Ethanol extract of Abelmoschus manihot suppresses endoplasmic reticulum stress in contrast-induced nephropathy

Objective:To explore the efficacy and potential mechanisms of the ethanol extract of Abelmoschus manihot(L.)Medic in contrast-induced nephropathy(CIN).Methods:CIN rat models and human renal proximal tubular cells(HK-2)with iopromide-induced injury were employed to mimic CIN conditions.The effect of Abelmoschus manihot extract on the rat models and HK-2 cells was evaluated.In rat models,kidney function,histology,oxidative stress and apoptosis were determined.In HK-2 cells,cell viability,apoptosis,mitochondrial membrane potential,and endoplasmic reticulum stress were assessed.Results:Abelmoschus manihot extract significantly improved structural and functional impairments in the kidneys of CIN rats.Additionally,the extract effectively mitigated the decline in cellular viability and reduced iopromide-induced oxidative stress and lipid peroxidation.Mechanistic investigations revealed that Abelmoschus manihot extract prominently attenuated acute endoplasmic reticulum stress-mediated apoptosis by downregulating GRP78 and CHOP protein levels.Conclusions:Abelmoschus manihot extract can be used as a promising therapeutic and preventive agent in the treatment of CIN.

Advances in Studies on Total Flavone of Abelmoschus manihot(L.)Medic.

Flos Abelmoschus manihot has a long history of application.Recent studies show that total flavone of A.manihot(L.)Medic(TFA)has a wide range of pharmacological activity.This article is a review mainly on chemical composition,method of determination and pharmacologic action of TFA,and it raises research and development direction.

Efficacy and Safety of Flos Abelmoschus Manihot(Malvaceae) on Type 2 Diabetic Nephropathy:A Systematic Review

Objective： To evaluate the efficacy and safety of Flos Abelmoschus manihot （Malvaceae） on type 2 diabetic nephropathy （DN）. Methods： The Cochrane Library, PubMed/MEDLINE, Excerpta Medical Database, Chinese electronic literature databases, and the references of relevant articles were searched in March 2012 for randomized controlled trials （RCTs） that reported the effects of Flos A. manihot on type 2 DN patients with overt but subnephrotic-range proteinuria （500-3,500 mg/24 h）. The quality of trials was evaluated using the Cochrane-recommended method. The results were summarized as risk ratios （RRs） for dichotomous outcomes or mean differences （MDs） for continuous outcomes. Results： Seven trials （531 patients） were included. F/os A. manihot significantly decreased proteinuria [MD -317.32 mg/24 h, 95% confidence interval （CI） [-470.48, -164.17], P〈0.01]. After excluding a trial that only included patients with well-preserved renal function, F/os A. manihot was associated with a significant decrease in serum creatinine （MD -11.99 i~ mol/L, 95% CI [-16.95, -7.04], P〈0.01）. Serious adverse events were not observed. The most common adverse event was mild to moderate gastrointestinal discomfort; however, patients receiving this herb did not have an increased risk for tolerated gastrointestinal discomfort （RR 1.48, 95% CI [0.39, 5.68], P=0.57）. Conclusions： F/os A. manihot may be considered as an important adjunctive therapy with the first-line and indispensable therapeutic strategies for type 2 DN. High-quality RCTs are urgently needed to confirm the effect of Flos A. manihot on definite endpoints such as end-stage renal disease.

