
浏览全部资源
扫码关注微信
1.北京中医药大学,北京 100029
2.首都医科大学 附属北京中医医院,北京 100010
3.北京中医药大学 附属东直门医院,北京 100007
4.日本武库川女子大学,日本 兵库县 663-8558
Received:06 May 2025,
Revised:2025-06-20,
Accepted:27 June 2025,
Online First:11 July 2025,
Published:20 March 2026
移动端阅览
包新翠,赵保胜,秦灵灵等.基于PI3K/Akt/mTOR信号通路探讨补肾通络降浊方改善慢性肾脏病大鼠肾纤维化的作用机制[J].中国实验方剂学杂志,2026,32(06):100-108.
BAO Xincui,ZHAO Baosheng,QIN Lingling,et al.Mechanisms of Bushen Tongluo Jiangzhuo Prescription in Improving Renal Fibrosis in Rats with Chronic Kidney Disease Based on PI3K/Akt/mTOR Signaling Pathway[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(06):100-108.
包新翠,赵保胜,秦灵灵等.基于PI3K/Akt/mTOR信号通路探讨补肾通络降浊方改善慢性肾脏病大鼠肾纤维化的作用机制[J].中国实验方剂学杂志,2026,32(06):100-108. DOI: 10.13422/j.cnki.syfjx.20251436.
BAO Xincui,ZHAO Baosheng,QIN Lingling,et al.Mechanisms of Bushen Tongluo Jiangzhuo Prescription in Improving Renal Fibrosis in Rats with Chronic Kidney Disease Based on PI3K/Akt/mTOR Signaling Pathway[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(06):100-108. DOI: 10.13422/j.cnki.syfjx.20251436.
目的
2
探究补肾通络降浊方通过磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)/哺乳动物雷帕霉素靶蛋白(mTOR)信号通路改善慢性肾脏病(CKD)大鼠肾纤维化的作用机制。
方法
2
70只SPF级SD大鼠随机分为空白组15只及造模组55只,造模组大鼠予2.5%的腺嘌呤混悬液200 mg·kg
-1
·d
-1
灌胃4周制备CKD模型,将造模成功的大鼠随机分为模型组,厄贝沙坦组(20.25 mg·kg
-1
·d
-1
),补肾通络降浊方低、中、高剂量组(5.82、11.64、23.28 g·kg
-1
·d
-1
),每组10只,各组分别予等体积的生理盐水、相应浓度的厄贝沙坦和补肾通络降浊方灌胃12周。动态检测大鼠体质量及肾功能指标;采用全自动生化仪检测大鼠血肌酐(SCr)、血尿素氮(BUN)、尿白蛋白肌酐比(ACR)、24 h尿蛋白定量(24 hUTP)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、白细胞介素(IL)-1
β
、IL-6、肿瘤坏死因子-
α
(TNF-
α
)情况;苏木素-伊红(HE)染色和马松(Masson)染色观察肾脏组织病理变化;免疫组化法(IHC)检测大鼠PI3K、Akt、磷酸化(p)-Akt、mTOR的表达;蛋白免疫印迹法(Western blot)检测大鼠肾组织PI3K、p-Akt、Akt、p-mTOR、mTOR的蛋白表达;实时荧光定量聚合酶链式反应(Real-time PCR)检测大鼠肾组织中PI3K、Akt、mTOR mRNA表达水平。
结果
2
与模型组比较,厄贝沙坦组及补肾通络降浊方低、中、高剂量组大鼠SCr、BUN、ACR、24 hUTP、IL-1
β
、IL-6、TNF-
α
均显著降低(
P
<
0.01),AST显著升高(
P
<
0.01),ALT差异无统计学意义;同时各给药组较模型组大鼠肾组织病理结果显示,肾小管上皮细胞水肿、坏死及肾小囊扩张减轻,肾组织炎症细胞浸润减少,肾间质及肾小球纤维化改善明显,以补肾通络降浊方高剂量组效果最佳。Real-time PCR结果显示,补肾通络降浊方高剂量组PI3K、Akt、mTOR的mRNA表达显著下调(
P
<
0.01)。IHC结果显示补肾通络降浊方高剂量组肾组织中PI3K、p-Akt表达水平显著降低(
P
<
0.01)。Western blot结果显示补肾通络降浊方高剂量组PI3K、p-Akt/Akt、p-mTOR/mTOR表达水平显著降低(
P
<
0.01)。
结论
2
补肾通络降浊方能改善CKD大鼠的肾功能指标,减少肾组织内胶原蛋白沉积,降低血清炎症因子水平,并通过下调PI3K/Akt/mTOR信号通路激活自噬,改善肾纤维化,保护肾功能。
Objective
2
To investigate the mechanisms by which Bushen Tongluo Jiangzhuo prescription improves renal fibrosis in rats with chronic kidney disease (CKD) through the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway.
