Don’t Just Know About Kidney Biopsy, You Can Also Do This For Early Diagnosis Of Lupus Nephritis

Systemic lupus erythematosus is a chronic inflammatory autoimmune connective tissue disease that is more common in children and young and middle-aged women. It often affects multiple organs and systems, with renal damage being the most common and a high mortality rate. Research shows that about 90% of patients with systemic lupus erythematosus have varying degrees of kidney damage and may develop lupus nephritis, and about 25% of patients with lupus nephritis will eventually develop end-stage renal disease [1].

Click to Cistanche for kidney disease

Once the kidneys are involved, the condition of systemic lupus erythematosus becomes more complex, treatment becomes more difficult, and the risk of poor prognosis also increases. If it cannot be detected in time and properly treated, it will gradually develop into irreversible kidney damage, ultimately endangering the patient's life. If early renal lesions can be treated promptly and reasonably, the prognosis can be improved. Therefore, early diagnosis of lupus nephritis is particularly important.

At present, the most diagnostic method is to perform kidney biopsy on patients, but kidney biopsy is invasive and cannot be accepted by many patients, and some medical units still do not have the conditions to perform kidney biopsy. In addition, renal tissue puncture sampling also has a certain rate of missed diagnosis of focal and mild stages of early renal lesions. These limitations bring many difficulties to the early diagnosis and disease observation of lupus nephritis. Therefore, it is very important to use non-kidney biopsy clinical indicators to warn and recognize early kidney damage in lupus erythematosus. Testing items such as 24-hour urine protein quantification and serum creatinine are commonly used clinically, but their sensitivity and specificity are limited, making them difficult to use for early diagnosis of kidney injury. Many scholars have explored more sensitive and specific biomarkers from non-invasive testing, including blood and urine biomarkers [2], to facilitate early diagnosis and monitoring of the progression of lupus nephritis.

01 blood biomarkers

(1) Anti-double-stranded DNA antibodies: directly or indirectly bind to cell surface antigens or exposed chromatin of the glomerular basement membrane, inducing an inflammatory cascade reaction; they can also penetrate cells, affect gene expression, and induce cell apoptosis. , is an important diagnostic marker for lupus nephritis.

(2) Anti-C1q antibody: C1q combines to form an immune complex, causing kidney damage and is significantly related to the disease activity of lupus nephritis.

(3) Anti-ribosomal P protein antibodies: Anti-ribosomal P protein antibodies mediate the occurrence of lupus nephritis through Th1 and may be involved in the occurrence of type V lupus nephritis. They have high sensitivity and specificity and can better predict the development of lupus nephritis. .

(4) Anti-Sm antibody: It is an antibody unique to systemic lupus erythematosus. It is related to proteinuria and can indicate nephritis. High titers of anti-Sm antibodies were identified as a predictor of asymptomatic lupus nephritis and predicted early poor prognosis in lupus nephritis.

(5) Anti-nucleosome antibodies: Anti-nucleosome antibodies can not only generate in-situ immune complexes with the glomerular basement membrane but also participate in the deposition of circulating immune complexes to mediate inflammation. The presence of antinucleosome antibodies is associated with glomerulonephritis and disease activity in patients with systemic lupus erythematosus.

(6) Antiphospholipid antibodies: Antiphospholipid antibodies can react with plasmin, thrombin, etc., affecting the body's anticoagulant and fibrinolytic systems, and are related to short-term renal function damage in patients with lupus nephritis.

(7) Monomeric C-reactive protein antibodies: bind to endogenous antigens and participate in the formation of immune complexes, thereby inducing/exacerbating inflammatory responses. It is used to monitor the activity of lupus nephritis, evaluate the effect of treatment, and can be used as a prognostic indicator of lupus nephritis.

(8) Dickkopf-1: Dysregulation of Dickkopf-1 may be related to the pathogenesis of lupus nephritis and renal fibrosis, and can be used as an independent indicator to identify active lupus nephritis.

02 Urine biomarkers

(1) B cell activating factors and proliferation-inducing ligands: can promote B cell activation and proliferation, and their urine concentrations can reflect renal function and can be used as markers for proliferative lupus nephritis.

(2) Lipocalin-2: It can induce cell apoptosis, upregulate B cells, and protect the kidneys. Its expression level in patients with lupus nephritis is related to the severity of the disease, and it can be used as an early diagnosis and recurrence predictor of lupus nephritis.