Anti-inflammatory effects of Abelmoschus manihot(L.)Medik.on LPS-induced cystitis in mice:potential candidate for cystitis treatment based on classic use

Abelmoschus manihot(L.)Medik.(A.manihot)is a traditional Chinese herbal medicine with a variety of pharmacological properties.It was first recorded in Jiayou Materia Medica dating back to the Song dynasty to eliminate urinary tract irritation by clearing away heat and diuretic effect.However,its pharmacological action on urinary tract infections has not been investigated.The present study aims to evaluate the anti-inflammatory activity of A.manihot on a mouse model of lipopolysaccharide(LPS)-induced cystitis.The results showed that A.manihot decreased white blood cell(WBC)count in urine sediments of the cystitis mice,alleviated bladder congestion,edema,as well as histopathological damage,reduced the expression levels of tumor necrosis factor-α,interleukin-6,and interleukin-1βsimultaneously.Moreover,A.manihot administration significantly downregulated the expression levels of TLR4,MYD88,IκBα,p-IκBα,NF-κB p65,and p-NF-κB p65 in LPS-induced cystitis mice.These findings demonstrated the protective effect of A.manihot against LPS-induced cystitis,which is attributed to its anti-inflammatory profile by suppressing TLR4/MYD88/NF-κB pathways.Our results suggest that A.manihot could be a potential candidate for cystitis treatment.

Total Flavonoids from Flowers of Abelmoschus manihot for Amelioration of α-naphthylisothiocyanate-induced Cholestasis by Regulating Expression of Transporters

Objective To explore the molecular mechanisms of the total flavonoids extracted from the flowers of Abelmoschus manihot（TFA） against α-naphthylisothiocyanate（ANIT）-induced cholestasis. Methods The hepatoprotective activities of TFA（125, 250 and 500 mg/kg） were investigated on ANIT-induced cholestatic liver injury in rats. Serum levels of alanine aminotransferase（ALT）, aspartate aminotransferase（AST）, total bilirubin（TBIL）, total bile acid（TBA）, and bile flow were measured to evaluate the protective effect of TFA. Furthermore, the hepatic m RNA and protein levels of transports, multidrug resistance-associated protein 2（MRP2）, bile salt export pump（BSEP）, and Na＋-taurocholate cotransporting polypeptide（NTCP） were investigated to elucidate the protective mechanisms of TFA against ANIT-induced cholestasis. Results Pretreatment of TFA significantly and dose-dependently decreased the ANIT-induced elevation of serum ALT, AST, TBIL, and TBA levels and increased the ANIT-induced suppression of bile flow. Moreover, TFA was found to increase the expression of liver MRP2, BSEP, and NTCP in both protein and m RNA levels in ANIT-induced liver injury in rats with cholestasis. Conclusion TFA exerts a therapeutic effect on ANIT-induced liver injury in rats with cholestasis, possibly through regulating the expressions of hepatic transporters.

Clinical Observation on Diabetic Nephropathy Treated with Alcohol Extraction of Flos Abelmoschus Manihot

Sixty-eight cases of Non-Insulin Dependent Diabetes Mellitus complicated with Nephropathywere randomly divided into two groups : the treated group, 35 cases treated with alcohol extraction of Flos A-belmoschus manihot, Gliclazide and Captopril Tablets; and the control group, 33 cases treated with Gli-clazide and Captopril Tablets, over a period of 8 weeks. The total effective rate in the treated and controlgroup were 83.87% and 31.03% respectively (P< 0 . 01 ) , urinary micro-albumin were 31 . 7 and 76.3mg/L(P < 0. 05) , proteinuria were 0. 41 and 0 . 77g/24hr ( P < 0. 01 ) , blood 2-microglobulin were 3317. 8 and3473. 1 hg/ml ( P < 0. 05) , urinary 2-microglobulin were 367. 2 and 641 . 5ng/ml ( P < 0. 01 ) , urinary N-acetyl- -glucosaminidase (NAG) were 26. 3 and 66. 7u/L ( P < 0. 01 ) , plasma lipid peroxide (LPO) were6. 13 and 8. 78 nmol/L ( P<0. 05) , and plasma superoxide anion were 8. 36 and 10. 42 kcpm respectively( P< 0. 05) . It was suggested that alcohol extraction of Abelmoschus manihot could eliminate oxygen freeradicals, alleviate renal tubular-interstitial diseases, improve renal function, and reduce proteinuria.