Research Progress of Chinese Medicinals on Adriamycin-Induced Nephrotoxicity
Adriamycin(ADR)is a commonly used antitumor drug,but its clinical use can lead to various toxic injuries in the body.Chinese medicinal extracts that have shown potential in alleviating ADR-induced nephrotoxicity include aqueous extracts of Huangqi(Radix Scutellariae),Yinchen(Herba Artemisiae Scopariae),Huzhang(Rhizoma Polygoni Cuspidati),water-ethanol extracts of Huangshukuihua(Abelmoschus Moschatus),and ethyl acetate extracts of Baimaogen(Rhizoma Imperatae).Compound formulas of Chi-nese medicinals such as True Warrior Decoction,Maidservant from Yue Decoction,Shenyan Xiaobai Granules,Spleen-Invigorating and Clearing and Resolving Formula,Yang-Warming and Turbidity-Resolving Formula,Right-Restoring Pill,etc.have also been noted for improving ADR nephrotoxicity.Active components from these,such as flavonoids,polysaccharides,polyphenols,saponins,alkaloids,and terpenes,etc.play a crucial role as well.However,after summarizing and analyzing the current research on the prevention and treat-ment of ADR nephrotoxicity with Chinese medicinals,several shortcomings have been identified as follows:(1)When modeling with ADR,factors such as strain,gender,age,source,administration route,frequency,and dosage in rats directly impact the modeling success rate and stability,which in turn affects the degree of kidney damage caused by ADR and subsequently the efficacy evaluation of the studied Chinese medicinals.(2)Some studies are limited to rat models with ADR nephropathy,focusing only on clinical biochemical in-dicators and pathological changes in kidney tissues.There is insufficient research on intrinsic renal cells like tubular cells and podo-cytes,making it difficult to assess the impact of Chinese medicinals on podocyte lesions and various protein-mediated molecular mech-anisms,thus hindering further in-depth research.(3)Current studies on Chinese medicinal prevention and treatment of ADR toxicity remain at the animal and cell experimental stages,with clinical research being relatively scarce and practical application still unclear.(4)Existing experimental research lacks a significant number of high-quality,multi-dimensional mechanism studies,such as pro-teomics,genomics,gut microbiota,and molecular biology,with many studies remaining superficial.5.Most studies focus on Chinese me-dicinal therapeutic effects on ADR-induced nephrotoxicity,with limited attention given to its impact on tumor cells and their synergis-tic effects.Therefore,future research should address the following aspects:First,strengthen research on the ADR nephropathy rat model by employing modern pharmacological methods for multi-directional,comparative experiments.Establish a complete experimental pro-tocol and clarify evaluation standards for the model,conduct multiple controlled experiments with various herbal extracts,formulas,and active components to identify the most effective and stable modeling methods,thereby improving the overall quality of subsequent stud-ies.Second,increase research on pathological changes in podocytes in ADR nephropathy rats,which will aid in elucidating the molecular mechanisms of ADR-induced kidney injury and provide new insights for further exploring the renal protective mechanisms of Chinese medicinals.Third,focus on the synergistic effects of Chinese medicinals and antitumor drugs,enhance multi-target and multi-signal pathway research to help identify drugs that address chemotherapy side effects.Metabolomics and proteomics can be utilized to study the synergistic detoxifying effects of Chinese medicinals in conjunction with ADR across multiple signaling pathways.Additionally,maintai-ning a clinical value-oriented approach,expanding clinical application research with larger sample sizes,and promoting the translation of existing experimental research findings into clinical applications are essential.Increasing multi-dimensional and multi-layered ex-perimental studies related to proteomics,genomics,and gut microbiota,among other fields,is also recommended.
Adriamycin(ADR)nephrotoxicityChinese medicinal extractChinese medicinal compound formulaactive ingredients of Chinese medicinal
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