China Department of Nephrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China.
Graduate School of Chinese Academy of Chinese Medical Sciences, Beijing, 100700, China.
Sci Rep. 2021 Sep 15;11(1):18338. doi: 10.1038/s41598-021-97137-2.
Jianpi Qushi Heluo Formula (JQHF) is an empirical traditional Chinese medicine prescription for treating Membranous Nephropathy (MN) clinically in China. The therapeutic effect of JQHF has been reported in our previous studies. However, the exact mechanism is still unknown. In this study, by establishing an experimental rat model of MN induced by Sheep anti-rat Fx1A serum, we evaluated the effects of JQHF and Tetrandrine (TET), and Benazepril was used as a positive control. As an autophagy agonist, TET is one of the most active components in JQHF. After 4 weeks, significant kidney damage was observed in the rats in the Model group; comparatively, JQHF markedly decreased 24 h urinary protein, Total Cholesterol (TC), and increased serum total Albumin (ALB). Histology showed that JQHF caused significant improvements in glomerular hyperplasia, renal tubular damage, IgG immune complex deposition, and the ultrastructure of mitochondria in MN rats. Flow cytometry analysis showed that treatment with JQHF reduced the level of reactive oxygen species and apoptosis rate, and upregulated mitochondrial membrane potential. Western blot analysis demonstrated that JQHF could protect against mitochondrial dysfunction and apoptosis by upregulating the expression of PINK1, Mitochondrial Parkin, and LC3-II/I, downregulating the expression of Cytoplasmic Parkin, P62, Cytochrome c, and Caspase-3 in the kidneys of MN rats. From images of co-immunofluorescence, it is observed significantly increase in the co-localization of PINK1 and Parkin, as well as LC3 and mitochondria. Similarly, TET treatment significantly upregulated the mitochondrial autophagy and reduced apoptosis in rats after 4 weeks compared with the model group. Comparatively, the ability of JQHF to alleviate renal damage was significantly higher than those of Benazepril and TET. It was demonstrated that JQHF could delay pathology damage to the kidney and hold back from the progression of MN by inhibiting apoptosis and upregulating the mitochondrial autophagy by PINK1/Parkin pathways.
健脾祛湿和络方(JQHF)是一种在中国临床上用于治疗膜性肾病(MN)的经验性中药方剂。我们之前的研究已经报道了 JQHF 的治疗效果。然而,确切的机制仍不清楚。在这项研究中,通过建立羊抗鼠 Fx1A 血清诱导的 MN 实验大鼠模型,我们评估了 JQHF 和汉防己甲素(TET)的作用,贝那普利作为阳性对照。作为自噬激动剂,TET 是 JQHF 中最活跃的成分之一。4 周后,模型组大鼠出现明显的肾脏损伤;相比之下,JQHF 显著降低了 24 小时尿蛋白、总胆固醇(TC),并增加了血清总白蛋白(ALB)。组织学显示 JQHF 使 MN 大鼠的肾小球增生、肾小管损伤、IgG 免疫复合物沉积和线粒体超微结构得到显著改善。流式细胞术分析表明,JQHF 可降低活性氧水平和细胞凋亡率,并上调线粒体膜电位。Western blot 分析表明,JQHF 通过上调 PINK1、线粒体 Parkin 和 LC3-II/I 的表达,下调细胞质 Parkin、P62、细胞色素 c 和 Caspase-3 的表达,可防止 MN 大鼠的线粒体功能障碍和细胞凋亡。从共免疫荧光图像中可以观察到 PINK1 和 Parkin 以及 LC3 和线粒体的共定位明显增加。同样,与模型组相比,TET 治疗可显著上调大鼠 4 周后线粒体自噬并减少细胞凋亡。相比之下,JQHF 缓解肾损伤的能力明显高于贝那普利和 TET。研究表明,JQHF 可通过抑制凋亡和上调 PINK1/Parkin 通路的线粒体自噬来延缓肾脏病理损伤并阻止 MN 的进展。