1.河北中医药大学 研究生院,石家庄 050000
2.河北中医药大学 第一附属医院,石家庄 050000
3.河北省脾肾病证中医治疗技术创新中心,石家庄 050000
侯露瑜,在读博士,从事中医药治疗肾脏病的研究,E-mail:houluyu2021@163.com
郭登洲,教授,博士生导师,从事中医药治疗肾脏病研究,E-mail:guodengzhou@sohu.com
收稿:2025-08-31,
修回:2025-10-13,
录用:2025-10-23,
网络首发:2025-10-30,
纸质出版:2026-03-20
移动端阅览
侯露瑜,郑琳琳,石文婧等.当归芍药散通过调节db/db小鼠肾脏巨噬细胞极化减轻糖尿病肾病炎症反应的作用机制[J].中国实验方剂学杂志,2026,32(06):1-10.
HOU Luyu,ZHENG Linlin,SHI Wenjing,et al.Mechanism of Dangui Shaoyaosan in Alleviating Inflammatory Responses in Diabetic Kidney Disease by Modulating Macrophage Polarization in Kidneys of db/db Mice[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(06):1-10.
侯露瑜,郑琳琳,石文婧等.当归芍药散通过调节db/db小鼠肾脏巨噬细胞极化减轻糖尿病肾病炎症反应的作用机制[J].中国实验方剂学杂志,2026,32(06):1-10. DOI: 10.13422/j.cnki.syfjx.20252302.
HOU Luyu,ZHENG Linlin,SHI Wenjing,et al.Mechanism of Dangui Shaoyaosan in Alleviating Inflammatory Responses in Diabetic Kidney Disease by Modulating Macrophage Polarization in Kidneys of db/db Mice[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(06):1-10. DOI: 10.13422/j.cnki.syfjx.20252302.
目的
2
观察当归芍药散对糖尿病肾病(DKD)模型db/db小鼠巨噬细胞极化及肾脏炎症的影响,探讨当归芍药散对db/db小鼠的肾脏保护作用及机制。
方法
2
将8只db/m小鼠设为正常组,40只db/db小鼠随机分为模型组,当归芍药散低、中、高剂量组(8.39、16.77、33.54 g·kg
-1
),厄贝沙坦组(0.025 g·kg
-1
)连续灌胃12周,观察小鼠一般状态,干预12周末,代谢笼留取各组小鼠24 h尿液后麻醉小鼠取材,摘眼球取血后离心取上清,检测糖化血清蛋白(GSP)、血清肌酐(SCr)、尿素氮(BUN)、总胆固醇(TC)、甘油三酯(TG)水平;检测小鼠尿微量白蛋白与尿肌酐比值(UACR)水平;苏木素-伊红(HE)染色、过碘酸-希夫反应(PAS)、马松(Masson)染色观察肾组织病理改变;酶联免疫吸附测定法(ELISA)检测小鼠血清肿瘤坏死因子-
α
(TNF-
α
)、白细胞介素-10(IL-10)、单核细胞趋化蛋白-1(MCP-1)水平;免疫荧光法(IF)检测小鼠肾组织F4/80表达水平;免疫组化法(IHC)检测小鼠肾组织CD206表达水平;实时荧光定量聚合酶链式反应(Reai-time PCR)检测小鼠肾组织TNF-
α
、IL-10、诱导型一氧化氮合酶(iNOS)、精氨酸酶-1(Arg-1)表达水平;蛋白免疫印迹法(Western blot)检测小鼠肾组织iNOS、Arg-1、CD86、CD206蛋白表达。
结果
2
与正常组比较,模型组小鼠GSP、UACR、SCr、BUN、TC、TG升高,炎症因子TNF-
α
、趋化因子MCP-1水平升高,IL-10水平降低(
P
<
0.01),肾小球肥大,系膜细胞增殖,系膜区域明显扩张,可见炎性细胞浸润,肾小管上皮细胞空泡样变性,糖原沉积明显,胶原纤维沉积增多,F4/80相对荧光强度增强,CD206在肾小球及肾间质表达减少,TNF-
α
、iNOS mRNA表达增加,IL-10、Arg-1 mRNA表达降低,iNOS、CD86蛋白表达增加,Arg-1、CD206蛋白表达降低(
P
<
0.05,
P
<
0.01)。与模型组比较,当归芍药散组及厄贝沙坦组小鼠GSP、UACR、SCr、BUN、TC、TG水平下降,血清TNF-
α
、MCP-1水平下降,IL-10水平升高,肾组织病理学损伤可见不同程度改善,F4/80相对荧光强度减弱,CD206在肾小球及肾间质表达增加,TNF-
α
、iNOS mRNA表达降低,IL-10、Arg-1 mRNA表达增加,iNOS、CD86蛋白表达下降,Arg-1、CD206蛋白表达增加(
P
<
0.05,
P
<
0.01)。
结论
2
当归芍药散能改善db/db小鼠肾功能,减轻肾脏病理损伤,其机制可能与抑制M1型促炎巨噬细胞极化,促进M2型抗炎巨噬细胞极化,减轻炎症反应,延缓肾脏纤维化进展,改善肾脏病理损伤,发挥肾脏保护作用有关。
Objective
2
To observe the effects of Danggui Shaoyaosan on macrophage polarization and renal inflammation in db/db mice with diabetic kidney disease (DKD), and to explore its renal protective effects and underlying mechanisms.
Methods
2
Eight db/m mice were assigned to the normal group, and forty db/db
mice were randomly divided into a model group, low-, medium-, and high-dose Danggui Shaoyaosan groups (8.39, 16.77, 33.54 g·kg
-1
), and an irbesartan group (0.025 g·kg
-1
