title: Combination ofTripterygium wilfordiiHook F and angiotensin receptor blocker synergistically reduces excretion of urinary podocytes in patients with type 2 diabetic kidney disease.
abstract: The aim of this study was to investigate whetherTripterygium wilfordiiHook F (TwHF) and irbesartan could synergistically affect the urinary excretion of podocytes and proteins in type 2 diabetic kidney disease (DKD) patients and the underlying mechanisms. Forty DKD patients were divided into a DI group (DKD patients treated with irbesartan alone) and a DTI group (DKD patients treated with Tripterygium wilfordii Hook F and irbesartan). Urinary podocytes were observed by immunofluorescence. Urinary levels of connective tissue growth factor (CTGF) and transforming growth factor-β1(TGF-β1) were detected by enzyme-linked immunosorbent assay. Immunofluorescence indicated that shed podocytes were not detected in urine samples of normal controls, whereas the detection rate of urinary podocytes was 82.5% in DKD patients. Urinary CTGF and TGF-β1levels were significantly higher in urinary podocyte-positive DKD patients than in urinary podocyte-negative patients. Furthermore, urinary podocyte excretion was closely correlated with urinary protein excretion and urinary CTGF/TGF-β1levels. Treatments with TwHF and irbesartan significantly reduced the urinary excretion of proteins and podocytes, and decreased the urinary levels of CTGF and TGF-β1. Our results suggest that urinary podocyte excretion might serve as a predictor for DKD progression. TwHF/irbesartan combination could reduce the urinary excretion of proteins and podocytes synergistically in DKD patients, which might result from the synergistic inhibition of CTGF and TGF-β1in urine.
authors.affiliation: Department of Nephrology, Affiliated Hospital of Medical College, Qingdao University , Qingdao , Shandong , P.R. China.
authors.forename: Ruixia
authors.initials: R
authors.lastname: Ma
authors.affiliation: Department of Nephrology, Affiliated Hospital of Medical College, Qingdao University , Qingdao , Shandong , P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Nephrology, Affiliated Hospital of Medical College, Qingdao University , Qingdao , Shandong , P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Department of Nephrology, Affiliated Hospital of Medical College, Qingdao University , Qingdao , Shandong , P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
keywords: Tripterygium wilfordii Hook F; diabetic kidney disease; podocytes; transforming growth factor-β1