title: Effects of Yishenjiangzhuo granules on immunity and bone metabolism in patients with stage 3-4 chronic kidney disease.
abstract: OBJECTIVE
  To determine the effects of Yishenjiangzhuo granules (YJG) on bone metabolism and to explore the changes in levels of bone Gla protein (BGP), tartrate-resistant acid phosphatase (TRAP), as well as their relationships with levels of B cells, regulatory T cells (Treg) and interleukin (IL)-17 in patients with stage 3-4 chronic kidney disease (CKD) before and after treatment.
  
  
  METHODS
  Fifty-three stage 3-4 CKD patients were divided randomly into two groups: YJG treatment and control. Peripheral blood was taken from two groups of CKD patients and 21 healthy subjects in the normal group. The parameters determined were the levels of CD4+, CD19+, CD19+ CD69+, CD19+ av, Treg (CD4 + CD25 + CD127lo), BGP, TRAP, IL-17, calcium, phosphate, blood urea nitrogen, serum creatinine (SCr), hemoglobin (Hb) in peripheral blood, and urinary creatinine. Calcium-phosphate products and endogenous creatinine clearance rate (CCr) were calculated according to standard protocols.
  
  
  RESULTS
  In YJG and control groups, SCr levels were lowered (P < 0.01) after treatment, whereas CCr (P < 0.05) as well as Hb and albumin levels (P < 0.01) were increased. The changes in levels of CCr and SCr in the YJG group were more significant. After treatment, CD19+CD69+ and Treg levels in the two groups varied (P < 0.01) compared with those of the normal group; the level of CD19+ increased but the levels of CD4+ and CD19 + AV decreased (P < 0.01) in both groups. Compared with the control group, the changes of CD19+ and CD19 + AV in the YJG group were more apparent (P < 0.05). Compared with the normal group, levels of IL-17 in both groups increased significantly (P < 0.01), and the difference in the control group was more significant (P < 0.05). After treatment, the TRAP level increased (P < 0.05), but the difference in BGP level (P > 0.05) was not significant.
  
  
  CONCLUSIONS
  In stage 3-4 CKD patients, B cells and IL-17 participated in the induction of osteoclast activation. YJG could also elevate the level of B cells and decrease their apoptosis, but showed no significant effects on active B cells, IL-17 or osteoclast activity.
authors.forename: Jing
authors.initials: J
authors.lastname: Zheng
authors.forename: Yingda
authors.initials: Y
authors.lastname: Lin
authors.forename: Lu
authors.initials: L
authors.lastname: Huang
authors.forename: Caifeng
authors.initials: C
authors.lastname: Chen
authors.forename: Xuemin
authors.initials: X
authors.lastname: Zheng
authors.forename: Xinhong
authors.initials: X
authors.lastname: Wu
authors.forename: Ciyun
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism*; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007109:Immunity / Q000187:drug effects*; D020381:Interleukin-17 / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000276:immunology* / Q000378:metabolism; D016176:T-Lymphocyte Subsets / Q000276:immunology
chemical_list: D004365:Drugs, Chinese Herbal; D020381:Interleukin-17; D015675:Osteocalcin