). All mice were administered treatment by gavage for 12 consecutive weeks. General conditions of the mice were observed during the intervention. At the end of the 12-week intervention, 24-h urine samples were collected using metabolic cages, after which the mice were anesthetized for sample collection. Blood was collected by enucleation and centrifuged to obtain serum for the determination of glycated serum protein (GSP), serum creatinine (SCr), blood urea nitrogen (BUN), total cholesterol (TC), and triglycerides (TG). The urinary albumin-to-creatinine ratio (UACR) was measured. Renal pathological changes were observed using hematoxylin-eosin (HE) staining, periodic acid-Schiff (PAS) staining, and Masson staining. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum tumor necrosis factor-
α
(TNF-
α
), interleukin-10 (IL-10), and monocyte chemoattractant protein-1 (MCP-1) levels. Immunofluorescence (IF) was performed to detect F4/80 expression in renal tissue, and immunohistochemistry (IHC) was used to assess CD206 expression. Real-time quantitative polymerase chain reaction (Real-time PCR) was employed to measure the mRNA expression of TNF-
α
, IL-10, inducible nitric oxide synthase (iNOS), and arginase-1 (Arg-1). Western blot analysis was us
ed to detect the protein expression of iNOS, Arg-1, CD86, and CD206 in renal tissue.
Results
2
Compared with the normal group, the model group showed increased levels of GSP, UACR, SCr, BUN, TC, and TG, elevated levels of the inflammatory factor TNF-
α
and the chemokine MCP-1, and decreased IL-10 levels (
P
<
0.01). Pathological examination revealed glomerular hypertrophy, mesangial cell proliferation with marked mesangial expansion, inflammatory cell infiltration, vacuolar degeneration of renal tubular epithelial cells, prominent glycogen deposition, and increased collagen fiber deposition. In addition, relative F4/80 fluorescence intensity was enhanced, CD206 expression in the glomeruli and renal interstitium was reduced, and TNF-
α
and iNOS mRNA expression was increased. IL-10 and Arg-1 mRNA expression was decreased, iNOS and CD86 protein expression was increased, and Arg-1 and CD206 protein expression was decreased (
P
<
0.05,
P
<
0.01). Compared with the model group, the Danggui Shaoyaosan groups and the irbesartan group showed decreased levels of GSP, UACR, SCr, BUN, TC, and TG, reduced serum TNF-
α
and MCP-1 levels, and increased IL-10 levels. Renal pathological damage was improved to varying degrees. Relative F4/80 fluorescence intensity was reduced, CD206 expression in the glomeruli and renal interstitium was increased, and TNF-
α
and iNOS mRNA expression was decreased. IL-10 and Arg-1 mRNA expression was increased, iNOS and CD86 protein expression was reduced, and Arg-1 and CD206 protein expression was increased (
P
<
0.05,
P
<
0.01).
