nrog tshuaj ntsuab tshuaj tua kab mob. Kev tshawb nrhiav cov ntaub ntawv no muaj peev xwm ua tau zoo rau kev nkag siab txog cov txheej txheem muaj peev xwm thiab kev kho mob cuam tshuam txog tshuaj ntsuab tshuaj tua kab mob. Hauv kev ua haujlwm no, cov txheej txheem thiab kev cuam tshuam ntawm qee cov tshuaj bioactive nto moo xws li silymarin, curcumin, resveratrol, emodin, thiab quercetin ntawm qhov tshwm sim ntawm kev lim ntshav hauv cov neeg mob raum mob (CKD) tau tshawb nrhiav. Cov yam ntxwv tiv thaiv ntawm silymarin yog vim muaj cov flavonoid complex silybin. Curcumin yog ib qho tseem ceeb ntawm cov hauv paus hniav ntawm Curcuma longa uas muaj txiaj ntsig zoo, suav nrog cov tshuaj tua kab mob antioxidant, tiv thaiv kev ua haujlwm, thiab inhibitory cuam tshuam ntawm cell apoptosis. Resveratrol tuaj yeem txo qisoxidative kev nyuaj siablos ntawm neutralization ntawm dawb radicals. Emodin yog lub npe hu ua ntuj anthraquinone derivative cais los ntawm suav tshuaj ntsuab. Thaum kawg, quercetin tau raug tshaj tawm los nthuav tawm ntau yam khoom xws li tshuaj tua kab mob, tshuaj tiv thaiv kab mob ntshav qab zib, tshuaj tua kab mob, tshuaj tua kab mob, tshuaj tua kab mob, cov roj cholesterol, thiab lub raum hemodynamic modulator. Txawm li cas los xij, cov txheej txheem muaj peev xwm thiab kev cuam tshuam txog kev kho mob ntawm cov tshuaj ntsuab tshuaj tua kab mob tau hais los saum no zoo li nyuaj, uas yog, xav tau kev tshawb fawb ntxiv hauv daim teb no.
Cov ntawv luv: ROS: hom pa oxygen reactive; MDA: malondialdehyde; GPx: glutathione peroxidase; SOD: superoxide dismutase; CAT: catalase; TGF: transforming loj hlob yam; IL: interleukin; NF-kB: nuclear factor kappa B; CRP: C-reactive protein
KEYWORDS Dialysis; oxidative kev nyuaj siab; mob; tshuaj ntsuab antioxidant; silymarin; curcumin; resveratrol; emodin; quercetinTaw qhia
Mob raum mob (CKD), ib qho teeb meem kev noj qab haus huv rau pej xeem, yog qhov tshwj xeeb los ntawm kev mob raum tsis ua haujlwm uas kav ntev tshaj peb lub hlis [1,2]. Nyob ntawm lub teb chaws, nws tuaj yeem cuam tshuam ze li ntawm 10 feem pua ntawm cov pej xeem thiab suav nrog cov txiv neej thiab poj niam [3]. Cov neeg mob nrog CKD yog tus cwj pwm los ntawm kev txo qis hauv lub raum ua haujlwm lossis txawm tias poob sijhawm dhau los vim muaj kev cuam tshuam ntawm interstitial fibrosis [4]. Hauv xyoo 2010, lub raum hloov kho (RRT) tau siv rau kwv yees li 2.62 lab tus neeg mob thoob ntiaj teb uas xav tias yuav nce ob npaug los ntawm 2030 vim tias muaj kev pheej hmoo ntawm kev rog rog thiab ntshav qab zib mellitus ntawm cov neeg sib txawv thiab cov neeg laus hauv ntau lub tebchaws [5]. Kev mob ntshav qab zib thiab kev tuag ntawm cov neeg mob lim ntshav tseem siab vim muaj teeb meem xws li kab mob plawv [6,7].
oxidative kev nyuaj siab, ib lub xeev pathological, yog txuam nrog overproduction ntawm reactive oxygen hom (ROS) thiab reactive nitrogen hom (RNS), uas txo cov scavenging peev xwm ntawm antioxidant systems [8]. Txhim kho oxidation ntawm lipids, proteins, thiab DNA uas tau pom nyob rau hauv cov neeg mob CKD txij thaum ntxov yuav ua rau lub cev puas tsuaj [9]. Kev nce qib ntawm CKD mus rau ESRD yog cuam tshuam nrog kev txhim kho oxidative kev nyuaj siab vim lub raum tsis ua haujlwm ua rau muaj kev cuam tshuam ntawm uremic toxins uas ua rau exacerbation ntawm ROS ntau lawm thiabmobcov lus teb thiab ua rau muaj kev pheej hmoo ntawm cov teeb meem cuam tshuam [10].oxidative kev nyuaj siabtseem muaj lub luag haujlwm tseem ceeb hauv kev txhawb nqa atherosclerosis hauv ESRD cov neeg mob [11]. Ntxiv mus, oxidative kev nyuaj siab thiabmoblub xeev ua rau peritoneum fibrosis hauv peritoneal dialysis (PD) cov neeg mob [12].
Lub cev loj hlob ntawm cov pov thawj qhia tau hais tias oxidative kev nyuaj siab yog qhov tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas tau lim ntshav [13]. Qhov tseem ceeb, kev lim ntshav kuj nce ROS ntau lawm thiab ua rau oxidative kev nyuaj siab thiab mob los ntawm kev sib txawv mechanisms [14].
