Kev cuam tshuam ntawm Astragalus Polysaccharide Ntawm Lub raum Status Thiab Fibrosis Indices Ntawm Ib Tus nas Model Ntawm Streptozotocin-induced Diabetic Nephropathy

Yog xav paub ntxiv:emily.li@wecistanche.com

Yue Ji, Xue-Rou Yan, Hong-Tao Yang, Kang Yang, Qing-Yun Zhao, Shou-Ci Hu, Qi-Hang Su

1 Tianjin University of Traditional suav tshuaj, Tianjin, Suav.

2 Thawj Tsev Kho Mob ntawm Tianjin University of Traditional Chinese Medicine, Tianjin, Suav

Qhov tseem ceeb

Txawm hais tias tsis muaj kev tswj hwm ntawm cov ntshav qab zib tau pom, astragalus polysaccharide tuaj yeem txhim kholub raumcevinterstitial raug mob nyob rau hauv cov ntshav qab zib nephropathy nas thiab thaum ntxov theem ntawmlub raummuaj nuj nqikev puas tsuaj, uas tej zaum yuav cuam tshuam txog kev txo qis ntawm TGF- 1 thiab -SMA.

Abstract

Yam khoom: Txhawm rau tshuaj xyuas cov txiaj ntsig ntawm astragalus polysaccharide (APS) ntawm lub raum kab mob thiab cov kab mob fibrosis ntawm cov nas uas muaj ntshav qab zib nephropathy. Txoj kev: 72 txiv neej nas tau muab faib ua peb pawg: pawg tswj tsis zoo (NC, n=24); mob ntshav qab zib nephropathy qauv pawg (DNM, n=24); thiab mob ntshav qab zib nephropathy qauv nrog APS pawg (DNM ntxiv rau APS, n=24). Cov nas ntawm DNM thiab DNM ntxiv rau APS pawg tau raug rau ob qho tib si nephrectomy thiab txhaj tshuaj streptozotocin (STZ) (65 mg / kg). DNM ntxiv rau APS pab pawg nas tau tswj hwm 50 IU / kg / d APS los ntawm kev txhaj tshuaj subcutaneous txij thawj lub lim tiam tom qab ua haujlwm txog thaum tuag. NC thiab DNM pab pawg nas tau txhaj tshuaj subcutaneously nrog cov ntim zoo tib yam ntawm lub cev saline. Thaum lub lis piam 3, 8, thiab 13 tom qab ua haujlwm, 6 nas los ntawm txhua pab pawg tau muab faib ua ntu zus thiab muab cov ntshav los ntsuas cov ntshav creatinine thiab ntshav urea nitrogen. Nyob rau hnub ua ntej kev txi, cov nas tau muab tso rau hauv ib lub tawb metabolic rau 24 teev kom khaws zis. Thaum lub lim tiam 14 tom qab ua haujlwm, 6 nas los ntawm txhua pab pawg raug xaiv los ntsuas lub cev qhov hnyav thiab lub raum ntsuas. Cov ntshav tau sau los ntsuas cov ntshav qabzib. Lub raum tau raug sau los txheeb xyuas cov kev hloov pauv pathological los ntawm hematoxylin thiab eosin staining. Cov txiaj ntsig: Kev ntsuam xyuas histological ntawm DNM nas pom tias muaj kev puas tsuaj rau cov tsos mob raws li pom los ntawm hyperplasia ntawm glomerular mesangial matrix, atrophy ntawm lub raum tubules, thiab thickening ntawm lub hauv paus membrane. Hauv qhov sib piv, STZ-vim mob ntshav qab zib nephropathy nas kho nrog APS (50 IU / kg / d) tau pom tias muaj txiaj ntsig zoo ntawm histological, qhia tias APS muaj txiaj ntsig zoo raulub raumcov ntaub so ntswghauv STZ-induced DNM nas. Peb cov txiaj ntsig kuj tau qhia tias APS txo qhov mob raum thiab txhim kho lub cev hnyav hauv DNM nas. Qhov piv ntawm lub raum qhov hnyav rau lub cev hnyav tau txo qis thiab cov theem pib ntawm lub raum kev puas tsuaj tau zoo dua tom qab kev kho APS. Hauv cov theem tom qab ntawm tus kab mob, 24 teev cov zis protein txo qis heev. Ntxiv mus, APS down-regulated TGF- 1 thiab -SMA qhia ntawm lub raum. Xaus: APS ua tau zoo dualub raumcevinterstitial raug mob nyob rau hauv DNM nas thiab thaum ntxov theem ntawm lub raum ua hauj lwm puas. Cov txheej txheem yuav cuam tshuam nrog kev txo qis ntawm kev qhia ntawm TGF- 1 thiab -SMA uas ncua kev loj hlob ntawm lub raum interstitial fibrosis hauv DNM nas.

