Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China; Jiangsu Center for Pharmacodynamics Research and Evaluation, China Pharmaceutical University, Nanjing 210009, China.
Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China; Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, China Pharmaceutical University, Nanjing 210009, China.
Chin J Nat Med. 2020 Mar;18(3):196-205. doi: 10.1016/S1875-5364(20)30021-2.
With the internationally growing popularity of traditional Chinese medicine (TCM), TCM-induced nephropathy has attracted public attention. Minimizing this toxicity is an important issue for future research. Typical nephrotoxic TCM drugs such as Aristolochic acid, Tripterygium wilfordii Hook. f, Rheum officinale Baill, and cinnabar mainly damage renal proximal tubules or cause interstitial nephritis. Transporters in renal proximal tubule are believed to be critical in the disposition of xenobiotics. In this review, we provide information on the alteration of renal transporters by nephrotoxic TCMs, which may be helpful for understanding the nephrotoxic mechanism of TCMs and reducing adverse effects. Studies have proven that when administering nephrotoxic TCMs, the expression or function of renal transporters is altered, especially organic anion transporter 1 and 3. The alteration of these transporters may enhance the accumulation of toxic drugs or the dysfunction of endogenous toxins and subsequently sensitize the kidney to injury. Transporters-related drug combination and clinical biomarkers supervision to avoid the risk of future toxicity are proposed.
随着传统中药（TCM）在国际上的日益普及，中药引起的肾病已引起公众关注。最大限度地减少这种毒性是未来研究的一个重要问题。马兜铃酸、雷公藤、大黄和朱砂等典型的肾毒性中药主要损伤肾近端小管或引起间质性肾炎。人们认为肾近端小管中的转运体在异生物质的处置中起关键作用。在这篇综述中，我们提供了有关肾毒性 TCM 改变肾转运体的信息，这可能有助于了解 TCM 的肾毒性机制并减少不良反应。研究已经证明，当给予肾毒性 TCM 时，肾转运体的表达或功能会发生改变，特别是有机阴离子转运体 1 和 3。这些转运体的改变可能会增强有毒药物的积累或内源性毒素的功能障碍，从而使肾脏更容易受到损伤。提出了与转运体相关的药物联合和临床生物标志物监测，以避免未来毒性的风险。