Methods
2
Seventy specific pathogen-free (SPF) Sprague-Dawley (SD) rats were randomly divided into a control group (
n
=15) and a modeling group (
n
=55). Rats in the modeling group were administered a 2.5% adenine suspension at a dose of 200 mg·kg
-1
·d
-1
by gavage for 4 weeks to establish a CKD model. Successfully modeled rats were randomly divided into a model group, an irbesartan group (20.25 mg·kg
-1
·d
-1
), and Bushen Tongluo Jiangzhuo prescription low-, medium-, and high-dose groups (5.82, 11.64, and 23.28 g·kg
-1
·d
-1
, respectively), with 10 rats in each group. Each group was administered an equal volume of physiological saline, the corresponding concentration of irbesartan, or Bushen Tongluo Jiangzhuo prescription by gavage for 12 weeks. Body weight and renal function indices were dynamically monitored. Serum creatinine (SCr), blood urea nitrogen (BUN), urine albumin-to-creatinine ratio (ACR), 24-hour urinary total protein (24 hUTP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), interleukin-1
β
(IL-1
β
), interleukin-6 (IL-6), and tumor necrosis factor-
α
(TNF-
α
) levels were measured using an automatic biochemical analyzer. Renal histopathological changes were observed by hematoxylin-eosin (HE) and Masson staining. Immunohistochemistry (IHC) was used to detect the expression of PI3K, Akt, phosphorylated Akt (p-Akt), and mTOR in renal tissues. Western blot was performed to assess the protein expression of PI3K, p-Akt, Akt, phosphorylated mTOR (p-mTOR), and mTOR in renal tissues. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to determine the mRNA expression levels of PI3K, Akt, and mTOR in renal tissues.
Results
2
Compared with the model group, rats in the ir
besartan group and the low-, medium-, and high-dose Bushen Tongluo Jiangzhuo prescription groups showed significantly decreased levels of SCr, BUN, ACR, 24 hUTP, IL-1
β
, IL-6, and TNF-
α
(
P
<
0.01). AST levels were significantly increased (
P
<
0.01), while no significant difference was observed in ALT levels. Histopathological examination revealed that, compared with the model group, renal tubular epithelial cell edema and necrosis and Bowman's capsule dilation were alleviated, inflammatory cell infiltration was reduced, and interstitial and glomerular fibrosis was markedly improved in all treatment groups, with the most pronounced effect observed in the high-dose Bushen Tongluo Jiangzhuo prescription group. Real-time PCR results showed that mRNA expression levels of PI3K, Akt, and mTOR were significantly downregulated in the high-dose group (
P
<
0.01). IHC results demonstrated that PI3K and p-Akt expression levels in renal tissues were significantly decreased in the high-dose group (
P
<
0.01). Western blot analysis further confirmed that the expression levels of PI3K, p-Akt/Akt, and p-mTOR/mTOR were significantly reduced in the high-dose group (
P
<
0.01).
Conclusion
2
Bushen Tongluo Jiangzhuo prescription improves renal function indices in CKD rats, reduces collagen deposition in renal tissues, and decreases serum inflammatory factor levels. Its protective effect on renal function may be achieved by activating autophagy through downregulation of the PI3K/Akt/mTOR signaling pathway, thereby alleviating renal fibrosis.
王松 . 《KDIGO慢性肾脏病评估与管理临床实践指南(2024版)》解读 [J]. 浙江医学 , 2024 , 46 ( 16 ): 1681 - 1685,1691 .
WANG S . Interpretation of the KDIGO clinical practice guidelines for the assessment and management of chronic kidney disease (2024 edition) [J]. Zhejiang Med J , 2024 , 46 ( 16 ): 1681 - 1685,1691 .
FANG J L , GUO Y H , YIN W , et al . Neoxanthin alleviates the chronic renal failure-induced aging and fibrosis by regulating inflammatory process [J]. Int Immunopharmacol , 2023 , 114 : 109429 .
LUYCKX V A , CHERNEY D Z I , BELLO A K . Preventing CKD in developed countries [J]. Kidney Int Rep , 2020 , 5 ( 3 ): 263 - 277 .