Nws tau raug pom tias qhov kev hloov pauv ntawmoxidative kev nyuaj siabthiabmobmob hauv cov neeg mob lim ntshav zoo li txhim kho txoj sia nyob mus ntev hauv ntau hom kev tshawb fawb [15]. Cov tshuaj tiv thaiv antioxidant feem ntau los ntawm cov peev txheej ntuj yog lub tswv yim tawm tshiab kom txo qis oxidative kev nyuaj siab thiab tom qab.mobnyob rau hauv pathology [16] Muaj qee cov pov thawj hais txog kev tiv thaiv lub luag haujlwm ntawm cov neeg ua haujlwm no hauv kev tswj hwm CKD thiab kev lim ntshav vimoxidative kev nyuaj siabthiabmob[17,18].
Txoj kev tshawb fawb tam sim no tsom rau kev ntsuas qhov ua tau zoo ntawm cov tshuaj tiv thaiv antioxidant nrog cov khoom siv ntuj tsim hauv kev tswj hwm ntawm ntau hom RTT feem ntau HD thiab PD-induced oxidative kev nyuaj siab, mob, thiab, cov teeb meem tom qab. Tsis tas li ntawd, qhov kev tshawb fawb no tau tshawb xyuas cov txheej txheem molecular ntawm cov tshuaj antioxidants.
Cov txheej txheem hauv qab rau kev lim ntshav ua rau muaj kev puas tsuaj rau cov neeg mob CKD
Ib txwm muaj kev pheej hmoo tsis tuaj yeem piav qhia txog cov txheej txheem hauv qab ntawm CKD thiab nws cov kab mob plawv [19]. Ob leegoxidative kev nyuaj siabthiab mobmoblub xeev yog ib qho tseem ceeb hauv cov kab mob pathophysiology ntawm cov teeb meem ntawm kev lim ntshav xws li mob plawv thiab tseem txhim kho qhov kev tuag ntawm cov neeg mob no [11,20]. Oxidative kev nyuaj siab, ib qho kev pheej hmoo tsis zoo, thiab ib qho tseem ceeb ntawm cov kab mob pathogenic cuam tshuam nrog kev tsis sib xws ntawm kev tsim cov ROS thiab RNS thiab cov kab mob antioxidant kom tshem tawm cov dawb radicals [11,21]. Nws yog ib qho ua rau muaj kev hloov pauv ntawm cov qauv ntawm tes xws li DNA puas thiab oxidation ntawm lipids thiab cov proteins [22], uas ua rau apoptosis lossis cellular necrosis [23].oxidative kev nyuaj siabkuj tseem ua lub luag haujlwm tseem ceeb hauv kev nce qib ntawm CKD mus rau ESRD, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob dialysis [17,24].
Cov txheej txheem hauv qab los piav qhia cov peev txheej ntawm kev txhim kho oxidative kev nyuaj siab thiabmobtseem tsis tau qhia. Txhim kho oxidative kev ntxhov siab, nrog rau kev tuag ntau ntxiv, tau raug pov thawj hauv cov neeg mob HD thiab PD [25,26]. Cov txheej txheem sib txawv zoo li ua rau muaj kev txhim kho ROS ntau lawm thiab tom qab oxidative kev nyuaj siab, nrog raumobNyob rau hauv cov neeg mob dialysis xws li dialysis membrane induced activation ntawm leukocytes, dialysis-induced tshem tawm ntawm tsawg molecular hnyav molecules ntawm lub antioxidant system, thiab txwv tsis pub cov txiv hmab txiv ntoo thiab zaub noj nyob rau hauv cov neeg mob no [14].
Ntau yam yog suav tias yog nyob rau hauv oxidative stress-induced pathologic mob hauv HD thiab PD cov neeg mob. Cov ntawv ceeb toom tau qhia tias yuav tsum muaj cov txheej txheem kev kho mob sib txawv hauv oxidative kev ntxhov siab ntawm HD thiab PD [25,27]. Oxidative stress nyob rau hauv cov neeg mob dialysis yog ntau tshaj li ntawd nyob rau hauv cov neeg mob CKD, zoo ib yam li, Oxidative stress nyob rau hauv HD cov neeg mob yog ntau tshaj li ntawd nyob rau hauv cov neeg mob PD [12]. Hom dialysis membrane, intravenous tswj ntawm hlau, siv heparin, activation ntawm platelets thiab leukocytes, thiab tseem ceeb tshaj yog tsis muaj los yog txo nyob rau hauv cov zis ntim, raws li zoo raws li ib co degree ntawm malnutrition yog lub luag hauj lwm rau zus tau tej cov oxidation khoom nyob rau hauv HD cov neeg mob [17 ].
