FOLLOWUS
Colon may provide new therapeutic targets for treatment of chronic kidney disease with Chinese medicine
- Chinese Journal of Integrative Medicine Vol. 19, Issue 2, Pages: 86-91(2013)
- Affiliations：
1. Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine,Guangzhou,China
2. Key Unit of Methodology in Clinical Research for Traditional Chinese Medicine, Evidence-Based Medicine and Clinical Research Service Group, Guangdong Provincial Hospital of Chinese Medicine,Guangzhou,China
- Author bio：
- Funds：Supported by National Natural Science Foundation of China (No. 81202819) and the 2011 Construction Project from Research Studio of Famous Old Traditional Chinese Medicine Practitioners Experience Heritage, State Administration of Traditional Chinese Medicine (No. 2012KT1301)
DOI：10.1007/s11655-013-1351-8
CLC：Published：2013，
Published Online：31 January 2013，
Scan for full text
Zou, C., Lu, Zy., Wu, Yc. et al. Colon may provide new therapeutic targets for treatment of chronic kidney disease with Chinese medicine., Chin. J. Integr. Med. 19, 86–91 (2013). https://doi.org/10.1007/s11655-013-1351-8
Chuan Zou, Zhao-yu Lu, Yu-chi Wu, et al. Colon may provide new therapeutic targets for treatment of chronic kidney disease with Chinese medicine. [J]. Chinese Journal of Integrative Medicine 19(2):86-91(2013)
Zou, C., Lu, Zy., Wu, Yc. et al. Colon may provide new therapeutic targets for treatment of chronic kidney disease with Chinese medicine., Chin. J. Integr. Med. 19, 86–91 (2013). https://doi.org/10.1007/s11655-013-1351-8 DOI：
Chuan Zou, Zhao-yu Lu, Yu-chi Wu, et al. Colon may provide new therapeutic targets for treatment of chronic kidney disease with Chinese medicine. [J]. Chinese Journal of Integrative Medicine 19(2):86-91(2013) DOI： 10.1007/s11655-013-1351-8.
摘要
Chronic kidney disease (CKD) has become a worldwide health and social problem. Retarding its progression to end-stage renal disease is beneficial both to the patients and the healthcare system. Plenty of clinical trials have indicated that enema with Chinese medicine could effectively prevent chronic renal failure
and was widely used in the clinical practice. However
studies on mechanism were still nearly blank
which may prevent further improvement of therapeutic efficacy. Recent studies had discovered that colon was an important organ where uremic toxins were generated. The uremic toxins involved could not only promote CKD progression
but also was closely correlated with CKD mortality. Reducing production and promoting excretion of toxins were confirmed to reduce renal tubule interstitial fibrosis and delay renal progression. On the basis of the theory of gut-kidney axis above
we had conducted pilot clinical researches to evaluate the effect of enema with Chinese medicine on the intestinal flora
gut barrier
enterogenous uremic toxins and renal protection. The preliminary results revealed that rheum enema through colon could accelerate intestinal dynamics
improve intestinal barrier function
regulate intestinal flora and reduce production and absorption of intestine-derived uremic toxins such as indoxyl sulfate
which may reduce renal fibrosis and delay renal progression. Further studies could provide more evidence for colon as a new therapeutic target for the treatment of CKD with Chinese medicine.
Abstract
Chronic kidney disease (CKD) has become a worldwide health and social problem. Retarding its progression to end-stage renal disease is beneficial both to the patients and the healthcare system. Plenty of clinical trials have indicated that enema with Chinese medicine could effectively prevent chronic renal failure
and was widely used in the clinical practice. However
studies on mechanism were still nearly blank
which may prevent further improvement of therapeutic efficacy. Recent studies had discovered that colon was an important organ where uremic toxins were generated. The uremic toxins involved could not only promote CKD progression
but also was closely correlated with CKD mortality. Reducing production and promoting excretion of toxins were confirmed to reduce renal tubule interstitial fibrosis and delay renal progression. On the basis of the theory of gut-kidney axis above
we had conducted pilot clinical researches to evaluate the effect of enema with Chinese medicine on the intestinal flora
gut barrier
enterogenous uremic toxins and renal protection. The preliminary results revealed that rheum enema through colon could accelerate intestinal dynamics
improve intestinal barrier function
regulate intestinal flora and reduce production and absorption of intestine-derived uremic toxins such as indoxyl sulfate
which may reduce renal fibrosis and delay renal progression. Further studies could provide more evidence for colon as a new therapeutic target for the treatment of CKD with Chinese medicine.
