1.北京中医药大学 东直门医院,北京 100029
2.北京中医药大学 中医内科学教育部重点实验室, 北京 100029
3.北京普仁医院,北京 100062
张轶斐,在读博士,从事中西医结合治疗肾脏疾病的研究,E-mail:zyfzyy14@163.com
刘忠杰,博士,主任医师,从事中西医结合诊疗肾脏疾病相关研究,E-mail:zkliuzhongjie@126.com
刘伟敬,博士,研究员,主任医师,从事中西医结合诊疗肾脏疾病和内分泌疾病相关研究,E-mail:liuweijing-1977@hotmail.com;
收稿:2024-09-16,
录用:2024-11-19,
网络出版:2024-11-21,
纸质出版:2025-03-05
移动端阅览
张轶斐,白雪慧,曹梓静等.基于Nrf2/HO-1/NQO1信号通路探讨益肾通络方改善糖尿病肾脏病小鼠氧化应激损伤的机制[J].中国实验方剂学杂志,2025,31(05):41-51.
ZHANG Yifei,BAI Xuehui,CAO Zijing,et al.Yishen Tongluo Prescription Ameliorates Oxidative Stress Injury in Mouse Model of Diabetic Kidney Disease via Nrf2/HO-1/NQO1 Signaling Pathway[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(05):41-51.
张轶斐,白雪慧,曹梓静等.基于Nrf2/HO-1/NQO1信号通路探讨益肾通络方改善糖尿病肾脏病小鼠氧化应激损伤的机制[J].中国实验方剂学杂志,2025,31(05):41-51. DOI: 10.13422/j.cnki.syfjx.20241801.
ZHANG Yifei,BAI Xuehui,CAO Zijing,et al.Yishen Tongluo Prescription Ameliorates Oxidative Stress Injury in Mouse Model of Diabetic Kidney Disease via Nrf2/HO-1/NQO1 Signaling Pathway[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(05):41-51. DOI: 10.13422/j.cnki.syfjx.20241801.
目的
2
基于核因子E
2
相关因子2/血红素加氧酶-1/NAD(P)H醌还原酶1(Nrf2/HO-1/NQO1)信号通路,探讨益肾通络方对糖尿病肾脏病(DKD)小鼠氧化应激损伤的干预作用及机制。
方法
2
采用SPF级雄性C57BL/6小鼠进行研究,分为正常组10只,造模组50只,采用腹腔注射链脲佐菌素(STZ)建立DKD模型。造模组随机分为模型组、司美格鲁肽组(40 μg·kg
-1
)、益肾通络方高、中、低剂量组(18.2、9.1、4.55 g·kg
-1
),每组10只,连续给药12周。留取标本后测定小鼠血糖、24 h尿蛋白;计算肾脏指数(KI);检测肌酐(SCr)、尿素氮(BUN)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST);苏木素-伊红(HE)、过碘酸-希夫(PAS)、过碘酸-六胺银(PASM)、马松(Masson)染色观察各组肾组织病理改变;酶联免疫吸附测定法(ELISA)试剂盒检测
β
2
-微球蛋白(
β
2
-MG)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)、肝脂肪酸结合蛋白(L-FABP)、一氧化氮合酶(NOS)、谷胱甘肽(GSH)、总抗氧化能力(T-AOC)和8-羟基脱氧鸟苷(8-OHdG)表达水平;免疫组化染色观察Kelch样环氧氯丙烷相关蛋白1(Keap1)、丙二醛(MDA)蛋白表达;实时荧光定量聚合酶链式反应(Real-time PCR)和蛋白免疫印迹法(Western blot)检测Nrf2/HO-1/NQO1 mRNA和蛋白表达水平。
结果
2
与正常组比较,DKD模型组小鼠血糖、24 h尿蛋白水平、KI、SCr、BUN、ALT升高,肾小球肥大、肾小管扩张、基底膜增厚、系膜增生、胶原沉积,
β
2-MG、NGAL、KIM-1、L-FABP水平增高,NOS、8-OHdG水平升高,GSH、T-AOC水平降低,MDA、Keap1表达增多,Nrf2、HO-1、NQO1、GCLC均表达降低(
P
<
0.05);与模型组比较,司美格鲁肽及益肾通络方组中、高剂量组血糖、24 h尿蛋白水平、KI、SCr、BUN、ALT降低,肾组织病理损伤有不同程度的改善,
β
2-MG、NGAL、KIM-1、L-FABP表达降低,NOS、8-OHdG水平降低,GSH、T-AOC水平升高,MDA、Keap1表达减少,Nrf2、HO-1、NQO1、GCLC表达增加(
P
<
0.05)。
结论
2
益肾通络方可调控Nrf2/HO-1/NQO1信号通路对抗氧化应激,减轻肾小管损伤,从而实现DKD的肾脏保护作用。
Objective
2
To investigate the effect and mechanism of Yishen Tongluo prescription in protecting mice from oxidative stress injury in diabetic kidney disease (DKD) via the nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1)/NAD(P)H quinone oxidoreductase 1 (NQO1) signaling pathway.