Hauv ESRD cov neeg mob, kev txhim kho ROS ntau lawm thiab lipid peroxidation ntawm cov ntshav, txo glutathione peroxidase (GPx), superoxide dismutase (SOD), thiab catalase (CAT) kev ua ub no vim lub membrane dialyzer thaum kho HD, uas qhia txog qhov tseem ceeb ntawm daim nyias nyias. hom tshwj xeeb tshaj yog biocompatible [28] Yog li, nws zoo nkaus li tias HD txheej txheem yuav cuam tshuam nrog kev tiv thaiv kab mob antioxidant. Cov ntshav raug rau dialysate nrog rau cov dialyzer daim nyias nyias nyob rau hauv feeb tom qab HD pib zoo li ua rau kev ua kom muaj cov ntsiab lus ntxiv, platelets, polymorphonuclear (PMN) leukocytes thiab yog li ua rau overproduction ntawm ROS [29]. Kev nce qib PMN leukocytes stimulation tau tshaj tawm tias yog qhov tseem ceeb hauv HD cov neeg mob thaum lub sijhawm HD [30]. Tsis tas li ntawd, myeloperoxidase ua ib qho enzyme active nyob rau hauv tiam ntawm reactive hom yog khaws cia nyob rau hauv PMN leukocytes thiab yog ib tug cim ntawm HD bio-incompatibility thiab oxidative kev nyuaj siab uas yuav tsum tau mobilized sai thiab dav mus rau hauv cov ntshav ncig los ntawm exogenous heparin, qhia lub myeloperoxidase oxidative kev nyuaj siab- Kev sib cuam tshuam ntawm heparin hauv HD cov neeg mob [31]. Tsis tas li ntawd, cov khoom lag luam lipid peroxidation nce ntxiv hauv 30 min ntawm HD pib tau pom tias muaj feem cuam tshuam rau kev ua kom muaj txiaj ntsig ntxiv lossis heparin-induced zus tau tej cov fatty acids dawb [32]. HD cov neeg mob kuj tau tshaj tawm tias tau txo cov ntshav plasma ntau ntau ntawm cov tshuaj antioxidants suav nrog cov vitamin (Vit) C, GSH-Px, thiab selenium, uas cuam tshuam rau exacerbation ntawm oxidative kev nyuaj siab los ntawm HD txheej txheem [30].
Kev mob, qhov kev kwv yees muaj zog ntawm cov txiaj ntsig tsis zoo hauv cov neeg mob lim ntshav [33], ua lub luag haujlwm tseem ceeb hauv uremia ntsig txog kev mob thiab kev tuag hauv cov neeg mob HD [34,35].Kev mobHauv cov neeg mob ntawm kev lim ntshav tuaj yeem cuam tshuam nrog cov lus teb ntawm tes rau oxidative kev nyuaj siab. Lwm yam tseem ceeb yog categorized li 1) cov ntaub so ntswg ntsig txog yam xws li hypoxia, kua dej, thiab sodium ntau dhau; 2) plab dysbacteriosis thiab lub cev tsis muaj zog; 3) khaws cia ntawm uremic toxins, xws li qib siab glycation end-products (AGEs), indoxyl sulfate, thiab calcioprotein hais; thiab thaum kawg 4) dialysis membranes thiab central venous catheters li lwm yam tseem ceeb [35]. HD txheej txheem-ua o ua rau muaj kev mob ntev ntev thiab kev tuag hauv cov neeg mob ESRD. Kev ua haujlwm ntawm interleukins thiab anaphylatoxins txhawb nqa cov nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, ib qho enzyme uas ua lub luag haujlwm tseem ceeb hauv kev tsim ntau dhau ntawm ROS, thiab yog li ua rau leukocyte activation, cytotoxicity, thiab [36] . Hyper o hauv cov neeg mob HD ntev ua rau cov kab mob plawv thiab ua rau cov neeg tuag ntau dua [37,38].
Kev sib sau ntawm cov khoom oxidative hauv PD cov neeg mob nyob ntawm PD cov yam ntxwv xws li nce osmolality, qis PH, nce qib lactate, thiab cov khoom ntawm cov piam thaj degradation [12,14]. Bio incompatibility ntawm cov pa PD cov kev daws teeb meem tau raug nthuav tawm los tsim cov khoom oxidation carbonyl, ua rau muaj kev cuam tshuam loj thiab kev ua haujlwm ntawm cov kab mob peritoneal vim muaj protein ntau oxidation thiab AGEs tsub zuj zuj [39]. Ib yam li ntawd, PD kev kho mob tau raug tshaj tawm kom nce peritoneal nitric oxide synthase (NOS) kev ua hauv biopsies uas yog lub luag haujlwm rau kev tsim cov prooxidant NO. Hauv cov neeg mob PD mus ntev, NOS overexpression thiab NO overproduction yuav ua rau muaj kev hloov pauv ntawm cov kab mob peritoneal nrog rau kev txhim kho vascular endothelial kev loj hlob zoo, AGEs tsub zuj zuj, thiab tom qab peritoneal membrane calcification [40].
Ntawm qhov tod tes, tus mobmobCov lus teb cuam tshuam los ntawm kev siv PD mus sij hawm ntev tuaj yeem cuam tshuam nrog cov qauv thiab kev ua haujlwm hloov pauv hauv peritoneal membrane thiab exacerbation ntawm cov khoom oxidative [41]. Nyob rau theem pib ntawm kev kho PD, txawm tias nyob rau hauv thawj teev tom qab pib, nce qib ntawm cov ntshavmobyam xws li interleukin -6 (IL- 6), tau tshaj tawm vim bio-incompatibility ntawm cov pa PD tov [42,43].
Ntuj antioxidants
Hauv tib neeg lub cev, cov kab mob antioxidant tuaj yeem tshem tawm cov dawb radicals thiab ua kom qhov sib npaug ntawm cov khoom oxidative thiab kev ua haujlwm oxidative [44]. Antioxidants tau muab faib ua ob hom endogenous uas yog ntuj tiv thaiv mechanisms tsim los ntawm tib neeg lub cev; thiab exogenous uas tuaj yeem pom hauv cov tshuaj thiab zaub mov [45]. Endogenous antioxidants tuaj yeem raug cais ntxiv raws li enzymatic lossis
tsis yog enzymatic. Antioxidants kuj raug cais raws li dej los yog fat-soluble molecules [46]. Endogenous antioxidant enzymes xws li SOD, CAT, thiab GPx tuaj yeem cuam tshuam cov tshuaj lom ROS ntau lawm thiab tswj lub cev homeostasis [47].