Ntsiab lus: Mob ntshav qab zibNephropathyAstragalus polysaccharide,Lub raumqhov ntsuas, Fibrosis, TGF- 1, -SMA

Cistanche yog qhov zoo rau lub raum ua haujlwm

Keeb kwm

Mob ntshav qab zib nephropathy (DN) yog ib qho teeb meem ntawm kev mob ntshav qab zib mellitus nrog kev mob siab. Kwv yees li ntawm 25-50 feem pua ​​​​ntawm cov neeg mob ntshav qab zib raug mob los ntawm DN. Cov neeg mob no pom kev poob zuj zuslub raummuaj nuj nqi, uas tuaj yeem ua rau mob raum kawg xws li lub raum tsis ua haujlwm [1]. Lub pathogenesis thiab mechanism ntawm DN tsis meej kiag li. Cov kev tshawb fawb tsis ntev los no tau pom tias kev ua haujlwm tsis zoo ntawm lub zog metabolism thiab dystrophia tuaj yeem ua rau cov metabolism hauv nco, uas inhibits kev loj hlob thiab kev ua haujlwm ntawm cov qog nqaij hlav pancreatic, thaum kawg ua rau DN [2].

Cov tshuaj suav tshuaj (TCM) tau siv dav los kho DN thiab tau pom cov txiaj ntsig zoo. Raws li TCM txoj kev xav, qhov etiological yam ntawm DN yog ntshav stasis, uas ua rau muaj kev cuam tshuam hauv lub cev ua haujlwm, inhibits Qi thiab ntshav, thiab ua rau Qi tsis txaus. Qi deficiency tuaj yeem ua rau DN nce ntxiv. Cov kev tshawb fawb tau qhia tias kev txhaj tshuaj Shuxuetong [extract ntawm Shuizhi (Hirudo) thiab Dilong (lumbricus)] ua rau cov ntshav qabzib nce siab thiablub raummuaj nuj nqintawm cov neeg mob DN [3]. Huangkui Capsule extract ntawm Huangkui (abelmosk)] txhim kho microinflammation hauv DN cov neeg mob [4]. Bailing Pills txo microinflammation thiab oxidative kev nyuaj siab nyob rau hauv cov neeg mob uas raug mob los ntawm DN-induced chroniclub raumua tsis tiav[5]. Tsis tas li ntawd, Tangweikang Pill, suav nrog Huangqi (Radix Astragali seu Hedsari), Shuizhi (Hirudo), thiab Wuweizhi (Fructus Schisandrae Chinensis), tau siv dav hauv kev kho mob [6, 7]. Cov kws tshawb fawb tau pom tias Tangweikang Pill up-regulates matrix metalloprotease-9 qhia thiab down-regulates cov ntaub so ntswg inhibitor ntawm metalloproteinases-1 qhia hauv lub raum ntawm Diabetic nephropathy qauv (DNM) nas [8, 9].

