Berberine ameliorates chronic kidney disease through inhibiting the production of gut-derived uremic toxins in the gut microbiota

At present, clinical interventions for chronic kidney disease are very limited, and most patients rely on dialysis to sustain their lives for a long time. However, studies on the gut-kidney axis have shown that the gut microbiota is a potentially effective target for correcting or controlling chronic kidney disease. This study showed that berberine, a natural drug with low oral availability, significantly ameliorated chronic kidney disease by altering the composition of the gut microbiota and inhibiting the production of gut-derived uremic toxins, including p-cresol. Furthermore, berberine reduced the content of p-cresol sulfate in plasma mainly by lowering the abundance of g_Clostridium_sensu_stricto_1 and inhibiting the tyrosine-p-cresol pathway of the intestinal flora. Meanwhile, berberine increased the butyric acid producing bacteria and the butyric acid content in feces, while decreased the renal toxic trimethylamine N-oxide. These findings suggest that berberine may be a therapeutic drug with significant potential to ameliorate chronic kidney disease through the gut-kidney axis.

The inhibition of interleukin-25 on the effect of interleukin-17 for ERK1/2 and matrix metalloprotei-3 in rheumatoid arthritis fibroblast-like synoviocytes / 中华风湿病学杂志

Objective To study the function of interleukin (IL)-25 for rheumatoid arthritis (RA) fibroblast-like synoviocytes (FLS) differentiation as well as on the expression of extracellular regulating protein kinase (ERK) and matrix metalloproteinases-3 (MMP-3).Methods The differences on ERK1/2 and MMP-3 protein levels were tested in RA-FLS of RA patients and healthy controls,then IL-17A (10 ng/ml) was tested when the RA-FLS were co-stimulated with different concentrations of IL-25 (0.01,0.1,1 and 10 ng/ml) and IL-17A(10 ng/ml) for 24 hours respectively.The expression of ERK1/2 and MMP-3 protein was detected by the Western blot.T test was used for the comparison between different groups.Results The expression of ERK1/2 (1.71±0.17) and MMP-3 (0.50±0.13) proteins in RA-FLS was higher than the healthy controls (0.50±0.15,0.17±0.05) (t=-9.13,P＜0.01 and t=-4.10,P＜0.05),after stimulated with IL-17A,the expression of ERK1/2 (0.77±0.22) and MMP-3 (0.59±0.13) proteins in RA-FLS were increased compared with the untreated groups (0.18±0.35,0.04±0.03) (t=-4.69,P＜0.01 and t=-7.47,P＜0.01).With increase of the concentration on IL-25,the level of ERK1/2 (0.54±0.26,0.48±0.18,0.48±0.23,0.23±0.06) and MMP-3 (0.58±0.09,0.59±0.14,0.21±0.04,0.04±0.02) in RA-FLS which were stimulated by IL-17A was decreased slowly (t=4.22,P＜0.05 and t=4.95,P＜0.01 and t=7.47,P＜0.01).Conclusion IL-25 can inhibit the stimulation of IL-17A on ERK1/2 and MMP-3 fractionally,which implies that it may take part in the development of RA through this pathway and may be a target for the RA treatment.

Comparison of safety and efficac y of short-term treatment between re-use and initial use in patients with ankylosing spondylitis treated with tumor necrosis factor inhibitors / 中华风湿病学杂志

Objective To investigate the possible differences in safety and efficacy between re-use and initial use in patients with ankylosing spondylitis (AS) treated with tumor necrosis factor inhibitors (TNFi). Methods From October 2016 to October 2017, 82 patients with AS who were admitted to the Second Hospital of Lanzhou University were studied. Among them, 57 patients used TNFi for the first time and 25 patients reuse it after the interruption. After 3 months of standardized use of TNF-inhibitor, we compared the efficacy indicators [visual analogue scale/score (VAS), morning stiffness, bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), Bath ankylosing spondylitis metroloty index (BASMI), ankylosing spondylitis disease activity score (ASDAS), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) 0 and safety events between the two groups. T test and covariance analysis were used. Results The efficacy indexes of the two groups after treatment were significantly improved, the difference was statistically significant (P<0.05) compared with the baseline [Before and after treatment in the first treatment group: ESR: (40±31) mm/1 h, (8±8) mm/1 h, CRP: (28±35) mg/L, (5±9) mg/L, VAS: (6.5±1.6), (2.0 ±1.7), Morning stiff time: (0.6 ±0.4) h, (0.1 ±0.2) h, BASDAI: (5.0 ±1.3) h, (1.6 ±1.2) h, BASFI: (4.1 ±2.3), (1.3±1.3), BASMI: (2.6±2.0), (0.8±1.0), ASDAS: (3.5±0.8), (1.2±0.7); Before and after treatment in the re-use group: ESR: (39 ±33) mm/1 h, (9 ±10) mm/1 h, CRP: (28 ±28) mg/L, (5 ±6) mg/L, VAS: (6.6 ±1.9), (1.6 ±1.0), Morning stiff time:(0.6±0.4) h, (0.1±0.1) h, BASDAI:(5.1±0.8), (1.4±1.4), BASFI (5.1±2.2), (1.3±1.4), BASMI:(3.4 ±1.8), (1.0 ±0.9), ASDAS: (3.6 ±0.8), (1.2 ±0.4)]. But there was no statistical significant difference between the two groups in patients after treatment (P>0.05). Conclusion Patients with AS who re-uses TNFi after discontinuation could achieve the same safety and efficacy as they first use it.

One hepatic echinococcosis patient complicated with systemic sclerosis / 中国血吸虫病防治杂志

This article reports one hepatic echinococcosis patient complicated with systemic sclerosis. His clinical manifesta?tions were the progressive fibrosis of the skin,sour regurgitation,and belching. The blood examination showed that eosinophils was reduced,and antinuclear antibody(ANA)was positive at 1∶100 in cytoplasm particle type. He was given prednisone ace?tate 25 mg,q. d.,aspirin 100 mg,q. d.,centella triterpenes cream 12 mg t. i. d.,esomeprazole 40 mg q. d.,and domperidone 10 mg t. i. d. After one week,the Rodnan skin score reduced from 27 to 17. The liver hydatid cyst resection was performed,and the follow?up showed that his clinical manifestations improved and the Rodnan skin score reduced further.