Cov nroj tsuag tshuaj muaj lub luag haujlwm tseem ceeb hauv kev tiv thaiv tib neeg kev noj qab haus huv tsis yog thaum lub sijhawm qub, tab sis kuj tseem nyob hauv kab lis kev cai niaj hnub no. Feem ntau ntawm exogenous antioxidants yog cais los ntawm cov nroj tsuag tshuaj thiab cov khoom noj xws li zaub, txiv hmab txiv ntoo, cereals, txiv ntseej, paj, legumes, dej haus, fungi, spices, thiab lwm yam. [48]. Feem ntau, cov tshuaj antioxidants ntuj los ntawm cov ntaub ntawv cog qoob loo feem ntau yog categorized raws li hauv qab no: (1) polyphenols, suav nrog flavonoids, phenolic acids, lignans, anthocyanins, thiab stilbenes; (2) carotenoids, nrog rau xanthophylls thiab carotene, thiab (3) vitamins, tshwj xeeb tshaj yog cov vitamins E thiab C [49]. Ntau yam tseem ceeb ntawm cov dej num lom neeg xws lianti-inflammatory, antiviral, antibacterial, anti-aging, thiab anticancer kev ua ub no tau tshwm sim rau cov natural antioxidants, tshwj xeeb tshaj yog rau polyphenols thiab carotenoids [50]. Kev tswj hwm ntawm exogenous antioxidants tuaj yeem txo qhov kev puas tsuaj los ntawm oxidative kev nyuaj siab hauv lub cev los ntawm kev tawm tsam ntawm kev pib lossis kev loj hlob ntawm oxidative saw cov tshuaj tiv thaiv, yog li, lawv tuaj yeem ua cov tshuaj dawb radical neutralizers [51].
Cov txiaj ntsig zoo ntawm kev kho mob cog extract ntawm lub raum puas tau lees paub los ntawmanti-inflammatory, anti-apoptotic, thiab anti-oxidative zog [52-54]. Tsis tas li ntawd, cov tshuaj ntsuab tau ua tiav siv los kho qhov tshwm sim ntawm cov neeg mob ntawm kev lim ntshav [55,56]. Txawm li cas los xij, kev tswj hwm ntawm cov khoom siv los ntawm cov nroj tsuag muaj txiaj ntsig zoo piv rau cov nroj tsuag kho mob, qhia tias cov khoom siv bioactive no yog ib qho ntawm cov tshuaj cog qoob loo uas muaj kev phiv qis dua [57]. Tsis tas li ntawd, cov khoom tshwm sim ib txwm muaj sib txawv ntawm cov tshuaj siv tshuaj hauv ntau yam xws li lawv cov nqi, kev tswj hwm, kev tsim khoom, thiab kev siv tshuaj kho mob [58]. Hauv qhov kev tshuaj xyuas no, peb tau sim tshawb xyuas qhov cuam tshuam ntawm qee cov npe nrov bioactive sub-stances ntawm qhov tshwm sim ntawm kev lim ntshav hauv cov neeg mob CKD.
Silymarin
Silymarin yog ib qho flavonoid cais tawm thawj zaug hauv xyoo 1968 los ntawm cov noob extract ntawm cov mis thistle cog [59] uas yog qhov sib xyaw ntawm lignin-derived flavonols, suav nrog silybin, silydianin, silychristin, thiab yog silybin [60]. Silymarin muaj cov ntaub ntawv muaj kev nyab xeeb zoo yam tsis muaj kev phiv tshuaj [61] uas tuaj yeem ua rau muaj kev phom sij dawb radicals thiab inhibit oxidation ntawm lipid cell membranes [62]. Cov yam ntxwv tiv thaiv ntawm silymarin yog vim lub flavonoid complex silybin, uas yog ib tug muaj zog antioxidant neeg sawv cev thiab scavenge ROS ua nyob rau hauv ib txwm metabolic dab thiab thaum lub sij hawm neutralization ntawm cov tshuaj lom. Silymarin kuj tseem txhim kho cov concentrations ntawm endogenous antioxidants xws li GSH-Px, thiab SOD [63]. Vim hais tias ntawm nws cov anti-fibrotic thiab anti-inflammatory zog, silymarin yog suav hais tias yog ib tug natural neeg sawv cev rau kev tiv thaiv thiab kev kho mob ntawm daim siab thiab raum mob [64,65].
Cov nyhuv nephron-tiv thaiv ntawm silymarin tau raug lees paub hauv ntau qhov kev tshawb fawb. Raws li kev sim cov txiaj ntsig, silymarin tuaj yeem tiv thaiv cisplatin thiab adriamycin ua rau lub raum raug mob los ntawm nws cov antioxidant thiabanti-inflammatorykhoom [66,67]. Tsis tas li ntawd, lwm yam kev tshawb fawb tsiaj tau tshaj tawm tias silymarin tuaj yeem txo qis kev ua haujlwm thiab lub raum ntawm lub raum hloov pauv vim raug mob ischemia / reperfusion raug mob [68,69]. Txawm li cas los xij, hauv kev tshawb fawb hauv vitro, silymarin tsis tuaj yeem txo cov lipid thiab DNA oxidation los ntawm glycerol hauv cov nas lub raum hlwb [70]. Txhawm rau qhia cov yam ntxwv nephroprotective hauv tib neeg, 60 tus neeg mob uas muaj ntshav qab zib hauv lub raum tau txais cov placebo lossis silymarin (420 mg / hnub) hauv kev tshawb fawb randomized, tswj, ob qhov muag tsis pom kev. Cov txiaj ntsig tau pom qhov txo qis hauv cov zis TNF-a thiab MDA qib thiab tseem albuminuria tau txhim kho hauv pab pawg silymarin, hais txog qhovanti-inflammatorythiab anti-oxidative zog ntawm tus neeg sawv cev no [71].