Huangqi (Radix Astragali seu Hedysari), uas pab Qi, ua kom cov hlab ntsha, thiab txo cov ntshav stasis, yog cov tshuaj tseem ceeb tshaj plaws rau kev kho DN hauv tsev kho mob [10,11]. Raws li tau hais hauv qee phau ntawv qub qub ntawm TCM, suav nrog Tang Ye Ben Cao sau los ntawm Wang Haogu [12] thiab Yi Zong. Jin Jian muab tso ua ke los ntawm Wu Qian [13], cov tsos mob ntawm DN zoo ib yam li cov kab mob ntawm "kev nqhis dej", "hydrous", "urine turbid", thiab "consumptive disease" hauv Suav tshuaj, thiab lub ntsiab pathogenesis ntawm DN. yog vim qhov txawv txav ntawm Sanjiao (saum toj, lossis nruab nrab, lossis qis dua) [14]. Qi thiab Yin tsis muaj peev xwm yog qhov tshwm sim ntawm kev ua haujlwm tsis zoo ntawm viscera lossis plab hnyuv. Huangqi (Radix Astragali seu Hedysari) tau siv rau hauv DN [15] los kho lub ntsws, spleen, daim siab, thiab lub raum raug mob ntxiv rau ntxiv rau Qi thiab Yin, ua kom ntshav txaus, thiab cov hlab ntsha ntshiab. Astragalus polysaccharide (APS) (pom zoo No. Z20040085) yog ib qho ntawm cov khoom tseem ceeb hauv Huangqi (Radix Astragali seu Hedysari). Nyob rau hauv xyoo tas los no, APS tau pom tias muaj ntau yam tshuaj muaj txiaj ntsig ntawm kev qhia ntawm insulin signaling molecules hauv lub raum cov ntaub so ntswg ntawm hom 2 mob ntshav qab zib nas [16]. Txawm li cas los xij, me ntsis paub txog cov xwm txheej cuam tshuam rau cov txheej txheem ntawm nruab nrab thiab theem kawg ntawm DN. Lub hom phiaj ntawm txoj kev tshawb no yog txhawm rau tshawb xyuas qhov cuam tshuam ntawm APS ntawm lub raum kab mob thiab cov kab mob fibrosis ntawm nas nrog DN.

Cov ntaub ntawv thiab reagents

Tsiaj txhu thiab kev kho mob

Laboratory tsiaj thiab noj ib puag ncig. Xya caum-ob noj qab nyob zoo Sprague-Dawley txiv neej nas, nrog qhov nruab nrab lub cev hnyav ntawm 180 ± 20 g thaum muaj hnub nyoog 8 lub lis piam, tau nyob hauv chav tsev kub (23 ± 1 degree) nrog lub teeb 12 teev thiab 12 teev tsaus ntuj (teeb pom kev los ntawm 6:00 am txog 6:00 pm). Khoom noj thiab dej muaj nyob rau hauv libitum. Kev sim tau ua raws li cov kev cai ntawm lub koom haum thiab lub teb chaws cov txheej txheem rau kev sim tsiaj. Lub Tsev Haujlwm Saib Xyuas Kev Ncaj Ncees Tsiaj Txhaum Cai tau tshuaj xyuas tag nrho cov txheej txheem tsiaj ua ntej ua qhov kev sim. Cov txheej txheem kev sim ua raws li cov lus qhia 2010/63/EU ntawm European Parliament thiab tag nrho cov tsiaj tau ua raws li cov lus qhia ntawm Tianjin University of TCM Animal Research Committee (TCMLAEC2014005).

Tsiaj pab pawg thiab ua qauv. DN raug ntxias los ntawm unilateral nephrectomy thiab ib leeg intraperitoneal tswj ntawm 65 mg / kg ntawm streptozotocin (STZ) [17. 21], uas tau yaj hauv sodium citrate tsis nyob ntawm pH 4.2.4.5. Cov tsiaj tswj tau txhaj tshuaj nrog lub tsheb (sodium citrate buffer, pH 4.2-4.5).Kats tau muab faib ua peb pawg tswj tsis zoo (NC, n =24); DNM, n{11}}; thiab DNM nrog pab pawg APS (DNM ntxiv rau APS, n =24). DNM ntxiv rau APS pab pawg nas tau tswj hwm APS (50 IU / kg / d) los ntawm kev txhaj tshuaj subcutaneous txij thawj lub lim tiam tom qab ua haujlwm txog thaum tuag. NC thiab DNM pab pawg nas tau txhaj tshuaj subcutaneously nrog cov ntim zoo tib yam ntawm lub cev saline.

Indicators thiab nrhiav kom tau txoj kev

Cov lus qhia dav dav. Thaum lub lim tiam 14 tom qab ua haujlwm, 6 nas los ntawm txhua pab pawg tau xaiv los ntsuas qhov hnyav ntawm lub cev, lub raum qhov hnyav, thiab lub raum Performance index. Cov ntshav tau sau los ntawm cov txheej txheem sab hauv canthus rau kev kuaj ntshav qabzib biochemical (ACCU -CHEK, Indianapolis, IN, USA). Lub raum Performance index raug xam raws li hauv qab no: lub raum Performance index=raum hnyav / lub cev hnyav × 100 feem pua.

