Song Lixia, Wang Ke, Yin Jianying, Yang Yiqi, Li Bo, Zhang Dongxing, Wang Hong, Wang Weixuan, Zhan Wenjing, Guo Caijuan, Gu Zhanhui, Wang Lexun, Zeng Zhihuan, Bei Weijian, Rong Xianglu, Guo Jiao
Guangdong Metabolic Disease Research Center of Integrated Chinese and Western Medicine, Guangdong, China.
Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangdong, China.
Chin Med. 2022 Aug 30;17(1):102. doi: 10.1186/s13020-022-00648-x.
Renal injury is one of the common microvascular complications of diabetes, known as diabetic kidney disease (DKD) seriously threatening human health. Previous research has reported that the Chinese Medicine Fufang-Zhenzhu-Tiaozhi (FTZ) capsule protected myocardia from injury in diabetic minipigs with coronary heart disease (DM-CHD). And we found significant renal injury in the minipigs. Therefore, we further investigated whether FTZ prevents renal injury of DM-CHD minipig and HO-induced oxidative injury of HK-2 cells.
DM-CHD model was established by streptozotocin injection, high fat/high-sucrose/high-cholesterol diet combined with balloon injury in the coronary artery. Blood lipid profile, fasting blood glucose (FBG), and SOD were measured with kits. The levels of blood urea nitrogen (BUN), serum creatinine (Scr), urine trace albumin (UALB), urine creatinine (UCR) (calculate UACR), cystatin (Cys-C), and β-microglobulin (β-MG) were measured by ELISA kits to evaluate renal function. TUNEL assay was performed to observe the apoptosis. qPCR was used to detect the mRNA expression levels of HO-1, NQO1, and SOD in kidney tissue. The protein expressions of Nrf2, HO-1, NQO1, Bax, Bcl-2, and Caspase 3 in the kidney tissue and HK-2 cells were detected by western blot. Meanwhile, HK-2 cells were induced by HO to establish an oxidative stress injury model to verify the protective effect and mechanisms of FTZ.
In DM-CHD minipigs, blood lipid profile and FBG were elevated significantly, and the renal function was decreased with the increase of BUN, Scr, UACR, Cys-c, and β-MG. A large number of inflammatory and apoptotic cells in the kidney were observed accompanied with lower levels of SOD, Bcl-2, Nrf2, HO-1, and NQO1, but high levels of Bax and Cleaved-caspase 3. FTZ alleviated glucose-lipid metabolic disorders and the pathological morphology of the kidney. The renal function was improved and the apoptotic cells were reduced by FTZ administration. FTZ could also enhance the levels of SOD, Nrf2, HO-1, and NQO1 proteins to promote antioxidant effect, down-regulate the expression of Bax and Caspase3, as well as up-regulate the expression of Bcl-2 to inhibit cell apoptosis in the kidney tissue and HK-2 cells.
We concluded that FTZ prevents renal injury of DM-CHD through activating anti-oxidative capacity to reduce apoptosis and inhibiting inflammation, which may be a new candidate for DKD treatment.
肾损伤是糖尿病常见的微血管并发症之一,即糖尿病肾病(DKD),严重威胁人类健康。先前的研究报道,中药复方珍珠调脂(FTZ)胶囊可保护患有冠心病的糖尿病小型猪(DM-CHD)的心肌免受损伤。并且我们发现这些小型猪存在明显的肾损伤。因此,我们进一步研究FTZ是否能预防DM-CHD小型猪的肾损伤以及HO诱导的HK-2细胞氧化损伤。
通过链脲佐菌素注射、高脂/高糖/高胆固醇饮食并结合冠状动脉球囊损伤建立DM-CHD模型。使用试剂盒检测血脂谱、空腹血糖(FBG)和超氧化物歧化酶(SOD)。通过酶联免疫吸附测定试剂盒检测血尿素氮(BUN)、血清肌酐(Scr)、尿微量白蛋白(UALB)、尿肌酐(UCR)(计算尿白蛋白肌酐比值UACR)、胱抑素(Cys-C)和β-微球蛋白(β-MG)的水平,以评估肾功能。进行TUNEL检测以观察细胞凋亡情况。采用qPCR检测肾组织中HO-1、NQO1和SOD的mRNA表达水平。通过蛋白质免疫印迹法检测肾组织和HK-2细胞中Nrf2、HO-1、NQO1、Bax、Bcl-2和Caspase 3的蛋白表达。同时,用HO诱导HK-2细胞建立氧化应激损伤模型,以验证FTZ的保护作用及机制。
在DM-CHD小型猪中,血脂谱和FBG显著升高,随着BUN、Scr、UACR、Cys-c和β-MG的升高,肾功能下降。观察到肾内有大量炎性和凋亡细胞,同时SOD、Bcl-2、Nrf2、HO-1和NQO1水平较低,但Bax和裂解的Caspase 3水平较高。FTZ减轻了糖脂代谢紊乱和肾脏的病理形态学改变。给予FTZ可改善肾功能并减少凋亡细胞。FTZ还可提高SOD、Nrf2、HO-1和NQO1蛋白水平以促进抗氧化作用,下调Bax和Caspase3的表达,并上调Bcl-2的表达,从而抑制肾组织和HK-2细胞中的细胞凋亡。
我们得出结论,FTZ通过激活抗氧化能力以减少细胞凋亡和抑制炎症来预防DM-CHD的肾损伤,这可能是DKD治疗的一种新候选药物。