Journal of Traditional Medicine & Clinical Naturopathy
Open Access

Traditional Chinese medicine; Anti-inflammatory; Rheum palmatum; Acute kidney injury

Introduction

Acute kidney injury (AKI) is a severe medical condition characterized by a sudden loss of kidney function, leading to the accumulation of waste products and electrolyte imbalances in the body. It can occur due to various factors such as infections, drug toxicity, dehydration, or reduced blood flow to the kidneys [1]. While conventional treatments focus on supportive care, recent research has shed light on the potential of Traditional Chinese Medicine (TCM) compounds in the management of AKI [2]. In particular, scientists have been uncovering new mechanisms by which these compounds can offer therapeutic benefits in the treatment of this debilitating condition . Traditional Chinese medicine (TCM) has been widely used for the treatment of AKI and its complications in China and neighboring countries, including Japan and Korea, for a long time. Some TCM-based therapies show good results and high efficacy in inhibiting inflammatory responses, programmed cell death and oxidative stress. In this regard, the therapeutic effects of TCMs have widely been tested in animal models of AKI and even in patients. For instance, the Xuebijing Injection is effective in improving clinical symptoms of sepsis-induced AKI patients after the Wenchuan Earthquake. Our recent study showed that wogonin not only protects cisplatin-induced AKI, but also preserves and even promotes the antitumor effect of cisplatin. However, it is noteworthy that some TCMs, such as aristolochic acids and other plant alkaloids are nephrotoxic the application of TCM should be carefully evaluated [3].

Ancient wisdom meets modern science

For thousands of years, TCM has relied on natural substances, herbal remedies, and holistic approaches to promote health and treat various ailments [4]. In recent years, researchers have turned their attention toward TCM compounds and their potential applications in modern medicine. AKI, being a complex multifactorial condition, presents an exciting opportunity for exploring the effectiveness of TCM compounds. In addition to their anti-inflammatory and antioxidant effects, TCM compounds have demonstrated the ability to modulate immune responses [5]. By regulating immune cell activation and reducing the release of pro-inflammatory cytokines, they contribute to an overall anti-inflammatory environment within the kidneys, promoting healing and regeneration. Scientific studies have been undertaken to elucidate the mechanisms by which TCM compounds exert their therapeutic effects in AKI. One important aspect is their anti-inflammatory properties. TCM compounds have shown the ability to inhibit inflammatory pathways and reduce the release of pro-inflammatory molecules, thereby alleviating kidney inflammation associated with AKI. Furthermore, TCM compounds have been found to possess antioxidant properties, helping to counteract oxidative stress-induced kidney damage. Oxidative stress plays a significant role in the pathogenesis of AKI, and TCM compounds rich in natural antioxidants can potentially mitigate the harmful effects of reactive oxygen species on kidney tissues [6].

Promising TCM compounds

Several TCM compounds have shown promising results in AKI treatment. For example, Astragalus membranaceus, commonly known as Huangqi, has been extensively studied for its Reno protective effects [7]. It exhibits anti-inflammatory and antioxidant properties and has been shown to improve renal function and reduce kidney injury in AKI animal models. Another notable compound is Rheum palmatum, commonly known as Dahuang. It possesses antiinflammatory, antioxidant, and diuretic properties, which contribute to its potential in alleviating AKI. Dahuang has shown effectiveness in reducing renal tubular damage and improving kidney function. The discovery of new mechanisms underlying the therapeutic effects of TCM compounds in AKI opens up exciting possibilities for developing novel treatment approaches [8]. Integrating TCM with conventional medicine could lead to improved outcomes and enhanced patient care in the management of AKI. However, it is essential to conduct rigorous clinical trials and further research to validate the safety and efficacy of TCM compounds in AKI treatment [9]. Standardization of TCM formulations, identification of active components, and understanding the optimal dosage and administration are crucial areas for future investigation. Moreover, we also summarized TCMs with nephrotoxicity, which provides a more comprehensive understanding of TCMs in the treatment of AKI. This review may provide a theoretical basis for the clinical application of TCMs in the future [10].

Conclusion

The exploration of TCM compounds in the treatment of acute kidney injury represents a fusion of ancient wisdom and modern scientific inquiry. By uncovering new mechanisms, researchers are expanding our understanding of the potential therapeutic benefits of TCM in AKI management. With further investigation and clinical validation, TCM compounds could offer a complementary approach to conventional treatments, potentially improving outcomes for AKI patients and paving the way for personalized and holistic care. These data support the potential application of these TCMs as novel therapeutic agents in treating patients with AKI. Although some TCMs have entered preclinical trials, it is essential to initiate pre-clinical pharmacologic and toxicological trials and clinical trials to evaluate the efficacy and safety of TCMs usage. Moreover, considering that some TCMs are deleterious to the kidney, they should be attracted more attention when utilized. In addition, it is believed that western medicines always relieve symptoms quickly while TCMs exert therapeutic effects gently and fundamentally. In this regard, the combination of TCMs and western medicines may become a promising treatment strategy for AKI by taking advantages of both and by limiting side effects.

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