Methods
2
Specific pathogen-free (SPF) male C57BL/6 mice were assigned into a control group (
n
=10) and a modeling group (
n
=50). The DKD model was established by intraperitoneal injection of streptozotocin. The mice in the modeling group were randomized into a model group, a semaglutide (40 μg·kg
-1
) group, and high-, medium-, and low-dose (18.2, 9.1, 4.55 g·kg
-1
, respectively) Yishen Tongluo prescription groups, with 10 mice in each group. The treatment lasted for 12 weeks. Blood glucose and 24-h urine protein levels were measured, and the kidney index (KI) was calculated. Serum levels of creatinine (SCr), blood urea nitrogen (BUN), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were assessed. The pathological changes in the renal tissue were evaluated by hematoxylin-eosin, periodic acid-Schiff, periodic acid-silver methenamine, and Masson’s trichrome staining. Enzyme-linked immunosorbent assay kits were used to measure the levels of
β
2-microglobulin (
β
2-MG), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver fatty acid-binding protein (L-FABP), nitric oxide synthase (NOS), glutathione (GSH), total antioxidant capacity (T-AOC), and 8-hydroxy-2'-deoxyguanosine (8-OHdG). Immunohistochemical staining was performed to examine the expression of Kelch-like ECH-associated protein 1 (Keap1) and malondialdehyde (MDA). Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot were employed to determine the mRNA and protein levels, respectively, of factors in the Nrf2/HO-1/NQO1 signaling pathway.
Results
2
Compared with the control group, the DKD model group showed rises in blood glucose, 24-h urine protein, KI, SCr, BUN, and ALT levels, along with glomerular hypertrophy, renal tubular dilation, thickened basement membrane, mesangial expansion, and collagen deposition. Additionally, the model group showed elevated levels of
β
2-MG, NGAL, KIM-1, L-FABP, NOS, and 8-OHdG, lowered levels of GSH and T-AOC, up-regulated expression of MDA and Keap1, and down-regulated expression of Nrf2, HO-1, NQO1, and glutamate-cysteine ligase catalytic subunit (GCLC) (
P
<
0.05). Compared with the model group, the semaglutide group and the medium- and high-dose Yishen Tongluo prescription groups showed reductions in blood glucose, 24-h urine protein, KI, SCr, BUN, and ALT levels, along with alleviated pathological injuries in the renal tissue. In addition, the three groups showed lowered levels of
β
2-MG, NGAL, KIM-1, L-FABP, NOS, and 8-OHdG, elevated levels of GSH and T-AOC, down-regulated expression of MDA and Keap1, and up-regulated expression of Nrf2, HO-1, NQO1, and GCLC (
P
<
0.05).
Conclusion
2
Yishen Tongluo prescription exerts renoprotective effects in the mouse model of DKD by modulating the Nrf2/HO-1/NQO1 signaling pathway, mitigating oxidative stress, and reducing renal tubular injuries.
SAEEDI P , PETERSOHN I , SALPEA P , et al . Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045:Results from the International Diabetes Federation Diabetes Atlas,9 th edition [J]. Diabetes Res Clin Pract , 2019 , 157 : 107843 .
ZHANG L , LONG J , JIANG W , et al . Trends in chronic kidney disease in China [J]. N Engl J Med , 2016 , 375 ( 9 ): 905 - 906 .
