A review of the Chinese medical theory of phlegm-stasis interactions in glomerulosclerotic diseases,with particular reference to metabolic reprogramming
Glomerular sclerosis(GS)is a prevalent consequence of glomerular injury and lesions resulting from a multitude of etiologies.It represents the primary pathological foundation for chronic renal failure.The disease is characterised by the proliferation of glomerular mesangial cells and the widening of the mesangial matrix.In the ini-tial phase,the distribution is focal segmental,whereas in the subsequent phase,it becomes diffuse globular.Glomeru-losclerosis is not referenced by name in the medical literature of previous generations.However,based on its clinical manifestations and characteristics,it can be attributed to the categories of zhenjiu and oedema in traditional Chinese medicine.The doctrine of phlegm and stasis is consistent with the development of GS,and TCM treatments guided by this doctrine have demonstrated efficacy in clinical settings.Metabolic reprogramming refers to the process by which cells adapt to different physiological or pathological states by regulating metabolic pathways and the production and utilisation of products.This regulation entails alterations in enzyme expression and activity,in addition to the synthe-sis,catabolism and transport of metabolites.The concept of metabolic reprogramming has been demonstrated in a va-riety of disease processes,including those affecting the liver and kidneys.This paper presents a discussion of the path-ogenesis of glomerular sclerosis,with a particular focus on the role of metabolic reprogramming in the context of phlegm and stasis.The aim is to provide insights and directions for the treatment of glomerular diseases by combi-ning Chinese and western medicine.
Metabolic reprogrammingMitochondriaEnergy metabolismPhlegm and stasis theoryGlomer-ular sclerosis
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