关键词
chronic kidney disensecolonChinese Medicinerheum
Keywords
chronic kidney disensecolonChinese Medicinerheum
references
Bethesda. US Renal Data System, USRDS 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. 2010.
Zhou G, Sun Q, Ruan X, Xu WH, Zhao GM, Gu JJ, et al. Epidemiological investigation of chronic kidney disease in adult in Shanghai Pudong new area. Chin J Nephrol (Chin) 2011;27:504–510.
Li Y, Zhou L, Liu F, Li J, Peng YM, Yang LJ, et al. Epidemiological investigation of chronic kidney disease in Hunan Changsha. Chin J Nephrol (Chin) 2010;26:9–14.
Levey AS, Coresh J. Chronic kidney disease. Lancet 2011;11:60178–60185.
Zou C, Lu F, Huang C. Experience of Professor Huang Clunlin about purgative method for chronic kidney disease. J New Chin Med (Chin) 2010;42:145–147.
Zhao C, Ding F, Lin H, Ran L, Zhang JX, Niu HL, et al. Clinical observation of colonic dialysis combined retention enema for chronic renal failure. Clin Focus (Chin) 2011;26:1310–1313.
Guo J, Chen L, Chang B, Zheng MY, Wen JJ, Sun GX. Research of rhubarb-based decoctions enema for type 2 diabetic nephropathy. Clin Focus (Chin) 2011;26:1595–1598.
Lin B. Clinical observation of Chinese medicine retention for chronic renal failure. J New Chin Med (Chin) 2011;43:38–40.
Zheng HS, He M, Jiang J. A Meta-analysis of Chinese compound formula enema for chronic renal failure. Liaoning Tradit Chin Med J (Chin) 2008;35:1650–1651.
Wu Y. Clinical study on Chinese herbal enema therapy in the treatment of chronic renal failure: Effect, safety, compliance and prognosis. Guangzhou: Guangzhou University of Chinese Medicine; 2011:30–32.
Wei XD, Li LJ, Wang DY. Niaoduqing enema on chronic renal failure in rats. Chin J Gerontol (Chin) 2010;22:3297–3298.
Xu SJ, Ma YG, Deng C, Yu HB. Effects of retention enema with rhubarb on liver and kidney function of acute renal failure rats. Pharmacol Clin Chin Mater Med (Chin) 2010;26:69–71.
Dong ZH, Zhang N, Li XH, Zhao TC, Zeng FH. Experimental study of Pai Du and Shuang Tiao synthetic therapy on plasma Ang-IIand ALD levels of nephrectomized CRF rats. Shanxi J Tradit Chin Med (Chin) 2010;31:750–752.
Xu HQ, Dong ZH, Li XH, Zeng FH. The effect of Pai Du and Shuang Tiao synthetic therapy to the contents of serum NO on the CRF rats with 5/6 nephrectomy. China Healthcare Frontiers (Chin) 2009;4:28–30.
Lu ZY, Xie YS, Liu XS, Cui SY, Wu YC, Cai C, et al. Effect of 5/6 nephrectomized rat serum on epithelial-to-mesenchymal transition in vitro. Renal Failure 2011;33:600–608.
Aronov PA, Frank JGL, Plummer NS, Quan Z, Holmes S, Hostetter TH, et al. Colonic contribution to uremic solutes. J Am Soc Nephrol 2011;22:1769–1776.
Friedman EA. Can the bowel substitute for the kidney in advanced renal failure? Curr Med Res Opin 2009;25:1913–1918.
Evenepoel P, Meijers BKI, Bammens BRM, Verbeke K. Uremic toxins originating from colonic microbial metabolism. Kidney Int 2009;76:S12–S19.
Niwa T. Uremic toxicity of indoxyl sulfate. Nagoya J Med Sci 2010;72:1–11.
Meijers BKI, Evenepoel P. The gut-kidney axis: indoxyl sulfate, p-cresyl sulfate and CKD progression. Nephrol Dial Transplant 2011;26:759.