Vim tias muaj txiaj ntsig zoo ntawm silymarin ntawm lub raum, cov tshuaj tiv thaiv kab mob no kuj tau siv los tiv thaiv PD thiab HD-induced teeb meem. Hauv kev tshawb fawb los ntsuas qhov ua tau zoo ntawm silymarin ntawm cov neeg mob HD, 80 HD cov neeg mob tau muab faib ua plaub pawg thiab tau txais silymarin (420 mg / hnub), vit E (400 IU / hnub), silymarin þ vit E, lossis placebo rau 3. lub lis piam. Cov txiaj ntsig zoo tshaj plaws tau tshaj tawm hauv silymarin þ vit E uas cov qib ntshav ntawm MDA tau txo qis thiab RBC qib ntawm GPx thiab qib hemoglobin tau nce [72]. Tsis tas li ntawd, kev kho mob ntawm 15 tus neeg mob PD mob ntev nrog silymarin (210 mg / hnub) rau 8 lub lis piam tau pom tias muaj kev txhim kho ntawm hemoglobin ntau ntxiv nrog rau cov ntshav qab zib tsawg TNF-a, qhia txog kev ua tau zoo ntawm silymarin hauv kev tswj hwm oxidative kev nyuaj siab thiab o. PD cov neeg mob [73]. Hauv kev tshawb fawb soj ntsuam randomized, 50 ESRD cov neeg mob nyob rau hauv PD tau kho nrog silymarin (140 mg txhua 8 h) lossis placebo rau ob lub hlis, thiab tom qab ntawd, biomarkers ntawm oxidative kev nyuaj siab hauv cov ntshav thiab erythrocytes raug ntsuas. Kev ua haujlwm ntawm cov tshuaj tua kab mob endogenous enzyme CAT hauv cov qe ntshav liab thiab ntshav liab vim qhov txiaj ntsig hemoglobin tau txhim kho hauv pawg silymarin piv rau cov placebo [74].
Curcumin
Curcumin (C21H20O6), hydrophobic polyphenol, yog ib qho tseem ceeb ntawm cov hauv paus hniav ntawm Curcuma longa, nrog rau cov khoom muaj txiaj ntsig zoo, suav nrog cov tshuaj tua kab mob antioxidant, tiv thaiv kab mob, thiab inhibitory cuam tshuam ntawm cell apoptosis [75]. Kev nyab xeeb thiab kev ua haujlwm ntawm tus neeg sawv cev no qhia txog nws txoj kev tiv thaiv thiab kev kho mob ntawm ntau hom tib neeg. Raws li cov dawb radicals scavenger, curcumin tuaj yeem cuam tshuam ncaj qha rau ROS los ntawm kev pub nws cov hydrogen ions thiab indirectly overexpress cov antioxidant system enzymes xws li CAT, SOD, thiab GSH [76]. Tsis tas li ntawd, cov tshuaj tiv thaiv antioxidant no siv nws cov kev ua haujlwm los ntawm inhibiting lub nuclear factor-kappa B (NF-kB) cell signaling pathway [77]. Cov kev tshawb fawb hauv vitro tau pom tias preincubation ntawm activated macrophages ntawm nas peritoneum nrog curcumin inhibited lub tsub zuj zuj ntawm ROS los ntawm macrophages [78] thiab tej zaum yuav muaj zog inhibitor ntawm lipid peroxidation [79].
Cov txiaj ntsig zoo ntawm curcumin ntawm cov tsiaj qauv ntawm nephropathy tau lees paub hauv ntau qhov kev tshawb fawb. Cov tshuaj ntxiv ntawm curcumin (75 mg / kg / hnub) tau tshaj tawm kom txo qis qhov mob, oxidative kev nyuaj siab, thiab lub raum fibrosis nyob rau hauv lub raum uas seem ntawm lub raum nuclear-erythroid-2-txog yam 2 (Nrf2)-keap1 txoj kev [ 80] ib. Tsis tas li ntawd, curcumin (ib hnub los ntawm gavage ntawm koob tshuaj 37.5, 75, thiab 150 mg / kg rau 35 hnub sib law liag) tuaj yeem txo qis CKD zoo li lub raum puas tsuaj los ntawm inhibition ntawm inflammatory cytokines (IL-1b, IL{{15). }}, thiab TNF-a), oxidative stress, fibrosis, thiab apoptosis [81]. Siv cov txheej txheem zoo sib xws, cov teebmeem nephroprotective ntawm curcumin tau tshwm sim hauv cov qauv tsiaj nrog nephrotoxicity thiab CKD [82–84]. Ntawm qhov tod tes, kev noj zaub mov uas muaj curcumin rau yim lub lis piam txo qis kev tso tawm ntawm lysosomal enzymes thiab eicosanoids hauv nas peritoneal macrophages [85].