Lub raum ua haujlwm thiab 24-h cov zis protein. Thaum lub lis piam 3, 8, thiab 13 tom qab ua haujlwm, 6 nas los ntawm txhua pab pawg tau muab faib ua ntu zus thiab cov ntshav tau sau los ntawm txoj kev plab aortic rau ntshav creatinine (Scr) thiab ntshav urea nitrogen (BUN) biochemical kuaj. Nyob rau hnub ua ntej kev txi, cov nas tau muab tso rau hauv cov kab mob metabolic rau 24 teev kom khaws cov zis, uas tau sim los ntawm cov tshuaj tiv thaiv biuret rau 24 teev cov zis protein. Cov ntshav kuaj tau centrifuged ntawm 3000 rpm rau 15 min thiab cov ntshav tau sau thiab khaws cia ntawm -80 degree kom txog thaum kev tshuaj xyuas raws li tau piav qhia hauv qab no. Scr, BUN, thiab cov zis tag nrho cov protein nyob rau hauv 24 teev tau sim ntawm lub phaj nyeem ntawv siv cov khoom siv sim reagent. Pathological thiab immunohistochemical kuaj. Raws li tau piav saum toj no, tom qab tau txais cov ntshav thiab zis, tag nrho cov tsiaj txhu tau muab txi los ntawm lub ncauj tsev menyuam. Lub raum tau raug nthuav tawm tag nrho thiab sib cais kom zoo los ntawm cov ntaub so ntswg peripheral thiab lub raum capsule. Tom qab ua qhov kev txiav ntev ntev nrog rau lub raum cov ntaub so ntswg nrog lub ntsej muag ntse thiab sau, 10 feem pua ​​​​ formalin fixation tau ua los xyuas cov kev hloov pauv ntawm hematoxylin thiab eosin (HE) staining thiab immunohistochemistry (IHC). Cov ntaub so ntswg hauv lub raum tau muab tso rau hauv paraffin thiab txiav rau hauv 5 ntu ntu rau staining nrog HE, thaum qhia txog TGF- 1 thiab -SMA tau kuaj pom los ntawm IHC siv txoj kev streptavidin-peroxidase.

Kev txheeb cais

Cov ntaub ntawv tau txheeb xyuas nrog SPSS 13.0 software (SPSS. Inc., Chicago, IL, USA). Tag nrho cov ntaub ntawv tau qhia raws li qhov nruab nrab ± tus qauv sib txawv hauv cov ntxhuav thiab qhia los ntawm cov kab ntsug hauv cov duab. Qhov sib txawv ntawm pawg tau txiav txim siab los ntawm kev txheeb xyuas qhov sib txawv. Qhov tshwm sim tus nqi ntawm P tsawg dua 0.05 tau suav tias yog qhov tseem ceeb.

Kev tshwm sim

Cov yam ntxwv dav dav

Lub cev hnyav hauv pawg DNM tau poob qis dua piv rau hauv pawg (P=0.001, Table 1). Lub cev hnyav hauv DNM ntxiv rau APS pawg tau nce ntxiv piv rau hauv pawg DNM (P=0.017, Table 1). Lub raum Performance index siab dua nyob rau hauv pawg DNM dua li NC pawg (P=0.001, Table 1). Ntxiv mus, lub raum Performance index tau txo qis hauv DNM ntxiv rau APS pawg piv rau hauv pawg DNM (P= 0.026, Tab 1). Cov ntshav qabzib tau nce ntxiv hauv DNM pawg piv rau hauv pawg NC (P=0.001, Table 1), tab sis tsis muaj qhov sib txawv hauv cov ntshav qabzib DNM pawg, ntawm pawg] thiab DNM ntxiv rau APPS qhia tias APS ib leeg los tswj cov ntshav qab zib kom ruaj khov ntawm lub lim tiam 14 tsis zoo.

