Anthraquinones from Rheum officinale Ameliorate Renal Fibrosis in Acute Kidney Injury and Chronic Kidney Disease
Hao-Yu Feng, Yiqi Wang, Jianhua Yang, Hua Miao, Ying-Yong Zhao, Xiaojuan Li
Abstract
Abstract: Renal diseases including acute kidney injury (AKI) and chronic kidney disease (CKD) has become a significant public health concern due to its high morbidity and mortality. Rheum officinale Baill (Polygonaceae) exhibits diuretic, renoprotective, lipid-lowering, anti-inflammatory, and antifibrotic properties. Accumulating evidence has highlighted the anthraquinones in R. officinale as key components contributing to its renoprotective effects. The available information on R. officinale was searched by several electronic database such as PubMed, Web of Science, Springer, ScienceDirect, etc. This review summarizes the anthraquinones and their renoprotective effects in R. officinale , evaluating its clinical potential for managing renal disease including AKI and CKD. Studies demonstrate that R. officinale contains bioactive components such as anthraquinones, stilbenes, phenylbutazones, and tannins. This review discusses the renoprotective effects of R. officinale , including improvements in renal function, reduction of podocyte damage, and inhibition of renal fibrosis. These effects are mediated through the regulation of pro-inflammatory (IκB/NF-κB and Keap1/Nrf2), pro-fibrotic (TGF-β 1/Smad and Wnt/β-catenin), AMP-activated protein kinase and phosphoinositide 3-kinase signaling pathways in AKI and CKD. Additional mechanisms include modulation of anti-ageing Klotho expression, autophagy, and apoptosis. These findings expand the understanding of the therapeutic effects on AKI and CKD of R. officinale and provide valuable information on its clinical application in traditional Chinese medicine. This review presents a concept-driven therapeutic strategy for renal disease management. Keywords: acute kidney injury, chronic kidney disease, Rheum officinale , anthraquinones, oxidative stress and inflammation, TGF-β/Smad