YANG C , WANG H , ZHAO X , et al . CKD in China:Evolving spectrum and public health implications [J]. Am J Kidney Dis , 2020 , 76 ( 2 ): 258 - 264 .
中华医学会肾脏病学分会专家组 . 糖尿病肾脏疾病临床诊疗中国指南 [J]. 中华肾脏病杂志 , 2021 , 37 ( 3 ): 50 .
Expert Group of Chinese Society of Nephrology . Chinese guidelines for diagnosis and treatment of diabetic kidney disease [J]. Chin J Nephrol , 2021 , 37 ( 3 ): 50 .
TUTTLE K R , AGARWAL R , ALPERS C E , et al . Molecular mechanisms and therapeutic targets for diabetic kidney disease [J]. Kidney Int , 2022 , 102 ( 2 ): 248 - 260 .
IMPRIALOS K P , STAVROPOULOS K , DOUMAS M . Liraglutide and renal outcomes in type 2 diabetes [J]. N Engl J Med , 2017 , 377 ( 22 ): 2196 .
YAO L , LIANG X , WANG P . Therapeutic perspective:Evolving evidence of nonsteroidal mineralocorticoid receptor antagonists in diabetic kidney disease [J]. Am J Physiol Endocrinol Metab , 2023 , 324 ( 6 ): E531 - e41 .
WINIARSKA A , KNYSAK M , NABRDALIK K , et al . Inflammation and oxidative stress in diabetic kidney disease:The targets for SGLT2 inhibitors and GLP-1 receptor agonists [J]. Int J Mol Sci , 2021 , 22 ( 19 ): 10822 .
MA Q . Role of Nrf2 in oxidative stress and toxicity [J]. Annu Rev Pharmacol Toxicol , 2013 , 53 : 401 - 426 .
中华中医药学会 , 北京中医药大学东直门医院 , 北京中医药大学 . 糖尿病肾脏疾病中西医结合诊疗指南 [J]. 北京中医药大学学报 , 2024 , 47 ( 4 ): 580 - 592 .
China Association of Chinese Medicine , Dongzhimen Hospital of Beijing University of Chinese Medicine , Beijing University of Chinese Medicine . Diagnosis and treatment guideline of integrated traditional Chinese and western medicine for diabetic kidney disease [J]. J Beijing Univ Chin Med , 2024 , 47 ( 4 ): 580 - 592 .
QIYAN Z , ZHANG X , GUO J , et al . JinChan YiShen TongLuo Formula ameliorate mitochondrial dysfunction and apoptosis in diabetic nephropathy through the HIF-1 α -PINK1-Parkin pathway [J]. J Ethnopharmacol , 2024 , 328 : 117863 .
贾奇 , 邓健锟 , 冯振东 , 等 . 蝉花通过抑制肾小管NADPH氧化酶/氧化应激治疗糖尿病肾病的研究 [J]. 中国中西医结合肾病杂志 , 2018 , 19 ( 12 ): 5 .
JIA Q , DENG J K , FENG Z D . et al.Cordyceps sobolifera mycelium treats diabetic nephropathy by suppressing NADPH oxidase/oxidative stress in renal tubules [J]. Chin J Integr Tradit West Nephrol , 2018 , 19 ( 12 ): 5 .
赵伟 , 孙国志 . 不同种实验动物间用药量换算 [J]. 畜牧兽医科技信息 , 2010 , 5 : 52 - 53 .
ZHAO W , SUN G Z . Dose conversion among different experimental animals [J]. Anim Husb Vet Sci Technol Inf , 2010 , 5 : 52 - 53 .
章溥 , 梁建庆 , 杨霞 , 等 . 大黄糖络丸调控AGEs/RAGE/IKK/NF- κ B通路改善糖尿病肾病小鼠肾脏炎症损伤的机制 [J]. 中国实验方剂学杂志 , 2024 , 30 ( 20 ): 77 - 85 .
ZHANG P , LIANG J Q , YANG X , et al . Mechanism of Dahuang Tangluo pill in improving renal inflammatory injury in diabetic kidkdey disease by regulating AGEs/RAGE/IKK/NF- κ B pathway [J]. Chin J Exp Tradit Med Form , 2024 , 30 ( 20 ): 77 - 85 .
