目的:探讨肾复康Ⅱ号胶囊联合氯沙坦钾片对免疫球蛋白A肾病(immunoglobulin A nephropathy,IgAN)伴肾小管间质纤维化患者尿蛋白定量与中医证候积分的影响及其相关性。方法:将80例IgAN伴肾小管间质纤维化患者分为对照组和试验组各40例,...目的:探讨肾复康Ⅱ号胶囊联合氯沙坦钾片对免疫球蛋白A肾病(immunoglobulin A nephropathy,IgAN)伴肾小管间质纤维化患者尿蛋白定量与中医证候积分的影响及其相关性。方法:将80例IgAN伴肾小管间质纤维化患者分为对照组和试验组各40例,对照组予氯沙坦钾片治疗,试验组在对照组基础上予肾复康Ⅱ号胶囊,观察两组患者治疗12、24周后尿蛋白定量及治疗前后中医证候积分。结果:与治疗前比较,试验组治疗12、24周后尿蛋白定量下降(P<0.05),对照组治疗24周尿蛋白定量下降(P<0.05);与对照组比较,试验组治疗12、24周尿蛋白定量降低(P<0.05);治疗24周后试验组中医证候积分较治疗前降低(P<0.05)。结论:IgAN伴肾小管间质纤维化患者尿蛋白定量与中医证候积分之间存在相关性,尿蛋白定量及预后与中医证候、总有效率具有一致性。展开更多
目的采用网络药理学方法探究中药赤芍的主要活性成分及其治疗IgA肾病(IgA Nephropathy,IgAN)的作用机制。方法以口服生物利用度(Oralbioavailability,OB)≥30%和类药性(Drug like,DL)≥0.18为标准,从中药系统药理学数据库分析平台(Tradi...目的采用网络药理学方法探究中药赤芍的主要活性成分及其治疗IgA肾病(IgA Nephropathy,IgAN)的作用机制。方法以口服生物利用度(Oralbioavailability,OB)≥30%和类药性(Drug like,DL)≥0.18为标准,从中药系统药理学数据库分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP)中筛选出赤芍的活性成分、作用靶点,采用Cytoscape 3.7.2软件构建活性成分-作用靶点网络图。在GeneCards、DrugBank、DisGeNET、GAD等数据库中寻找与IgAN有关的所有靶点,将赤芍作用靶点与IgAN相关靶点取交集,筛选出赤芍治疗IgAN的活性成分及作用靶点。借助Cytoscape3.7.2软件,构建赤芍治疗IgAN的活性成分-作用靶点网络,选出关键化合物。通过STRING数据库构建靶蛋白质-蛋白质相互作用(Protein-Protein Interaction,PPI)网络,并选出核心靶点。在基因表达综合(Gene Expression Omnibus,GEO)数据库,下载基因矩阵与平台数据文件,运用Perl脚本和R语言分析验证关键靶点可行性。使用DAVID数据库分析平台,对靶点基因进行GO富集分析和KEGG信号通路富集分析。结果从赤芍中筛选获得13个有效活性成分,80个作用靶点,与IgAN有关的有效活性成分11个,核心靶点35个。利用GEO数据库中GSE93798芯片与平台数据,分析验证前10个关键靶点,其中FOS、JUN为赤芍治疗IgAN的显著性差异基因。KEGG信号通路主要涉及乙型肝炎(Hepatitis B)通路、IL-17信号通路、TNF信号通路等,这些通路可能是赤芍防治IgAN的作用途径。结论初步研究了赤芍治疗IgAN的药效物质基础及其可能的作用机制,赤芍可以通过多个靶点、多条通路来发挥治疗IgAN。展开更多
Immunoglobulin A nephropathy (IgAN) was first identified and described as a disease by Berger and Hinglais in 1968. It is the most common primary glomerulopathy worldwide [1], most prevalent in East Asians and Caucasi...Immunoglobulin A nephropathy (IgAN) was first identified and described as a disease by Berger and Hinglais in 1968. It is the most common primary glomerulopathy worldwide [1], most prevalent in East Asians and Caucasians and rare in black individuals. There are four key elements that contribute to IgAN, which determine the severity, course, and prognosis of the disease: circulating IgA immunocomplexes that favor mesangial deposition, the efficiency of the reticuloendothelial system, mesangial cell affinity and reaction to mesangial accumulation of poorly glycosylated IgA1, and the renal tendency to glomerulosclerosis and interstitial fibrosis. Clinical manifestations among patients with IgAN include hematuria, approximately 40% to 50% of cases present with one or more episodes of hematuria, usually preceded by upper respiratory tract infections. Between 30% and 40% present with hematuria and non-nephrotic range proteinuria that may be associated with arterial hypertension and impaired renal function. The TESTING study reveal a significant decrease in outcomes such as the risk of a 40% decrease in glomerular filtration rate or the need for renal replacement therapy in the group treated with steroids. The decrease in renal function compared to the group treated in the previously mentioned STOP-IgAN trial was 4 times less than in the TESTING study. Are we doing enough? Obviously, more trials are required with the use of adequate nephroprotection measures. We present 3 patients with a diagnosis of IgA nephropathy who attend the follow-up consultation and voluntarily decide to take part in the review.展开更多