BIKBOV B , PURCELL C A , LEVEY A S , et al . Global,regional,and national burden of chronic kidney disease,1990-2017:A systematic analysis for the Global Burden of Disease Study 2017 [J]. Lancet , 2020 , 395 ( 10225 ): 709 - 733 .
FOREMAN K J , MARQUEZ N , DOLGERT A , et al . Forecasting life expectancy,years of life lost,and all-cause and cause-specific mortality for 250 causes of death:Reference and alternative scenarios for 2016-40 for 195 countries and territories [J]. Lancet , 2018 , 392 ( 10159 ): 2052 - 2090 .
陈驰 , 吕静 . 中医药防治慢性肾脏病肾间质纤维化的研究进展 [J]. 湖南中医杂志 , 2024 , 40 ( 1 ): 182 - 185 .
CHEN C , LYU J . Research progress of traditional Chinese medicine in the prevention and treatment of interstitial fibrosis in chronic kidney disease [J]. Hunan J Tradit Chin Med , 2024 , 40 ( 1 ): 182 - 185 .
上海慢性肾脏病早发现及规范化诊治与示范项目专家组 , 高翔 , 梅长林 . 慢性肾脏病筛查诊断及防治指南 [J]. 中国实用内科杂志 , 2017 , 37 ( 1 ): 28 - 34 .
Shanghai Chronic Kidney Disease Early Detection and Standardized Diagnosis and Treatment and Demonstration Project Expert Group , GAO X , MEI C . Guidelines for screening and diagnosis and prevention of chronic kidney disease [J]. Chin J Prac Inter Med , 2017 , 37 ( 1 ): 28 - 34 .
王诗尧 , 王世东 , 傅强 , 等 . 国医大师吕仁和“微型癥瘕”病理假说的源流及发展 [J]. 中华中医药杂志 , 2022 , 37 ( 8 ): 4555 - 4559 .
WANG S Y , WANG S D , FU Q , et al . Origin and development of LYU Ren-he's pathological hypothesis of 'micro-Zhengjia' theory [J]. China J Tradit Chin Med Phar , 2022 , 37 ( 8 ): 4555 - 4559 .
桑永浩 , 宋立群 , 贠捷 . 基于PI3K/Akt/mTOR信号通路探讨中医药治疗糖尿病肾病的研究进展 [J]. 中医药学报 , 2023 , 51 ( 9 ): 111 - 118 .
SANG Y H , SONG L Q , YUAN J . Research progress of traditional Chinese medicine in the treatment of diabetic nephropathy based on PI3K/Akt/mTOR signaling pathway [J]. Acta Chin Med Phar , 2023 , 51 ( 9 ): 111 - 118 .
WANG Y Y , LIU Y Y , LI J , et al . Gualou Xiebai decoction ameliorates cardiorenal syndrome type Ⅱ by regulation of PI3K/Akt/NF- κ B signalling pathway [J]. Phytomedicine , 2024 , 123 : 155172 .
DIWAN V , BROWN L , GOBE G C . Adenine‐induced chronic kidney disease in rats [J]. Nephrology , 2018 , 23 ( 1 ): 5 - 11 .
黄继汉 , 黄晓晖 , 陈志扬 , 等 . 药理试验中动物间和动物与人体间的等效剂量换算 [J]. 中国临床药理学与治疗学 , 2004 , 9 ( 9 ): 1069 - 1072 .
HUANG J H , HUANG X H , CHEN Z Y , et al . Dose conversion among different animals and healthy volunteers in pharmacological study [J]. Chin J Clin Pharmacol Ther , 2004 , 9 ( 9 ): 1069 - 1072 .
刘馨惠 . 通过大鼠肾组织中IRE1 α 及GRP78的表达探讨黄芪甲苷影响糖尿病肾病内质网应激的机制研究 [D]. 太原 : 山西医科大学 , 2021 .
LIU X H . Effects of Astragaloside Ⅳ on the expression of IRE1 α and GRP78 in renal tissue of diabetic nephropathy rats withendoplasmic reticulum stress [D]. Taiyuan : Shanxi Medical University , 2021 .
XING L N , FANG J , ZHU B B , et al . Astragaloside Ⅳprotects against podocyte apoptosis by inhibiting oxidative stress via activating PPAR γ -Klotho-FoxO1 axis in diabetic nephropathy [J]. Life Sci , 2021 , 269 : 119068 .