Meijers BK, De Loor H, Bammens B, Verbeke K, Vanrenterghem Y, Evenepoel P. p-Cresyl sulfate and indoxyl sulfate in hemodialysis patients. Clin J Am Soc Nephrol 2009;4:1932–1938.
Zou C, Wu YC, Lin QZ, Yang L, Deng YH, Li X, et al. Determination of indoxyl sulfate in human serum by HPLCFLU. Chin J Lab Med (Chin) 2010;5:221–222.
Liabeuf S, Barreto DV, Barreto FC, Meert N, Glorieux G, Schepers E, et al. Free p-cresylsulphate is a predictor of mortality in patients at different stages of chronic kidney disease. Nephrol Dial Transplant 2010;25:1183.
Wu I, Hsu KH, Lee CC, Sun CY, Hsu HJ, Tsai, CJ, et al. p-Cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease. Nephrol Dial Transplant 2011;26:938.
Wu IW, Hsu KH, Hsu HJ, Lee CC, Sun CY, Tsai CJ, et al. Serum free p-cresyl sulfate levels predict cardiovascular and all-cause mortality in elderly hemodialysis patients-a prospective cohort study. Nephrol Dial Transplant 2012;27:1169–1175.
Niwa T. Role of indoxyl sulfate in the progression of chronic kidney disease and cardiovascular disease: Experimental and clinical effects of oral sorbent AST-120. Ther Apheresis Dial 2011;15(2):120–124.
Barreto FC, Barreto DV, Liabeuf S, Meert N, Glorieux G, Temmar M, et al. Serum indoxyl sulfate is associated with vascular disease and mortality in chronic kidney disease patients. Clin J Am Soc Nephrol 2009;4:1551–1558.
Fukagawa M, Watanabe Y. Role of uremic toxins and oxidative stress in chronic kidney disease. Ther Apheresis Dial 2011;15:119.
Fujii H, Nakai K, Fukagawa M. Role of oxidative stress and indoxyl sulfate in progression of cardiovascular disease in chronic kidney disease. Ther Apheresis Dial 2011;15:125–128.
Shimizu H, Bolati D, Adijiang A, Muteliefu G, Enomoto A, Nishijima F, et al. NF-κB plays an important role in indoxyl sulfate-induced cellular senescence, fibrotic gene expression, and inhibition of proliferation in proximal tubular cells. Am J Physiol-Cell Physiol 2011;301:C1201–C1212.
Tumur Z, Shimizu H, Enomoto A, Miyazaki H, Niwa T. Indoxyl sulfate upregulates expression of ICAM-1 and MCP-1 by oxidative stress-induced NF-κB activation. Am J Nephrol 2 2010;31:435–441.
Meijers BKI. The uremic retention solute p-cresyl sulfate and markers of endothelial damage. Am J Kidney Dis 2009;54:891–901.
Schepers E, Meert N, Glorieux G, Goeman J, Van der Eycken J, Vanholder R. P-cresyl sulphate, the main in vivo metabolite of p-cresol, activates leucocyte free radical production. Nephrol Dial Transplant 2007;22:592.
Ranganathan N, Ranganathan P, Friedman EA, Joseph A, Delano B, Goldfarb DS, et al. Pilot study of probiotic dietary supplementation for promoting healthy kidney function in patients with chronic kidney disease. Adv Ther 2010;27:1–14.
Meijers BKI, De Preter V, Verbeke K, Vanrenterghem Y, Evenepoel P. p-Cresyl sulfate serum concentrations in haemodialysis patients are reduced by the prebiotic oligofructose-enriched inulin. Nephrol Dial Transplant 2010;25:219–224.
Nakabayashi I, Nakamura M, Kawakami K, Ohta T, Kato I, Uchida K, et al. Effects of synbiotic treatment on serum level of p-cresol in haemodialysis patients: a preliminary study. Nephrol Dial Transplant 2011;26:1094.
Akizawa T, Asano Y, Morita S, Wakita T, Onishi Y, Fukuhara S, et al. Effect of a carbonaceous oral adsorbent on the progression of CKD: a multicenter, randomized, controlled trial. Am J Kidney Dis 2009;54:459–467.