MARTINS F F , SANTOS-REIS T , MARINHO T S , et al . Hypothalamic anorexigenic signaling pathways (leptin,amylin,and proopiomelanocortin) are semaglutide (GLP-1 analog) targets in obesity control in mice [J]. Life Sci , 2023 , 313 : 121268 .
上海市肾内科临床质量控制中心专家组 . 慢性肾脏病早期筛查,诊断及防治指南(2022年版) [J]. 中华肾脏病杂志 , 2022 , 38 ( 5 ): 12 .
Expert Group on Kidney Clinical Quality Control Center in Shanghai . Guidelines for early SCreening,diagnosis,prevention and treatment of chronic kidney disease (2022 Edition) [J]. Chin J Nephrol , 2022 , 38 ( 5 ): 453 - 464 .
SHEN Q , FANG J , GUO H , et al . Astragaloside IV attenuates podocyte apoptosis through ameliorating mitochondrial dysfunction by up-regulated Nrf2-ARE/TFAM signaling in diabetic kidney disease [J]. Free Radic Biol Med , 2023 , 203 : 45 - 57 .
张璇 , 姜睿斌 , 张晓菊 , 等 . 基于NF- κ B通路研究生地黄-玄参对糖尿病肾病大鼠肾脏微炎症状态的影响 [J]. 国际中医中药杂志 , 2022 , 44 ( 1 ): 7 .
ZHANG X , JIANG R B , ZHANG X J , et al . Effects of Rehmannia glutinosa and Scrophularia ningpoensis on renal microinflammatory state in diabetic nephropathy rats based on the NF- κ B pathway [J]. Int J Tradit Chin Med , 2022 , 44 ( 1 ): 7 .
王文文 , 程锦国 . 温莪术对大鼠肾间质纤维化的保护作用及其机制研究 [J]. 中华中医药学刊 , 2014 , 32 ( 1 ): 4 .
WANG W W , CHENG J G . Protective effects and mechanism of curcuma Wenyujin on renal interstitial fibrosis in rats [J]. J Chin Med , 2014 , 32 ( 1 ): 4 .
魏升 , 钟光辉 , 曹晓丹 . 加味消癥方对慢性肾衰竭大鼠肾纤维化的保护作用及对肾小管上皮细胞TGF- β 1 /Smad3信号通路的影响 [J]. 中国中西医结合肾病杂志 , 2024 , 25 ( 5 ): 386 - 391, 后插1.
WEI S , ZHONG G H , CAO X D . Protective effects of modified xiaozheng decoction on renal fibrosis in rats with chronic renal failure and its influence on TGF- β 1 /Smad3 signaling pathway in renal tubular epithelial cells [J]. Chin J Integr Tradit West Nephrol , 2024 , 25 ( 5 ): 386 - 391, insert 1.
HAN J , ZUO Z , SHI X , et al . Hirudin ameliorates diabetic nephropathy by inhibiting Gsdmd-mediated pyroptosis [J]. Cell Biol Toxicol , 2023 , 39 ( 3 ): 573 - 589 .
陈明环 , 王咏兰 , 李相国 , 等 . 鬼箭羽醇提取物通过阻止氧化应激和抑制TNF- α -NF- κ B及T β R1-Smad2/3通路减轻兔肾缺血再灌注损伤 [J]. 中国病理生理杂志 , 2022 , 38 ( 4 ): 10 .
CHEN M H , WANG Y L , LI X G , et al . Ethanol Extract of Euonymus alatus alleviates renal ischemia-reperfusion injury in rabbits by blocking oxidative stress and inhibiting the TNF- α -NF- κ B and T β R1-Smad2/3 pathways [J]. Chin J Pathophysiol , 2022 , 38 ( 4 ): 10 .
WEN D , TAN R Z , ZHAO C Y , et al . Astragalus mongholicus Bunge and Panax notoginseng (Burkill) F.H.Chen formula for renal injury in diabetic nephropathy- in vivo and in vitro evidence for autophagy regulation [J]. Front Pharmacol , 2020 , 11 : 732 .
