Wang Yisu, Chen Baifan, Zhang Jinghong, Wang Dan, Ruan Yuan
Department of Endocrinology, Zhejiang Hospital, Hangzhou, China.
Department of Endocrinology, The First People's Hospital of Pinghu, Pinghu, China.
Planta Med. 2024 Dec;90(15):1100-1114. doi: 10.1055/a-2432-2732. Epub 2024 Oct 2.
Mulberry leaf polysaccharides (MLPs) have a variety of biological activities. Preliminary scattered evidence of preclinical studies have reported their potenzial effects on diabetic kidney disease (DKD). Here, we intended to assess the preclinical evidence of MLPs and explore their potenzial mechanisms on DKD, offering a scientific reference for the therapeutic use of MLPs. The study has been registered under the CRD42022309117 registration number at PROSPERO. Comprehensive search was conducted across eight databases from their establishment till January 2024, and eight studies with 270 animals were included in the meta-analysis. The primary outcome measurements in the MLP group, including serum creatinine (Scr) (P = 0.0005), blood urea nitrogen (BUN) (P = 0.02), 24-hour urinary protein (UP) (P = 0.001), and urinary microalbumin (UAlb) (P < 0.0001), were significantly reduced compared to the control group. Additionally, MLP treatment was significantly correlated with fasting blood glucose (FBG), total cholesterol (TC), protein expression of TGF-1, CTGF mRNA, and the kidney index (all P values < 0.05) and delayed the progression of local pathological changes in the kidney. Subgroup analysis revealed significant species differences in the efficacy of MLPs. Also, it showed that the dosage of streptozotocin potenzially affected the Scr and UAlb results, while the duration of MLP treatment influenced UAlb results. MLPs may exert potenzial renal protection by delaying renal fibrosis, inhibiting inflammatory reactions, suppressing the growth hormone-insulin-like growth factor-insulin-like growth factor binding protein axis, and regulating the insulin receptor pathway. In summary, MLPs have multifaceted renal protective effects, suggesting their potenzial for treating DKD.
桑叶多糖（MLPs）具有多种生物活性。临床前研究的初步零散证据报道了它们对糖尿病肾病（DKD）的潜在作用。在此，我们旨在评估MLPs的临床前证据，并探索其对DKD的潜在作用机制，为MLPs的治疗应用提供科学参考。该研究已在PROSPERO以CRD42022309117注册号注册。从八个数据库建立至2024年1月进行了全面检索，荟萃分析纳入了八项研究共270只动物。与对照组相比，MLP组的主要结局指标，包括血清肌酐（Scr）（P = 0.0005）、血尿素氮（BUN）（P = 0.02）、24小时尿蛋白（UP）（P = 0.001）和尿微量白蛋白（UAlb）（P < 0.0001）均显著降低。此外，MLP治疗与空腹血糖（FBG）、总胆固醇（TC）、TGF-1蛋白表达、CTGF mRNA以及肾脏指数均显著相关（所有P值< 0.05），并延缓了肾脏局部病理变化的进展。亚组分析显示MLPs的疗效存在显著的物种差异。此外，结果表明链脲佐菌素的剂量可能影响Scr和UAlb结果，而MLP治疗的持续时间影响UAlb结果。MLPs可能通过延缓肾纤维化、抑制炎症反应、抑制生长激素-胰岛素样生长因子-胰岛素样生长因子结合蛋白轴以及调节胰岛素受体途径发挥潜在的肾脏保护作用。总之，MLPs具有多方面的肾脏保护作用，表明其在治疗DKD方面的潜力。