Conclusion
2
Danggui Shaoyaosan can improve renal function and alleviate renal pathological damage in db/db mice. Its mechanism may be related to inhibiting M1 pro-inflammatory macrophage polarization, promoting M2 anti-inflammatory macrophage polarization, reducing inflammatory responses, delaying the progression of renal fibrosis, improving renal pathological injury, and thereby exerting renal protective effects.
中华医学会糖尿病学分会 . 中国糖尿病防治指南(2024版) [J]. 中华糖尿病杂志 , 2025 , 17 ( 1 ): 16 - 139 .
Chinese Diabetes Society . Guideline for the prevention and treatment of diabetes mellitus in China (2024 edition) [J]. Chin J Diabetes , 2025 , 17 ( 1 ): 16 - 139 .
ANDERS H J , HUBER T B , ISERMANN B , et al . CKD in diabetes:Diabetic kidney disease versus nondiabetic kidney disease [J]. Nat Rev Nephrol , 2018 , 14 ( 6 ): 361 - 377 .
SCHENA F P , GESUALDO L . Pathogenetic mechanisms of diabetic nephropathy [J]. J Am Soc Nephrol , 2005 , 16 ( Suppl 1 ): S30 - S33 .
YANG H , XIE T , LI D , et al . Tim-3 aggravates podocyte injury in diabetic nephropathy by promoting macrophage activation via the NF- κ B/TNF- α pathway [J]. Mol Metab , 2019 , 23 : 24 - 36 .
WADA J , MAKINO H . Innate immunity in diabetes and diabetic nephropathy [J]. Nat Rev Nephrol , 2016 , 12 ( 1 ): 13 - 26 .
NIEWCZAS M A , PAVKOV M E , SKUPIEN J , et al . A signature of circulating inflammatory proteins and development of end-stage renal disease in diabetes [J]. Nat Med , 2019 , 25 ( 5 ): 805 - 813 .
NGUYEN D , PING F , MU W , et al . Macrophage accumulation in human progressive diabetic nephropathy [J]. Nephrology (Carlton) , 2006 , 11 ( 3 ): 226 - 231 .
CHOW F , OZOLS E , NIKOLIC-PATERSON D J , et al . Macrophages in mouse type 2 diabetic nephropathy:Correlation with diabetic state and progressive renal injury [J]. Kidney Int , 2004 , 65 ( 1 ): 116 - 128 .
TESCH G H . Role of macrophages in complications of type 2 diabetes [J]. Clin Exp Pharmacol Physiol , 2007 , 34 ( 10 ): 1016 - 1019 .
WADA J , MAKINO H . Inflammation and the pathogenesis of diabetic nephropathy [J]. Clin Sci (Lond) , 2013 , 124 ( 3 ): 139 - 152 .
IKEZUMI Y , HURST L A , MASAKI T , et al . Adoptive transfer studies demonstrate that macrophages can induce proteinuria and mesangial cell proliferation [J]. Kidney Int , 2003 , 63 ( 1 ): 83 - 95 .
TANG P M , NIKOLIC-PATERSON D J , LAN H Y . Macrophages:versatile players in renal inflammation and fibrosis [J]. Nat Rev Nephrol , 2019 , 15 ( 3 ): 144 - 158 .
