Effects Of Berberine On IRE1-XBP1 Pathway In Endoplasmic Reticulum Stress In Patients With Heat Syndrome Metabolic Syndrome Conbining With Renal Damage

Objective:To observe the effects of BBR on the expression’s changes of IRE1,XBP1 and Caspase-12mRNA in patients Urine,as well as the expression’s changes of IRE1,XBP1,Caspase-12 protein expression in Blood and Urine with the heat type Metabolic syndrome Associated with Kidney Damage renal impairment.Meanwhile,the TCM Syndrome scores,Blood glucose,blood lipid,fasting insulin and urinary albumin/creatinine ratio were observed,and the protective effect of berberine on renal damage of metabolic syndrome from the mechanism of endoplasmic reticulum stress were explored.Methods:From February 2016 to January 2017 in Fuzhou General Hospital,the 25 cases thatclinical diagnosis of the heat type Metabolic syndrome Associated with Kidney Damage renalimpairment were be included.In the end,only Twenty patients were randomly divided into control group(group A)and treatment group(group B),including 10 cases in group A and 10 cases in group B.At the same time,10 healthy people from the physical examination centerduring the same period were selected as the health group(group H).The related indexes were measured as the baseline value.Control group:targeted treatment of patients with the original disease,such as diabetes,hyperlipidemia,hypertension,proteinuria targeted treatment.Treatment group:based on the basis of treatment,plus BBR each oral 0.3g,3 times a day.The observation time and control group were 8 weeks.The TCM Syndrome scores,BMI,Blood glucose,blood lipid,fasting insulin and urinary albumin/creatinine ratio,and the levels of IRE1,XBP1,Caspase-12mRNA in in urine,IRE1,XBP1 and Caspase-12 protein in the blood and urine as well.Thoes changes were recorded before and after treatment in each group,and we will observe the liver and kidney function,blood,gastrointestinal symptoms,rash and other possible adverse drug reactions.Data were expressed as mean ± standard and analyzed by SPSS 20.0 software.The enumeration data were expressed as the number and percentage of cases.The overall analysis using two factor repeated measures analysis of variance,P<0.05 for the difference was statistically significant.Comparison between the two groups using two independent sample t test,the group comparison using paired t test,the difference t test of the significant level of α’=0.05/3=0.017,P<0.017 for the difference was statistically significant.Results:1.The general indicators:After treatment for 8 weeks,the levels of BMI,FBG,2hPBG,TG,LDL-C and FINS in the treatment group were lower than those in the control group(P<0.05).There was no significant difference about BMI between the treatment group after 4 weeks and the 8th week(P>0.017).However,there are significant difference in the other index in treatment group(P<0.017).The every index of the control group was no significant difference about BMI between the treatment group after 4 weeks and the 8th week(P>0.017).After 8 weeks of treatment,the blood pressure and urine albumin/creatinine ratio decreased in both groups(P<0.05).There was no significant difference between the two groups(P>0.017).There was no significant difference between the two groups before and after treatment in waistline and HDL-C(P>0.05).2.ERS indicators:After treatment for 8 weeks,the expression of IRE1,XBP1,caspase-12mRNA,the expression of urine and serum IRE1,XBP1 and Caspase-12 in the treatment group were significantly lower than those in the control group(P<0.05).The expression of IRE1,XBP1,caspase-12mRNA,urine and serum IRE1,XBP1 and Caspase-12 protein in the treatment group were further decreased(P<0.05),while those was no significant difference in the control group’s 4 weeks and 8 weeks(P>0.05).3.TCM syndrome scores:After treatment for 8 weeks,the TCM syndrome scores in treatment group was significantly reduced than the control group(P<0.05),and the score of TCM syndromes decreased with the prolongation of treatment time(P<0.017),while there was not exist this phenomenon in the control group.The treatment’s effective rate of TCM syndrome was significantly better than that of the control group(P<0.05).Conclusion:Berberine can reduce the metabolic syndrome complicated with renal damage patients’ the TCM Syndrome scores,improving insulin resistance,regulating metabolic disorder level of glycolipids,and reducing urinary IRE1,XBP1,Caspase-12mRNA,blood and urine IRE1,XBP1 expression,Caspase-12 protein,whoes mechanism may be that berberine can inhibit the metabolic syndrome with renal damage in patients with endoplasmic reticulum stress pathway related to excessive activation of IRE1-XBP1.