WANG X , REN L , HUANG Y , et al . The role of tubulointerstitial markers in differential diagnosis and prognosis in patients with type 2 diabetes and biopsy proven diabetic kidney disease [J]. Clin Chim Acta , 2023 , 547 : 117448 .
MORI Y , AJAY A K , CHANG J H , et al . KIM-1 mediates fatty acid uptake by renal tubular cells to promote progressive diabetic kidney disease [J]. Cell Metab , 2021 , 33 ( 5 ): 1042 - 1061.e7 .
DUAN S , CHEN J , WU L , et al . Assessment of urinary NGAL for differential diagnosis and progression of diabetic kidney disease [J]. J Diabetes Complications , 2020 , 34 ( 10 ): 107665 .
TANABE J , OGURA Y , NAKABAYASHI M , et al . The possibility of urinary liver-type fatty acid-binding protein as a biomarker of renal hypoxia in spontaneously diabetic torii fatty rats [J]. Kidney Blood Press Res , 2019 , 44 ( 6 ): 1476 - 1492 .
TANASE D M , GOSAV E M , ANTON M I , et al . Oxidative stress and NRF2/KEAP1/ARE pathway in diabetic kidney disease (DKD):New perspectives [J]. Biomolecules , 2022 , 12 ( 9 ): 1227 .
DUAN S , LU F , SONG D , et al . Current challenges and future perspectives of renal tubular dysfunction in diabetic kidney disease [J]. Front Endocrinol (Lausanne) , 2021 , 12 : 661185 .
YAO L , LIANG X , QIAO Y , et al . Mitochondrial dysfunction in diabetic tubulopathy [J]. Metabolism , 2022 , 131 : 155195 .
CARLSTRÖM M . Nitric oxide signalling in kidney regulation and cardiometabolic health [J]. Nat Rev Nephrol , 2021 , 17 ( 9 ): 575 - 90 .
DEL RIO D , STEWART A J , PELLEGRINI N . A review of recent studies on malondialdehyde as toxic molecule and biological marker of oxidative stress [J]. Nutr Metab Cardiovasc Dis , 2005 , 15 ( 4 ): 316 - 28 .
KLATT P , LAMAS S . Regulation of protein function by S -glutathiolation in response to oxidative and nitrosative stress [J]. Eur J Biochem , 2000 , 267 ( 16 ): 4928 - 4944 .
CORTESE-KROTT M M , SUSCHEK C V , WETZEL W , et al . Nitric oxide-mediated protection of endothelial cells from hydrogen peroxide is mediated by intracellular zinc and glutathione [J]. Am J Physiol Cell Physiol , 2009 , 296 ( 4 ): C811 - C820 .
GRAILLE M , WILD P , SAUVAIN J J , et al . Urinary 8-OHdG as a biomarker for oxidative stress:A systematic literature review and Meta-analysis [J]. Int J Mol Sci , 2020 , 21 ( 11 ): 3743 .
DE ALMEIDA A , DE OLIVEIRA J , DA SILVA PONTES L V , et al . ROS:Basic concepts,sources,cellular signaling,and its implications in aging pathways [J]. Oxid Med Cell Longev , 2022 , 2022 : 1225578 .
FRAGA C G , OTEIZA P I , GALLEANO M . In vitro measurements and interpretation of total antioxidant capacity [J]. Biochim Biophys Acta , 2014 , 1840 ( 2 ): 931 - 934 .
LOBODA A , DAMULEWICZ M , PYZA E , et al . Role of Nrf2/HO-1 system in development,oxidative stress response and diseases:an evolutionarily conserved mechanism [J]. Cell Mol Life Sci , 2016 , 73 ( 17 ): 3221 - 3247 .
BELLEZZA I , GIAMBANCO I , MINELLI A , et al . Nrf2-Keap1 signaling in oxidative and reductive stress [J]. Biochim Biophys Acta Mol Cell Res , 2018 , 1865 ( 5 ): 721 - 33 .
ROSS D , SIEGEL D . The diverse functionality of NQO1 and its roles in redox control [J]. Redox Biol , 2021 , 41 : 101950 .
LU S C . Regulation of glutathione synthesis [J]. Mol Aspects Med , 2009 , 30 ( 1/2 ): 42 - 59 .
0
浏览量
184
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621