(3) Monocyte chemoattractant protein-1: Participates in the inflammatory response. Its expression is related to the infiltration of inflammatory cells in the renal tubules and fibrosis of the renal interstitium. It has high specificity and sensitivity and can monitor the occurrence and development of lupus nephritis.

(4) Tumor necrosis factor-like weak inducer of apoptosis: Promotes glomerular mesangial cells to release inflammatory chemokines, causing inflammatory cell infiltration. It is significantly increased in the urine of patients with lupus nephritis and serves as an indicator of the activity of lupus nephritis. index.

(5) Neutrophil gelatinase-related lipocalin: regulates the proliferation, differentiation, and apoptosis of renal epithelial cells and can protect the kidneys. It can specifically predict the activity of lupus nephritis and can be used as a biological indicator to monitor early kidney damage and treat acute renal failure.

(6) Vascular endothelial adhesion molecules and intercellular adhesion molecules: Their levels in urine are related to the activity of lupus nephritis, and their levels can reflect the development of nephritis in patients with lupus nephritis.

(7) miRNA: can regulate the release of inflammatory mediators, innate immune response, affect Toll-like receptors, etc., thereby regulating the occurrence and development of diseases. It can be used as a predictor of early renal fibrosis in patients with lupus nephritis.

How Does Cistanche Treat Kidney Disease?

Cistanche is a traditional Chinese herbal medicine used for centuries to treat various health conditions, including kidney disease. It is derived from the dried stems of Cistanche deserticola, a plant native to the deserts of China and Mongolia. The main active components of cistanche are phenylethanoid glycosides, echinacoside, and acteoside, which have been found to have beneficial effects on kidney health.

Kidney disease, also known as renal disease, refers to a condition in which the kidneys are not functioning properly. This can result in a buildup of waste products and toxins in the body, leading to various symptoms and complications. Cistanche may help treat kidney disease ase through several mechanisms.

Firstly, cistanche has been found to have diuretic properties, meaning it can increase urine production and help eliminate waste products from the body. This can help relieve the burden on the kidneys and prevent the buildup of toxins. By promoting diuresis, cistanche may also help Reduce high blood pressure, a common complication of kidney disease.

Moreover, cistanche has been shown to have antioxidant effects. Oxidative stress, caused by an imbalance between the production of free radicals and the body's antioxidant defenses, plays a key role in the progression of kidney disease. ies help neutralize free radicals and reduce Oxidative stress, thereby protecting the kidneys from damage. The phenylethanoid glycosides found in cistanche have been particularly effective in scavenging free radicals and inhibiting lipid peroxidation.

Additionally, cistanche has been found to have anti-inflammatory effects. Inflammation is another key factor in the development and progression of kidney disease. Cistanche's anti-inflammatory properties help reduce the production of pro-inflammatory cytokines and inhibit the activation of inflammation mandatory pathways, thus alleviating inflammation in the kidneys.

Furthermore, cistanche has been shown to have immunomodulatory effects. In kidney disease, the immune system can be dysregulated, leading to excessive inflammation and tissue damage. Cistanche helps regulate the immune response by modulating the production and activity of immune cells, such as T cells and macrophages. This immune regulation helps reduce inflammation and prevent further damage to the kidneys.

Moreover, cistanche has been found to improve renal function by promoting the regeneration of renal tubes with cells. Renal tubular epithelial cells play a crucial role in the filtration and reabsorption of waste products and electrolytes. In kidney disease, these cells can be damaged, leading to damaged renal function. Cistanche's ability to promote the regeneration of these cells helps restore proper renal function and improve overall kidney health.

In addition to these direct effects on the kidneys, cistanche has been found to have beneficial effects on other organs and systems in the body. This holistic approach to health is particularly important in kidney disease, as the condition often affects multiple organs and systems. che has been shown to have protective effects on the liver, heart, and blood vessels, which are commonly affected by kidney disease. By promoting the health of these organs, cistanche helps improve overall kidney function and prevent further complications.

In conclusion, cistanche is a traditional Chinese herbal medicine used for centuries to treat kidney disease. Its active components have diuretic, antioxidant, anti-inflammatory, immunomodulatory, and regenerative effects, which help improve renal function and protect the kidneys from further damage. , cistanche has beneficial effects on other organs and systems, making it a holistic approach to treating kidney disease.