XU Z , XIANG X , SU S L , et al . Multi-omics analysis reveals the pathogenesis of db/db mice diabetic kidney disease and the treatment mechanisms of multi-bioactive compounds combination from Salvia miltiorrhiza [J]. Front Pharmacol , 2022 , 13 : 987668 .
LIU J X , REN J , YANG K , et al . Discovery and biological evaluation of tanshinone derivatives as potent dual inhibitors of indoleamine 2,3-dioxygenase 1 and tryptophan 2,3-dioxygenase [J]. Eur J Med Chem , 2022 , 235 : 114294 .
WANG Z M , YING Z L , BOSY-WESTPHAL A , et al . Specific metabolic rates of major organs and tissues across adulthood:Evaluation by mechanistic model of resting energy expenditure [J]. Am J Clin Nutr , 2010 , 92 ( 6 ): 1369 - 1377 .
HUMPHREYS B D . Mechanisms of renal fibrosis [J]. Annu Rev Physiol , 2018 , 80 ( 1 ): 309 - 326 .
KALANTAR-ZADEH K , JAFAR T H , NITSCH D , et al . Chronic kidney disease [J]. Lancet , 2021 , 398 ( 10302 ): 786 - 802 .
YANG Y F , ZHAO L S , GAO F L , et al . Modulation of renal fibrosis-related signaling pathways by traditional Chinese medicine:Molecular mechanisms and experimental evidence [J]. Int Urol Nephrol , 2025 , 57 ( 10 ): 1 - 24 .
HUANG R S , FU P , MA L . Kidney fibrosis:From mechanisms to therapeutic medicines [J]. Sig Transduct Target Ther , 2023 , 8 ( 1 ): 129 .
ZHANG J Q , LI Y Y , ZHANG X Y , et al . Cellular senescence of renal tubular epithelial cells in renal fibrosis [J]. Front Endocrinol (Lausanne) , 2023 , 14 : 1085605 .
ZHOU L L , MO H Y , MIAO J H , et al . Klotho ameliorates kidney injury and fibrosis and normalizes blood pressure by targeting the renin-angiotensin system [J]. Am J Pathol , 2015 , 185 ( 12 ): 3211 - 3223 .
LIU G Y , SABATINI D M . mTOR at the nexus of nutrition,growth,ageing and disease [J]. Nat Rev Mol Cell Biol , 2020 , 21 ( 4 ): 183 - 203 .
KIM J , KUNDU M , VIOLLET B , et al . AMPK and mTOR regulate autophagy through direct phosphorylation of Ulk1 [J]. Nat Cell Biol , 2011 , 13 ( 2 ): 132 - 141 .
HOSOKAWA N , HARA T , KAIZUKA T , et al . Nutrient-dependent mTORC1 association with the ULK1-Atg13-FIP200 complex required for autophagy [J]. Mol Biol Cell , 2009 , 20 ( 7 ): 1981 - 1991 .
XIAO F , LIU X H , CHEN Y , et al . Tumor-suppressing STF cDNA 3 overexpression suppresses renal fibrosis by alleviating anoikis resistance and inhibiting the PI3K/Akt pathway [J]. Kidney Blood Press Res , 2021 , 46 ( 5 ): 588 - 600 .
LI Y Y , TIAN Z H , PAN G H , et al . Heidihuangwan alleviates renal fibrosis in rats with 5/6 nephrectomy by inhibiting autophagy [J]. Front Pharmacol , 2022 , 13 : 977284 .
HE P , LEI J , MIAO J N , et al . Cordyceps sinensis attenuates HBx‑induced cell apoptosis in HK‑2 cells through suppressing the PI3K/Akt pathway [J]. Int J Mol Med , 2020 , 45 ( 4 ): 1261 - 1269 .
赵志芬 , 张佳伟 , 翟文生 , 等 . 慢性肾脏病相关信号通路及其中医药调控研究进展 [J]. 世界中医药 , 2025 , 20 ( 1 ): 130 - 135 .
ZHAO Z F , ZHANG J W , ZHAI W S , et al . Research progress on signaling pathways related to chronic kidney disease and their regulation by traditional Chinese medicine [J]. World Chin Med , 2025 , 20 ( 1 ): 130 - 135 .
KAUSHAL G P , CHANDRASHEKAR K , JUNCOS L A , et al . Autophagy function and regulation in kidney disease [J]. Biomolecules , 2020 , 10 ( 1 ): 100 .
0
Views
63
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621