Kikuchi K, Itoh Y, Tateoka R, Ezawa A, Murakami K, Niwa T. Metabolomic search for uremic toxins as indicators of the effect of an oral sorbent AST-120 by liquid chromatography/tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2010;878:2997–3002.
Owada S, Maeba T, Sugano Y, Hirayama A, Ueda A, Nagase S, et al. Spherical carbon adsorbent (AST-120) protects deterioration of renal function in chronic kidney disease rats through inhibition of reactive oxygen species production from mitochondria and reduction of serum lipid peroxidation. Nephron Exp Nephrol 2010;115:e101–e111.
Zhang BD. The application of rheum in traditional Chinese medicine treatment of chronic renal failure. Chin J Tradit Chin Med (Chin) 2009;50:261
Zhang PQ, Li SJ, Wang JZ. Treatment experience of Professor Zhang Qi in the management of chronic renal failure. J New Chin Med 2011;43:171–173.
Zhu W, Wang XM. Progress in study on mechanisms of rhubarb in treating chronic renal failure. Chin J Integr Tradit West Med (Chin) 2005;25:471–475.
Shu ZJ, Cao Y, Halmurat U. Gut f lora may of fer new therapeutic targets for the traditional Chinese medicine enteric dialysis. Expert Opin Ther Targets 2011;15:1147–1152.
Zou C, Wu YC, Lin QZ, Liu XS. Effects of Chinese herbal enema therapy combined basic treatment on BUN, SCr, UA, and IS in chronic renal failure patients. Chin J Integr Tradit West Med (Chin) 2012;32:1192–1195.
Zou C, Wu YC, Luo L, Luo Q, Lu ZY, Liu XS. Colony therapy of rheum composition in chronic kidney disease stage 5 (non-dialysis) on intestine flora and intestine barrier function. Liaoning J Tradit Chin Med (Chin) 2012;39:1309–1311.
Jiang J, Zhang Q. Overview of Emodin prokinetic mechanism research. J Med Res (Chin) 2011;40:20–23.
Yan MJ, Sui F, Lin N. Progress in research on the regulatory functions and mechanisms of rhubarb to gastrointestinal tract. Chin J Exp Tradit Med Formul (Chin) 2010;16:181–184.
Cai CM, Li W. The advance of rhubarb on gastrointestinal mucosal barrier injury. Prog Modern Biomed (Chin) 2010;10:376–378.
Wei JT. Proceeding of rhubarb on critically ill gastrointestinal dysfunction protection mechanism. J Emerg Tradit Chin Med (Chin) 2010;19:300–302.
Zhao JF, Li G. Multiple protective targets effect of Rhubarb Radix and Salviae Miltiorrhizae on gut barrier function. Chin Med Sci Technol (Chin) 2009;16:109–111.
Jiang LF, Zhang GJ. The relationship between the changes of immune function and the bacterial translocation and rhubarb intervention in patients with severe acute pancreatitis. J Taishan Med Coll (Chin) 2010;31:94–96.
Li JT, Kuang ZY, Song SS, Xiao SS, Gao ZQ, Guo XF, et al. Effect of Wanshibaochiwan on intestine and liver of antibiotic-induced intestinal dysbacteriosis mice. Med J Jilin (Chin) 2010;31:867–869.
Fei N, Yang JJ. Comparison of in vitro antibacterial activity of four kinds of Chinese herbs such as rhubarb. Heilongjiang Med Pharm (Chin) 2010;33:18–19.
Chen ZH, Liu SM, Xu H, Cao HT, Lin YC, Ma GX. Comparative study of Chinese herbal medicine ethanol extract and water extract on Escherichia coli in vitro bacteriostatic activity. Chin J Vet Med (Chin) 2009;3:19–22.
0
Views
1837
Downloads
16
CSCD
- Meta-XMLDownload
- BibTeXDownload
- EndnoteDownload
- RefMan Download
- NoteExpressDownload
- NoteFirstDownload
Publicity Resources
Related Articles
Related Author
Related Institution
- Address：1 Caochang, xiyuan, Beijing, People's Republic of China Postal code：100091
- Tel：010-62886827, 62877592 Fax：010-62874291
- Technical support is provided by Beijing Founder electronics co., LTD 京ICP备05067934号-1
京公网安备11010802024621 - It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
- Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.