文摘目的:探讨肾复康Ⅱ号胶囊联合氯沙坦钾片对免疫球蛋白A肾病(immunoglobulin A nephropathy,IgAN)伴肾小管间质纤维化患者尿蛋白定量与中医证候积分的影响及其相关性。方法:将80例IgAN伴肾小管间质纤维化患者分为对照组和试验组各40例,对照组予氯沙坦钾片治疗,试验组在对照组基础上予肾复康Ⅱ号胶囊,观察两组患者治疗12、24周后尿蛋白定量及治疗前后中医证候积分。结果:与治疗前比较,试验组治疗12、24周后尿蛋白定量下降(P<0.05),对照组治疗24周尿蛋白定量下降(P<0.05);与对照组比较,试验组治疗12、24周尿蛋白定量降低(P<0.05);治疗24周后试验组中医证候积分较治疗前降低(P<0.05)。结论:IgAN伴肾小管间质纤维化患者尿蛋白定量与中医证候积分之间存在相关性,尿蛋白定量及预后与中医证候、总有效率具有一致性。
文摘目的采用网络药理学方法探究中药赤芍的主要活性成分及其治疗IgA肾病(IgA Nephropathy,IgAN)的作用机制。方法以口服生物利用度(Oralbioavailability,OB)≥30%和类药性(Drug like,DL)≥0.18为标准,从中药系统药理学数据库分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP)中筛选出赤芍的活性成分、作用靶点,采用Cytoscape 3.7.2软件构建活性成分-作用靶点网络图。在GeneCards、DrugBank、DisGeNET、GAD等数据库中寻找与IgAN有关的所有靶点,将赤芍作用靶点与IgAN相关靶点取交集,筛选出赤芍治疗IgAN的活性成分及作用靶点。借助Cytoscape3.7.2软件,构建赤芍治疗IgAN的活性成分-作用靶点网络,选出关键化合物。通过STRING数据库构建靶蛋白质-蛋白质相互作用(Protein-Protein Interaction,PPI)网络,并选出核心靶点。在基因表达综合(Gene Expression Omnibus,GEO)数据库,下载基因矩阵与平台数据文件,运用Perl脚本和R语言分析验证关键靶点可行性。使用DAVID数据库分析平台,对靶点基因进行GO富集分析和KEGG信号通路富集分析。结果从赤芍中筛选获得13个有效活性成分,80个作用靶点,与IgAN有关的有效活性成分11个,核心靶点35个。利用GEO数据库中GSE93798芯片与平台数据,分析验证前10个关键靶点,其中FOS、JUN为赤芍治疗IgAN的显著性差异基因。KEGG信号通路主要涉及乙型肝炎(Hepatitis B)通路、IL-17信号通路、TNF信号通路等,这些通路可能是赤芍防治IgAN的作用途径。结论初步研究了赤芍治疗IgAN的药效物质基础及其可能的作用机制,赤芍可以通过多个靶点、多条通路来发挥治疗IgAN。
文摘Immunoglobulin A nephropathy (IgAN) was first identified and described as a disease by Berger and Hinglais in 1968. It is the most common primary glomerulopathy worldwide [1], most prevalent in East Asians and Caucasians and rare in black individuals. There are four key elements that contribute to IgAN, which determine the severity, course, and prognosis of the disease: circulating IgA immunocomplexes that favor mesangial deposition, the efficiency of the reticuloendothelial system, mesangial cell affinity and reaction to mesangial accumulation of poorly glycosylated IgA1, and the renal tendency to glomerulosclerosis and interstitial fibrosis. Clinical manifestations among patients with IgAN include hematuria, approximately 40% to 50% of cases present with one or more episodes of hematuria, usually preceded by upper respiratory tract infections. Between 30% and 40% present with hematuria and non-nephrotic range proteinuria that may be associated with arterial hypertension and impaired renal function. The TESTING study reveal a significant decrease in outcomes such as the risk of a 40% decrease in glomerular filtration rate or the need for renal replacement therapy in the group treated with steroids. The decrease in renal function compared to the group treated in the previously mentioned STOP-IgAN trial was 4 times less than in the TESTING study. Are we doing enough? Obviously, more trials are required with the use of adequate nephroprotection measures. We present 3 patients with a diagnosis of IgA nephropathy who attend the follow-up consultation and voluntarily decide to take part in the review.