Cov kev sim tshuaj tau ua los tshawb xyuas cov txiaj ntsig ntawm curcumin rau cov neeg mob raum tsis zoo. Hauv kev ntsuam xyuas ntawm curcumin supplementation (66 mg ntawm curcumin ib hnub) rau 2 lub hlis hauv cov neeg mob ntshav qab zib CKD, 39 feem pua ntawm cov proteinuria txo qis thiab txo cov ntshav qabzib ntau ntawm kev hloov pauv kev loj hlob-beta (TGF-b) thiab TNF-a tau tshaj tawm [ 86]. Ib yam li ntawd, curcumin supplementation txo qis proteinuria hauv cov neeg mob lupus nephritis [87].
Hauv kev tshawb fawb tsawg, cov tshuaj tua kab mob antioxidant thiab tshuaj tiv thaiv kab mob ntawm kev tswj hwm curcumin hauv cov neeg mob ntshav qab zib tau zoo heev. Hauv kev tshawb fawb soj ntsuam, cov tshuaj tiv thaiv kab mob ntawm curcumin rau HD cov neeg mob siv ib lub tshuaj ntsiav uas muaj 500 mg turmeric nrog 22.1 mg active ingredient curcumin (3 caps / hnub rau 12 lub lis piam) tau tshawb xyuas. Cov txiaj ntsig tau pom tias curcumin uas tsis muaj qhov cuam tshuam tsis zoo tuaj yeem txo cov ntshav plasma ntawm C-reactive protein ntau (hs-CRP), TNF-a, thiab IL-6, thiab nce qib albumin hauv HD cov neeg mob. [88]. Hauv kev tshawb fawb ntawm 43 HD-dependent ent cadaver raum cov neeg tau txais, curcumin supplementation rau ib lub hlis tuaj yeem txo qis qhov tsis txaus siab thiab neurotoxicity hauv rau lub hlis [89]. Lwm qhov randomized, ob-dig muag txoj kev tshawb fawb ntawm cov neeg mob HD ruaj khov tau pom tias kev kho mob nrog curcumin (1500 mg / hnub) rau ob lub hlis ua rau muaj kev txhim kho tseem ceeb ntawm CAT kev ua ub no nrog rau cov erythrocytes concentration thiab txo cov ntshav hauv MDA piv rau cov placebo pawg [ 90] ib. Cov txiaj ntsig ntawm kev sim randomized, ob-dig muag, tswj kev tshawb fawb pom tau tias curcumin supplementation (100 mL ntawm txiv kab ntxwv kua txiv nrog 12 g ntawm zaub ntug hauv paus thiab 2.5 g ntawm turmeric tom qab txhua qhov kev lim ntshav / lim piam) rau 3 lub hlis ameliorated plasma qib ntawm hs CRP. thiab kev qhia ntawm Nrf2, NF-kB, NLRP3, thiab IL- 1b hauv peripheral ntshav mononuclear hlwb hauv HD cov neeg mob [91].
Resveratrol
Resveratrol (3,5,4-trihydroxystilbene) yog ib tsob nroj polyphenolic compound muaj nyob rau hauv liab cawu cub, txiv hmab txiv ntoo, berries, txiv apples, blueberries, plums, peanuts, thiab lwm yam roj noob [92]. Resveratrol tuaj yeem, ncaj qha thiab tsis ncaj, txo oxidative kev nyuaj siab los ntawm nruab nrab ntawm cov dawb radicals thiab up-regulation ntawm endogenous antioxidant enzymes xws li SOD, CAT, thiab GPx [93]. Kev tswj hwm ntawm Resveratrol nrog cov tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob ua rau txo qis oxidative kev ntxhov siab-kho lub raum puas tsuaj hauv cov tsiaj qauv ntawm septic nephropathy [94], ischemia / reperfusion mob raum mob [95], nephrotoxicity induced los ntawm gentamycin [96], cisplatin [97], thiab cyclosporin [98], as well as ntshav qab zib nephropathy [99]. Sib txawv intracellular signaling molecules nyob rau hauv lub raum hlwb cuam tshuam los ntawm kev tswj hwm ntawm resveratrol nrog rau txo oxidative kev nyuaj siab, txo qis ROS thiab MDA, nce antioxidant enzyme kev ua, thiab txhim kho mitochondrial biogenesis [100-103].
Tsis tas li ntawd, resveratrol tau raug tshaj tawm los qhia txog cov teebmeem inhibitory ntawm IL-6 qhia los ntawm kev txhawb nqa peritoneal macrophages hauv cov qauv nas [104].