Biochemical ntsuas

Tsis muaj qhov sib txawv tseem ceeb ntawm qib Scr thiab BUN lossis hauv qib 24 h cov zis protein ntawm lub sijhawm sib txawv hauv txhua pab pawg (Table 2-3), piv rau NC pab pawg, DNM pab pawg nas pom pom tseeb tias BUN ntau dua. ntawm ntau lub sijhawm cov ntsiab lus (P=0.021, P=0.012, P=0.008, raws li, Table 2). Piv nrog rau pawg DNM, DNM ntxiv rau APS nas pom tseeb qis dua BUN theem ntawm lub lis piam 3 thiab 8 (P=0.017 thiab P= 0.015, raws li, Table 2). Piv nrog rau NC pab pawg, DNM pab pawg nas pom pom tseeb dua qib Scr ntawm ntau lub sijhawm cov ntsiab lus (P=0.033, P=0.026, P=0.028, raws li, Table 3 ) Muab piv rau DNM pawg. DNM ntxiv rau APS nas pom tau tias qis dua Scr theem ntawm lub lim tiam 8 (P= 0.021, Table 3), thaum tsis muaj qhov sib txawv ntawm lub lis piam 3 thiab 13. Piv nrog rau NC pab pawg, DNM pab pawg nas pom muaj ntau dua 24 h cov zis protein ntau (P=0.021, P= 0.037, P= 0.019, raws li, Table 4) thiab tom qab lub lim tiam 8, cov zis muaj protein ntau ntau (P{{ 38}}.017, Table 4). Piv nrog rau pawg DNM.DNM ntxiv rau APS nas pom tau tias qis dua 24 teev cov zis protein ntau nyob rau lub lim tiam 13 (P=0.011, Table 4).

Pathological kev tshawb pom

Cov qauv glomerular tau pom tseeb hauv NC pab pawg thiab tsis pom qhov pom tseeb ntawm qhov tsis zoo mesenchymal hyperplasia lossis thickening ntawm cov ntaub hauv qab daus tau pom. Lub cortical thiab medullarylub raumcevCov qauv tsim tau zoo ib yam, npaj kom ua tiav, tsis muaj mob thiab fibrosis (Daim duab 1A), piv rau NC pawg. Nws staining nyob rau hauv pawg DNM (Daim duab 1B) qhia hyperplasia ntawm glomerular mesangial matrix, atrophy ntawm lub raum tubules, thiab thickening ntawm lub hauv paus membrane. Hauv qee qhov chaw, focal glomerulosclerosis, Bowman's capsule thickening, thiab lub raum interstitial inflammatory cell infiltration, thiab fibrous proliferation tau pom. Cov kev hloov pauv pathological no piv rau pawg DNM tau yooj yim rau ntau qib hauv DNM ntxiv rau APS pawg (Daim duab 1C). Ntxiv mus, pawg DNM ntxiv rau APS tau pom tias lub raum tubule atrophy tau txo qis thiab lub raum interstitial fibrosis tsis tau pom meej hauv HE staining.

Immunostaining nyhuv ntawm TGF- 1 thiab -SMA hauv cov ntaub so ntswg

Qhov tshwm sim ntawm kev tiv thaiv kab mob ntawm TGF- 1 hauv NC pawg (Daim duab 2A) tau nthuav tawm me ntsis kev qhia zoo nyob rau hauv lub raum tubular epithelial hlwb tshwm sim raws li diffuse xim av-daj lossis xim av thiab feem ntau glomeruli pom qhov tsis zoo. Piv nrog rau NC pawg, ntau cov xim av-daj zoo granules tau pom nyob rau hauv lub raum tubular thiab lub raum interstitial cheeb tsam hauv DNM pawg (Daim duab 2B), qhia tias TGF- 1 qhia hauvraumtau siab dua qhov hauv pawg NC. Ntxiv mus, nyob rau hauv DNM ntxiv rau APS pab pawg (Daim duab 2C) qib ntawm daj granular zoo reactants pom ib tug me ntsis poob ntawm cov xim thiab tau txo qis piv rau cov nyob rau hauv DNM pawg. Hauv pawg NC (Daim duab 2D), qhov kev qhia zoo ntawm -SMA tau tshwm sim raws li ob peb xim xim av-daj lossis xim av feem ntau nyob hauv lub raum hlab ntsha ntawm cov leeg nqaij leeg thiab qee zaus hauv lub raum tubules thiab lub raum interstitial. Piv rau NC pab pawg, ntau lub raum interstitial cheeb tsam tau them los ntawm cov xim daj-daj lossis xim av, qhia tias qhov kev qhia ntawm a-SMA tau txhim kho hauv DNM pawg (Daim duab 2E). Ntxiv mus, nyob rau hauv DNM ntxiv rau APS pawg (Daim duab 2F) theem ntawm daj granular zoo reactants pom ib tug me ntsis poob ntawm cov xim thiab tau tsawg dua piv rau hauv DNM pawg.