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 .
Chinese Association of Traditional 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 Tradit Chin Med , 2024 , 47 ( 4 ): 580 - 592 .
汪六林 , 李刚 , 程虹 , 等 . 当归芍药散治疗Ⅳ期糖尿病肾病的临床效果 [J]. 广西医学 , 2019 , 41 ( 15 ): 1910 - 1913 .
WANG L L , LI G , CHENG H , et al . Clinical effect of Danggui Shaoyao San on stage Ⅳ diabetic nephropathy [J]. Guangxi Med J , 2019 , 41 ( 15 ): 1910 - 1913 .
梅莎莎 , 宋恩峰 , 项琼 . 当归芍药散联合氯沙坦治疗早期糖尿病肾病临床观察 [J]. 辽宁中医药大学学报 , 2016 , 18 ( 2 ): 101 - 103 .
MEI S S , SONG , E F , XIANG Q . Clinical observation in the treatment of diabetic nephropathy in early stage with Danggui Shaoyao powder and Losartan [J]. J Liaoning Univ Tradit Chin Med , 2016 , 18 ( 2 ): 101 - 103 .
陈华平 , 宋恩峰 , 梅莎莎 . 免煎中药当归芍药散治疗早期糖尿病肾病临床观察 [J]. 湖北中医药大学学报 , 2015 , 17 ( 4 ): 68 - 70 .
CHEN H P , SONG E F , MEI S S . Clinical observation of non-decocted Chinese herb of Danggui Shaoyao powder in treatment of diabetic nephropathy in early stage [J]. J Hubei Univ Chin Med , 2015 , 17 ( 4 ): 68 - 70 .
郭晓娜 , 黄涛 , 陈文钰 , 等 . 当归芍药散对糖尿病大鼠炎症水平的影响及肾脏保护作用 [J]. 中国老年学杂志 , 2024 , 44 ( 23 ): 5773 - 5776 .
GUO X N , HUANG T , CHEN W Y , et al . Effects of Danggui Shaoyao powder on inflammatory levels and renal protective effects in diabetic rats [J]. Chin J Gerontol , 2024 , 44 ( 23 ): 5773 - 5776 .
夏振忠 , 宋恩峰 . 基于NF- κ B信号通路研究当归芍药散对糖尿病肾病大鼠肾脏的保护作用及其机制 [J]. 医药导报 , 2024 , 43 ( 8 ): 1205 - 1211 .
XIA Z Z , SONG E F . Protective effect and mechanism of Danggui Shaoyao powder on kidney of diabetic nephropathy rats based on NF- κ B signaling pathway [J]. Herald Med , 2024 , 43 ( 8 ): 1205 - 1211 .
AZUSHIMA K , GURLEY S B , COFFMAN T M . Modelling diabetic nephropathy in mice [J]. Nat Rev Nephrol , 2018 , 14 ( 1 ): 48 - 56 .
FENG Q , YANG Y , QIAO Y , et al . Quercetin ameliorates diabetic kidney injury by inhibiting ferroptosis via activating Nrf2/HO-1 signaling pathway [J]. Am J Chin Med , 2023 , 51 ( 4 ): 997 - 1018 .
YONEMOTO S , MACHIGUCHI T , NOMURA K , et al . Correlations of tissue macrophages and cytoskeletal protein expression with renal fibrosis in patients with diabetes mellitus [J]. Clin Exp Nephrol , 2006 , 10 ( 3 ): 186 - 192 .
段文晴 , 杜华 , 潘晓 , 等 . 当归芍药散在慢性肾脏病中的临床运用及作用机制研究 [J]. 中医研究 , 2025 , 38 ( 5 ): 82 - 86 .
DUAN W Q , DU H , PAN X , et al . Clinical application,effects and mechanism of Danggui Saoyao powder in chronic kidney disease [J]. Tradit Chin Med Res , 2025 , 38 ( 5 ): 82 - 86 .
