A review on the pathogenesis and the treatment of IgA nephropathy in TCM and Western medicine from the perspective of gut-kidney axis
Immunoglobulin A nephropathy is one of the primary glomerular diseases with the highest incidence in China.IgA nephropathy,as an autoimmune disease,is characterized by elevated circulating levels of galactose-deficient IgA1(Gd-IgA1)and immune complex deposition in the mesenteric region.Gd-IgA1 mainly originates from the gut-associated lymphoid tissue(GALT)and triggers an excessive immune response in the intestinal mucosa.Gd-IgA1 is mainly derived from GALT and triggers an excessive immune response in the intestinal mucosa.Intestinal dysfunction interacts with renal disease,resulting in the formation of the theory of gut-kidney axis.On the one hand,the dysregulation of intestinal ecological environment destroys the intestinal barrier,leading to the increase of intestinal endotoxins,which in turn triggers a systemic inflammatory response and aggravates renal injury.On the other hand,renal dysfunction leads to the deposition of uremic toxins in the intestinal circulation,which destroys the positive balance of the intestinal microbial environment.These two factors are mutually causal and influence.Inhibiting the excessive mucosal immune response in GALT is conducive to the reconstruction of intestinal microenvironment,and can maintain normal intestinal mucosal immunity,thereby reducing kidney injury.In recent years,based on the theory of gut-kidney axis,new therapeutic methods have been derived,such as intestinal-targeted immunomodulators,probiotics and other drugs,which can effectively maintain the balance of the intestinal microenvironment.Meanwhile,traditional Chinese medicine(TCM)shows significant therapeutic effects in stabilizing intestinal immune function,rebuilding the intestinal barrier,correcting the intestinal bacterial flora,etc.In clinical practice,according to disease condition,the method of clearing Fu(腑)organs and removing turbidity is mainly used to strengthen the body resistance and eliminate pathogenic factors,which effectively delays the progression of IgA nephropathy and stabilizes the disease condition.In this paper,combined with intestinal mucosal immunity and intestinal flora,the pathogenesis of IgA nephropathy in TCM and Western medicine and the emerging therapeutic achievements are reviewed from the perspective of gut-kidney axis,which reveals the importance of gut-kidney axis in the process of IgA nephropathy,and provides a new strategy for the treatment of IgA nephropathy in TCM and Western medicine.
Gut-kidney axisIntestinal mucosal immunityGut microbiotaGd-IgA1The integrative medicine
万方数据
维普