Kev sib tham

DN yog ib qho teeb meem mob ntshav qab zib loj nrog cov tsos mob ntawm cov zis protein excretory nce zuj zus ntxiv thiab lub raum hypofunction nce mus rau nephrosis nyob rau theem kawg. Ntau yam kab mob ntshav qab zib mellitus, suav nrog catecholamines, endothelin, insulin zoo li kev loj hlob zoo li -1, qib siab glycation end-products, thiab TGF- 1, tau cuam tshuam nrog lub cev fibrosis. Cov kev tshawb fawb yav dhau los tau qhia tias TGF- 1-induced signaling pathway exerts the tseem ceeb koom tes hauvlub raumfibrosisnyob rau hauv tej yam mob raum pathological [22]. Hauv txoj kev tshawb no, peb tau npaj tus qauv tsiaj ntawm DN los ntawm uninephrectomy thiab streptozotocin txhaj [23]. Cov nas nyob hauv DNM pab pawg pom muaj mob hnyavlub raumraug mobsuav nrog kev nce qib ntawm cov ntshav qabzib thiab cov ntshav BUN thiab nce cov zis protein ntau ntawm 24 teev, nrog rau kev txo qis hauv lub cev hnyav. Tsis tas li ntawd, cov kev tshawb fawb pathology nyob rau hauv lub raum qhia pom hyperplasia ntawm glomerular mesangial matrix, atrophy ntawm lub raum tubules, thiab infiltration ntawm inflammatory cells, qhia tias DN nyob rau hauv nas ua rau ib tug loj ntim ntawm proteinuria. Cov txiaj ntsig ntawm txoj kev tshawb fawb tam sim no tau qhia tias APS, ib feem ntawm TCM, txo qis- tswj kev qhia ntawm a-SMA thiab TGF- 1 hauv cov ntshav qab zib raum thiab ua lub luag haujlwm tseem ceeb hauv kev txhim kho lub raum fibrosis cuam tshuam nrog DN hauv cov nas. .

Kev sib sau ntawm cov kab mob extracellular yog ib qho ua rau glomerulosclerosis thiab tubulointerstitial fibrosis hauv cov txheej txheem pathological ntawm DN, thiab TGF- 1 plays lub luag haujlwm tseem ceeb hauv tubulointerstitial fibrosis. TGF- 1 tuaj yeem ua rau cov adhesion thiab sedimentation ntawm intercellular matrix thiab inhibit cellular matrix degradation, ua rau tubulointerstitial fibrosis [24, 25]. Yog li, inhibiting TGF- 1 tuaj yeem txo qhov kev loj hlob ntawm DN. Yelemis [26] tau ua qhov kev sim UUO nas thiab pom tias tom qab tshem tawm qhov cuam tshuam, lub raum tubular interstitial fibrosis tau txo qis thiab TGF- 1 kev qhia tau raug txo qis, txhawb nqa qhov kev txwv siab ntawm TGF- 1 tuaj yeem txo lossis ncua. raum tubule interstitial fibrosis.

Nyob rau hauv xyoo tas los no, feem ntau cov kev tshawb fawb ntawm TGF- tau tshawb nrhiav nws cov teeb liab hloov txoj hauv kev. TGF- tuaj yeem ua kom muaj ntau yam ntawm cov cim qhia, xws li Smad proteins, mitogen-activated protein kinases, thiab phosphatidylinositol 3 kinase / protein kinase B, thiab lwm yam, thiab TGF- 1 / Smad signaling txoj kev yog ib qho tseem ceeb. inducer [27] ntawm lub raum fibrosis. -SMA yog ib qho cytoskeleton protein nyob rau hauv eukaryotic hlwb uas cuam tshuam rau lub microfilament qauv ntawm hlwb [28]. Hauv cov ntaub so ntswg ntawm lub raum, -SMA tsuas yog qhia nyob rau hauv nruab nrab ntawm lub raum hlab ntsha thiab tsis tshua pom nyob rau hauv lub glomeruli thiab lub raum interstitium. Nyob rau hauv cov kab mob pathological hauv lub raum, -SMA tuaj yeem nthuav tawm thiab nthuav dav nyob ib puag ncig thaj tsam glomerular mesenchymal, thaj chaw ib puag ncig ntawm glomerulus, thaj chaw fibrosis ib puag ncig, thiab ib puag ncig cov hlab ntsha [29].