YANG H , SONG L , SUN B , et al . Modulation of macrophages by a paeoniflorin-loaded hyaluronic acid-based hydrogel promotes diabetic wound healing [J]. Mater Today Bio , 2021 , 12 : 100139 .
CAO Y , XIONG J , GUAN X , et al . Paeoniflorin suppresses kidney inflammation by regulating macrophage polarization via KLF4-mediated mitophagy [J]. Phytomedicine , 2023 , 116 : 154901 .
SHAO Y X , GONG Q , QI X M , et al . Paeoniflorin ameliorates macrophage infiltration and activation by inhibiting the TLR4 signaling pathway in diabetic nephropathy [J]. Front Pharmacol , 2019 , 10 : 566 .
SHAO Y X , XU X X , LI Y Y , et al . Paeoniflorin inhibits high glucose-induced macrophage activation through TLR2-dependent signal pathways [J]. J Ethnopharmacol , 2016 , 193 : 377 - 386 .
BARRERA-CHIMAL J , JAISSER F . Pathophysiologic mechanisms in diabetic kidney disease:A focus on current and future therapeutic targets [J]. Diabetes Obes Metab , 2020 , 22 ( Suppl 1 ): 16 - 31 .
TERVAERT T W , MOOYAART A L , AMANN K , et al . Pathologic classification of diabetic nephropathy [J]. J Am Soc Nephrol , 2010 , 21 ( 4 ): 556 - 563 .
HICKEY F B , MARTIN F . Diabetic kidney disease and immune modulation [J]. Curr Opin Pharmacol , 2013 , 13 ( 4 ): 602 - 612 .
LIM A K , TESCH G H . Inflammation in diabetic nephropathy [J]. Mediators Inflamm , 2012 , doi: 10.1155/2012/146154 http://dx.doi.org/10.1155/2012/146154 .
VIEDT C , ORTH S R . Monocyte chemoattractant protein-1 (MCP-1) in the kidney:Does it more than simply attract monocytes? [J]. Nephrol Dial Transplant , 2002 , 17 ( 12 ): 2043 - 2047 .
CHOW F Y , NIKOLIC-PATERSON D J , OZOLS E , et al . Monocyte chemoattractant protein-1 promotes the development of diabetic renal injury in streptozotocin-treated mice [J]. Kidney Int , 2006 , 69 ( 1 ): 73 - 80 .
WEN Y , YAN H R , WANG B , et al . Macrophage heterogeneity in kidney injury and fibrosis [J]. Front Immunol , 2021 , 12 : 681748 .
SICA A , MANTOVANI A . Macrophage plasticity and polarization: In vivo veritas [J]. J Clin Invest , 2012 , 122 ( 3 ): 787 - 795 .
MOSSER D M . The many faces of macrophage activation [J]. J Leukoc Biol , 2003 , 73 ( 2 ): 209 - 212 .
WANG N , LIANG H , ZEN K . Molecular mechanisms that influence the macrophage M1-M2 polarization balance [J]. Front Immunol , 2014 , 5 : 614 .
LI H D , YOU Y K , SHAO B Y , et al . Roles and crosstalks of macrophages in diabetic nephropathy [J]. Front Immunol , 2022 , 13 : 1015142 .
ZHANG X L , GUO Y F , SONG Z X , et al . Vitamin D prevents podocyte injury via regulation of macrophage M1/M2 phenotype in diabetic nephropathy rats [J]. Endocrinology , 2014 , 155 ( 12 ): 4939 - 4950 .
JI L , CHEN Y , WANG H , et al . Overexpression of Sirt6 promotes M2 macrophage transformation,alleviating renal injury in diabetic nephropathy [J]. Int J Oncol , 2019 , 55 ( 1 ): 103 - 115 .
GUITERAS R , SOLA A , FLAQUER M , et al . Exploring macrophage cell therapy on diabetic kidney disease [J]. J Cell Mol Med , 2019 , 23 ( 2 ): 841 - 851 .
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