Cov kev tshawb fawb soj ntsuam ntawm cov teebmeem resveratrol raug txwv. Nyob rau hauv ib tug randomized, yav tom ntej, ob-dig muag txoj kev tshawb no, ib tug kaum ob-lub lim tiam kev kho mob nrog high-dose trans-resveratrol (450 mg / d) ua rau cov kev pab cuam noj qab haus huv thiab kev txhim kho ntawm ultrafiltration nyob rau hauv PD cov neeg mob los ntawm down-regulation ntawm angiogenesis yam xws li vascular. endothelial kev loj hlob zoo, angiopoietin-2, thiab fetal siab kinase-1 nyob rau hauv peritoneal effluent induced los ntawm cov pa lactate-buffered PD cov kev daws teeb meem, qhia tias resveratrol nrog cov koob tshuaj ntau thiab ntev ntawm kev tswj xyuas yuav muab cov txiaj ntsig zoo rau cov neeg mob PD. los ntawm angiogenesis-ameliorating cuam tshuam [105]. Hloov pauv, kev tswj hwm plaub lub lis piam ntawm 500 mg / hnub tau tshaj tawm tias tsis muaj qhov cuam tshuam loj [106]. Nyob rau hauv ib qho randomized, ob-dig muag, placebo-tswj mus sib hais, tag nrho ntawm 40 CKD cov neeg mob uas muaj hlau overloading hauv HD, tau muab tso rau hauv cov pab pawg ntawm (1) supplementation nrog resveratrol (500 mg) thiab Curcumin (500 mg); thiab (2) cov placebo. Cov pab pawg ntxiv tau qhia txog kev txhim kho cov pob txha thiab cov leeg nqaij nrog rau kev nthuav dav ferritin qib, lees paub tias qhov kev sib xyaw tshiab no muaj txiaj ntsig zoo hauv cov neeg mob HD [107].
Emodin
Emodin (3-methyl-1,6,8 trihydroxyanthraquinone) yog lub npe hu ua ntuj anthraquinone derivative cais los ntawm cov tshuaj suav suav xws li hauv paus ntawm rheum palmatum L [108]. Nyob rau hauv cov kev tshawb fawb tsis ntev los no, ib tug dav spectrum ntawm pharmacological teebmeem ntawm emodin tau raug lees paub nrog rau cov tshuaj tiv thaiv, tiv thaiv qog, antiviral, antibacterial, anti-allergic, chemo-tiv thaiv, anti-diabetic, thiab immunosuppressive kev ua ub no [109]. Tsis tas li ntawd, cov tshuaj tiv thaiv kab mob thiab tiv thaiv proliferative ntawm emodin muaj feem xyuam rau nws cov teebmeem inhibitory ntawm tyrosine kinase kev ua haujlwm [110,111].
Hauv ntau qhov kev tshawb fawb, cov teebmeem nephroprotective ntawm emodin tau raug tshaj tawm. Kev tswj hwm ntawm emodin tuaj yeem ua tiav TGF-b1 thiab fibronectin synthesis nyob rau hauv mesangial hlwb nyob rau hauv cov mob ntshav qab zib mellitus los ntawm inhibition ntawm NF-jB signaling pathway [112], thiab kuj txo lub raum hypertrophy thiab hyperfiltration hauv nas qauv ntawm ntshav qab zib nephropathy [113]. Nephroprotective teebmeem ntawm emodin tiv thaiv mob raum mob ntshav qab zib mellitus hauv cov qauv nas tau tshaj tawm los ntawm kev ua kom PI3K / Akt / glycogen synthase kinase 3b qhia txoj hauv kev tiv thaiv kev mob, Bax / Caspase3 txoj hauv kev [114], thiab phosphorylation ntawm P38 MAPK [114], uas mitigated podocytes apoptosis induced los ntawm endoplasmic reticulum kev nyuaj siab los ntawm inhibition ntawm PERK txoj kev [116]. Raws li ib qho inhibitor ntawm cov txheej txheem fibrotic hauv CKD, emodin tau tshwm sim los txhawm rau txo qis kev tsim cov cellular matrix los ntawm kev hloov pauv ntawm P38 thiab ERK1/2 txoj hauv kev hauv TGF-b1-stimulated NRK- 49F hlwb [117]. Tsis tas li ntawd, emodin tau tshaj tawm los txo qis kev cuam tshuam ntawm fibrosis los ntawm kev tswj hwm ntawm TIMP1 thiab Smad7 qhia thiab txo qis ntawm MMP9, TGF-b1, thiab smurf hauv lub raum ntawm nas [118,119].
Txij li thaum cov lus teb inflammatory thiab fibrosis tau kho los ntawm peritoneal mesothelial hlwb uas raug rau lub siab dialysate qabzib concentration thaum lub sij hawm PD, emodin tau tshaj tawm kom ameliorate cov kev hloov morphologic thiab chronic fibronectin synthesis nyob rau hauv tib neeg peritoneal mesothelial hlwb induced los ntawm 30 mmol D-glucose. ]. Emodin kuj tau pom tias txo cov piam thaj hauv cov piam thaj hauv tib neeg lub cev mesothelial hlwb los ntawm inhibition ntawm protein kinase C ua kom thiab cAMP teb cov ntsiab lus-binding protein (CREB) phosphorylation, uas lees paub tias emodin tej zaum yuav yog lub hom phiaj tiv thaiv thiab kho cov piam thaj. -induced pathological hloov nyob rau hauv lub peritoneal membrane [121]. Hauv lwm txoj kev tshawb fawb, emodin ameliorates cov piam thaj hauv cov qauv tsim thiab kev ua haujlwm hloov pauv hauv tib neeg peritoneal mesothelial hlwb ntawm inhibition ntawm TGF b1 thiab fibronectin synthesis [120]. Emodin tau ua pov thawj los txo cov peritoneal fibrosis los ntawm inhibition ntawm mRNA qib ntawm Notch1, Jagged-1, thiab Nws yog -1 hauv cov ntaub so ntswg peritoneal hauv cov qauv nas ntawm PD [122].