Fibroblasts tuaj yeem hloov mus rau hauv myofibroblasts hauv qee qhov xwm txheej, thiab cov kev hloov hauv microenvironment tuaj yeem cuam tshuam rau kev hloov pauv ntawm fibroblasts rau hauv myofibroblasts. Tsis tsuas yog transdifferentiation ntawm lub raum tubular epithelial cell muaj nuj nqi tab sis kuj ua kom lub raum interstitial fibroblasts ua rau lub raum interstitial fibrosis, uas ua rau cov leeg nqaij fibroblast proliferation ntawm activation. Ntau cov kev tshawb fawb ntawm cov kab mob hauv lub raum tau lees paub tias muaj pes tsawg leeg ntawm cov leeg nqaij fibroblasts, -SMA qhia theem, thiab qib ntawm lub raum interstitial fibrosis muaj kev cuam tshuam zoo nrog rau kev mob raum. Cov cim protein -SMA yog ib qho tseem ceeb qhia ntawm lub raum interstitial fibrosis kev loj hlob [30].

Lwm cov kev tshawb fawb tau tshaj tawm tias TCM muaj txiaj ntsig zoo hauv kev kho DN. Chen et al [31] tau qhia tias kev sib xyaw ntawm Gegen (Radix Puerariae) thiab Shanzha (Fructus Crataegi) inhibits lub raum raug mob hauv hom 2 mob ntshav qab zib los ntawm kev txo qis PI3K / Akt. Zhang et al [32] qhia tias Shenkang granules ameliorate lub raum raug mob nyob rau hauv ib tug nas qauv ntawm DN los ntawm kev tiv thaiv cov tsub zuj zuj ntawm extracellular matrix, txo cov kev qhia ntawm collagen I thiab III, thiab inhibiting kev qhia ntawm matrix metalloproteinases -2 thiab { {5}} nyob rau hauv lub raum ntaub so ntswg. Tshwj xeeb tshaj yog cuam tshuam rau txoj kev tshawb fawb tam sim no yog qhov kev tshawb pom tsis ntev los no uas muaj kev sib xyaw ntawm APS thiab lwm TCM extract, rhein, alleviates pathologies ntawm kev mob ntev.lub raumua tsis tiav, suav nrog kev ua haujlwm puas rau lub glomeruli, interstitial o, thiab apoptosis ntawm lub raum tubular hlwb [33].

Hauv txoj kev tshawb fawb tam sim no, peb pom tias APS txo qhov kev qhia ntawm -SMA thiab TGF- 1 hauv vivo thiab txo cov mob raum mob. Piv rau cov kev tshawb fawb yav dhau los ntawm TCM hauv DN, qhov kev tiv thaiv tshwm sim los ntawm kev sib txawv, qhia tias TCM compound therapeutic lub tswv yim rau DN yuav ua tau zoo.

Txawm li cas los xij, qhov txo qis ntawm cov piam thaj hauv cov ntshav tsis tau pom tom qab kev kho APS. Peb kwv yees tias raws li tus kab mob tau nce mus ntxiv (lub sijhawm soj ntsuam: 13 lub lis piam), kev siv APS ib leeg los tswj cov ntshav qab zib kom ruaj khov nyob rau lub sijhawm tsis zoo. Cov kev sim yav dhau los tau pom cov txiaj ntsig zoo sib xws [34, 35], txawm li cas los xij, yuav tsum muaj kev lees paub ntxiv. Hauv qee qhov kev sim tshuaj, TCM cov neeg sawv cev raug sau ua ib tus neeg sawv cev, thiab kev sib koom ua ke ntawm ob lossis ntau tus neeg sawv cev (APS ntxiv rau metformin lossis APS ntxiv rau insulin) yuav tsim nyog rau cov neeg mob feem ntau.

Xaus

Hauv kev xaus, peb tau pom tias APS muaj qhov cuam tshuam loj rau DN, APS tsis tsuas yog txo qis rau lub raum kev puas tsuaj hauv thawj theem thiab tso zis albumin hauv nruab nrab thiab theem nrab tab sis kuj txhim kho lub raum tubular interstitial raug mob hauv DN nas. Cov txheej txheem yuav cuam tshuam nrog kev txo qis ntawm kev qhia ntawm TGF- 1 thiab -SMA thiab raws li kev ncua ntawm kev loj hlob ntawm lub raum interstitial fibrosis hauv DN nas.

Cov ntaub ntawv

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