Chen Xiao-Mei, Lin Gui-Xuan, Wang Xue, Ma Hong-Yan, Wang Ru-Shang, Wang Shu-Mei, Tang Dan
Key Laboratory of Digital Quality Evaluation of Chinese Materia Medica of State Administration of TCM and Engineering & Technology Research Center for Chinese Materia Medica Quality of Guangdong Province, Guangdong Pharmaceutical University, Guangzhou, 510006, China.
Institute of Consun Co. for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, Guangzhou, 510530, China.
J Ethnopharmacol. 2023 Feb 10;302(Pt A):115860. doi: 10.1016/j.jep.2022.115860. Epub 2022 Oct 29.
Ginseng is one of the most widely used herbs in the world for the treatment of various diseases, and ginsenoside is the representative bioactive component in ginseng. There have been many in vivo studies on ginsenoside for the treatment of diabetic nephropathy (DN), the most common diabetic microvascular complication and the main cause of diabetic morbidity and mortality.
The purpose of this study is to evaluate the efficacy of ginsenosides on DN by preclinical evidence and meta-analysis. Meanwhile, the main possible action mechanisms of ginsenosides against DN were also summarized.
We systematically searched PubMed, WOS, Embase, Cochrane, WanFang, Cqvip, CNKI and CBM databases from January 1, 2000, to November 15, 2021, to evaluate the animal experiments of ginsenosides for the treatment of DN. Finally, 30 animal experiments were included. Twelve outcome measures, including renal function indicators (24-h urine protein, serum creatinine, urea nitrogen, creatinine clearance, uric acid, urinary albumin to creatinine ratio), oxidative stress biomarkers (GPX, MDA, SOD), inflammatory factors (IL-1, IL-6, TNF-α) were obtained by using RevMan 5.4 software for meta-analysis.
The results showed that except for no significant difference in CCr, other indicators such as 24h UP, SCr, blood urea nitrogen, uric acid and UACR were significantly decreased. It showed that ginsenoside could improve renal function in diabetes. Meanwhile ginsenoside significantly up-regulated antioxidant enzymes SOD and GPX, down-regulated MDA and inflammatory factors IL-1, IL-6 and TNF-α, indicating that ginsenoside may have antioxidant and anti-inflammatory effects.
Ginsenoside can protect against the renal failure in diabetes through anti-inflammation, anti-oxidation, anti-renal fibrosis, anti-apoptosis/pyroptosis, regulation of blood glucose/lipid metabolism, etc. Which provides preclinical evidence for the application of ginsenoside in the treatment of DN.
人参是世界上治疗各种疾病应用最广泛的草药之一,人参皂苷是人参中的代表性生物活性成分。关于人参皂苷治疗糖尿病肾病(DN)已有许多体内研究,糖尿病肾病是最常见的糖尿病微血管并发症,也是糖尿病发病和死亡的主要原因。
本研究旨在通过临床前证据和荟萃分析评估人参皂苷对糖尿病肾病的疗效。同时,还总结了人参皂苷抗糖尿病肾病的主要可能作用机制。
我们系统检索了2000年1月1日至2021年11月15日期间的PubMed、WOS、Embase、Cochrane、万方、维普、知网和中国生物医学文献数据库,以评估人参皂苷治疗糖尿病肾病的动物实验。最终纳入30项动物实验。使用RevMan 5.4软件进行荟萃分析,获得了12项结局指标,包括肾功能指标(24小时尿蛋白、血清肌酐、尿素氮、肌酐清除率、尿酸、尿白蛋白与肌酐比值)、氧化应激生物标志物(谷胱甘肽过氧化物酶、丙二醛、超氧化物歧化酶)、炎症因子(白细胞介素-1、白细胞介素-6、肿瘤坏死因子-α)。
结果显示,除肌酐清除率无显著差异外,24小时尿蛋白、血清肌酐、血尿素氮、尿酸和尿白蛋白与肌酐比值等其他指标均显著降低。表明人参皂苷可改善糖尿病患者的肾功能。同时,人参皂苷显著上调抗氧化酶超氧化物歧化酶和谷胱甘肽过氧化物酶,下调丙二醛和炎症因子白细胞介素-1、白细胞介素-6和肿瘤坏死因子-α,表明人参皂苷可能具有抗氧化和抗炎作用。
人参皂苷可通过抗炎、抗氧化、抗肾纤维化、抗凋亡/焦亡、调节血糖/脂质代谢等作用预防糖尿病肾病。这为人参皂苷在糖尿病肾病治疗中的应用提供了临床前证据。