| Objective To test the expression of TLR4 and epithelial mesenchymal transition related proteins MMP9 and ZO-1 in lipopolysaccharide stimulated podocytes of mouse treated with triptolide,and to investigate the mechanism of triptolide in podocytes of mouse kidney.Materials and methods We used mouse kidney podocytes(mouse podocyte,MPC)as the research object,three groups of models were established as control(CON),lipopolysaccharide(LPS),and lipopolysaccharide plus triptolide(TP + LPS)groups,respectively,each group was treated for 24 h,the protein was extracted to determine the expression of target proteins(TLR4,MMP9,ZO-1)using Western blot.Results The relative expression of TLR4 was higher in the LPS group(1.24 ± 0.04)than in the CON group(1.07 ± 0.03)(P = 0.026),and lower in the TP + LPS group(0.98 ± 0.11)than in the LPS group(P = 0.004).These two sets of distinctions were statistically significant(P < 0.05).The relative expression related to MMP9 in LPS group(0.87 ± 0.03)was higher than that in CON group(0.61 ± 0.16)(P = 0.012),and that in TP + LPS group(0.60 ± 0.01)was lower than that in LPS group(P = 0.011).There were statistically significant(P < 0.05)in these two sets of distinctions.The relative expression related to ZO-1 in the LPS group(0.59 ± 0.10)was lower than that in the CON group(0.88 ± 0.09)(P = 0.017),and that in the TP + LPS group(0.82 ± 0.14)was higher than that in the LPS group(P = 0.04).The differences between the two groups were statistically significant(P < 0.05).Conclusions Stimulation of podocytes by lipopolysaccharide leads to the elevation of TLR4 expression,the occurrence of inflammatory responses,and the upregulation of MMP9 expression by ZO-1 expression decreases podocytes to undergo epithelial mesenchymal transition.TLR4 and MMP9 expressions were decreased and ZO-1 was up-regulated after celastrol intervention.Triptolide exerts anti-inflammatory anti epithelial mesenchymal transition and thereby protects podocytes in mouse kidney.Objective Compare the efficacy and safety of tripterygium glycosides combined with glucocorticoids combined with tripterygium glycosides or glucocorticoids alone for IgA nephropathy.Methods Electronic databases in both Chinese and English were searched,and the literatures that met the inclusion criteria were included in the study.Two researchers respectively evaluated the literature quality and extracted the data,and the data were analyzed by Review Manager5.3 and Stata14.0 software.The indexes of analysis were 24 h proteinuria,serum creatinine,urinary erythrocyte and adverse reactions.Results A total of nine studies were included.Meta results showed that 24-hour proteinuria was lower in the combination therapy group than in the monotherapy group [MD=-0.45,95%CI(-0.50,-0.40),P < 0.00001].Serum creatinine in the combination treatment group was lower than that in the monotherapy group [MD=-14.79,95%CI(-18.18,-11.36),P < 0.00001].Urine erythrocyte count in the combined treatment group was lower than that in the monotherapy group [Md =-21.56,95%CI(-33.49,-9.63),P < 0.00001].There was no significant difference in the incidence of adverse events between the treatment of IgA nephropathy with tripterygium glycosides combined with glucocorticoid and the treatment of glucocorticoid alone [RR=0.61,95%CI(0.33,1.15),P=0.13].There were fewer adverse reactions in the treatment of tripterygium glycosides combined with glucocorticoid,and the difference was statistically significant [RR=0.45,95%CI(0.22,0.93),P=0.03].Conclusion The efficacy of tripterygium glycosides combined with glucocorticoid in the treatment of IgA nephropathy is better than that of single use of tripterygium glycosides or glucocorticoid,and the safety of tripterygium glycosides combined with glucocorticoid is better than that of single use of tripterygium glycosides in the treatment of IgA nephropathy. |
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