Quercetin
Quercetin (3, 5, 7, 30 & 40 -pentahydroxy flavonol), muaj ntau cov zaub ntsuab flavonoid hauv Mediterranean noj zaub mov, tau raug tshaj tawm los nthuav tawm ntau yam khoom xws li antioxidant, tiv thaiv ntshav qab zib, analgesic, antihistaminic, antiviral, anti- inflammatory, cholesterol reducer, thiab lub raum hemodynamic modulator [123,124]. Hauv cov qauv tsiaj ntawm CKD, kev kho mob nrog quercetin txhim kho lub raum kev ua haujlwm thiab cov kev hloov pauv hauv histopathological los ntawm kev txo qis ntawm oxidative kev ntxhov siab, qib ntshav ntawm fibroblast kev loj hlob 23, parathyroid hormone, inorganic phosphate raws li qhov ntsuas ntawm CKD txoj kev loj hlob, thiab raum mob [123]. Lwm txoj kev tshawb fawb ntawm nas pom tau tias quercetin ameliorated methotrexate [125] thiab cisplatin-induced [126] raum puas los ntawm kev txo cov apoptosis thiab oxidative kev nyuaj siab. Kev tswj hwm ntev ntawm quercetin kuj tseem muaj kev txhawb nqa rau cadmium-induced raum puas vim muaj cov tshuaj tiv thaiv antioxidant, tiv thaiv kab mob, thiab vasodilator zog [127]. Cov teebmeem nephroprotective ntawm no flavonoid hauv tus qauv ischemia / reperfusion kuj tau raug pov thawj [128]. Tsis tas li ntawd, hauv ntshav qab zib nephropathy, quercetin txhim kho lub raum ua haujlwm los ntawm kev txo qis ntawm lub raum fibrosis thiab mammalian lub hom phiaj ntawm rapamycin (mTOR / p70S6) kinase (p70S6K) signaling uas kho lub raum tubular epithelial-mesenchymal hloov [129]. Hauv kev tshawb fawb hauv vitro, cov nyhuv reno-tiv thaiv ntawm quercetin tau tshaj tawm rau tubular epithelial hlwb ntawm kev tshem tawm cov dawb radical thiab txo cov lipid peroxidation [130,131]. Tsis tas li ntawd, tus neeg sawv cev no tau pom tias txo qis TGFb induced fibrosis nyob rau hauv lub raum tubular epithelial hlwb ntawm upregulation ntawm PTEN thiab TIMP3, thiab suppression ntawm miR21, uas qhia txog cov anti-fibrotic feature ntawm quercetin rau cov neeg mob CKD [132]. Hauv kev tshawb fawb hauv vitro, quercetin tau pom tias tiv thaiv tib neeg cov hlwb mesothelial los ntawm cov qauv kev hloov pauv tiv thaiv kev raug rau PD kua los ntawm kev txo qis lactate dehydrogenase [133] (Daim duab 1).
Xaus
Ntau cov kev tshawb fawb soj ntsuam muaj nyob rau hauv cov ntaub ntawv pej xeem tau tshaj tawm txog kev txhim kho qhov tshwm sim ntawm kev lim ntshav hauv cov neeg mob ntxiv nrog tshuaj ntsuab antioxidants. Nws txhais tau hais tias kev noj cov tshuaj tiv thaiv kab mob exogenous cais los ntawm cov tshuaj ntsuab tau pom muaj txiaj ntsig zoo ntawm kev ua kom lub cev lim ntshav cuam tshuam los ntawm kev cuam tshuam oxidative kev nyuaj siab thiab cov txheej txheem inflammatory. Cov txheej txheem thiab kev cuam tshuam ntawm qee cov tshuaj bioactive nto moo xws li silymarin, suav nrog curcumin, resveratrol, emodin, thiab quercetin ntawm qhov tshwm sim ntawm kev lim ntshav hauv cov neeg mob raum mob (CKD) tau tshawb nrhiav hauv txoj kev tshawb no. Nws zoo nkaus li tias cov txiaj ntsig zoo ntawm cov bioactive substances feem ntau cuam tshuam nrog lawv cov dawb radical savaging thiab kev ua haujlwm tiv thaiv. Hauv lwm lo lus, cov txheej txheem HD thiab PD yog nrog los ntawm cov teeb meem uas cuam tshuam nrog ntau yam feem ntau oxidative kev nyuaj siab thiab o. Cov dialysate muaj pes tsawg leeg nyob rau hauv PD thiab dialysis membrane nyob rau hauv HD yog txuam nrog pathological alterations. Txij li ob peb txoj kev kho mob tau tsim los tswj PD thiab HD qhov tshwm sim, ntxiv rau cov neeg mob lim ntshav nrog cov tshuaj tiv thaiv kab mob tshwm sim zoo li muaj txiaj ntsig. Txawm li cas los xij, cov kev tshawb fawb loj dua nrog cov ntsiab lus nyuaj kawg thiab lub sijhawm kho mob ntev dua yuav tsum tau soj ntsuam cov txiaj ntsig ntawm ntuj antioxidants ntawm PD thiab HD cov txiaj ntsig.
Cov lus qhia tawm
Tsis muaj peev xwm tsis sib haum xeeb ntawm kev txaus siab tau tshaj tawm los ntawm tus sau.
ORCIDMasoumeh Asgharpour http://orcid.org/0000-0002- 5504-4612
Amirhesam Alirezaeihttp://orcid.org/0000-0001-9720-6723
Masoumeh Asgharpoura thiab Amirhesam Alirezaeib
ib lub Department of Nephrology, Rouhani Tsev Kho Mob, Babol University of Medical Sciences, Babol, Iran;
b Department of Nephrology, Shahid Modarres Tsev Kho Mob, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Cov ntaub ntawv
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