Effects of Shendibushen on the Expression of CD146 and its Metabolic Pathways.

Context: Evidence from multiple studies has revealed that it's meaningful to evaluate the clinical significance of CD146 because it's related to an early diagnosis of chronic renal failure as well as to the severity of illness and the patient's prognosis.

Objective: The current study intended to evaluate the therapeutic effects of Shendibushen on the clinical parameters of blood and urine and on fibrosis in the kidney in a rat model, using simulated renal tissue fibrosis that was surgically induced with unilateral ureteral obstruction (UUO). Also, our research team intended to analyze the metabolic pathway activated by Shendibushen both in rat and human kidneys through use of the Kyoto Encyclopedia of Genes and Genomes (KEGG) database and the GeneNetwork. The aim is to discover if a connection existed between CD146 and key genes in these pathways.

Design: The research team conducted an animal study in Wistar rats.

Intervention: The rats were divided into 5 groups of 14 animals each: (1) blank control group, (2) sham control group, (3) model group, (4) Niaoduqing group, and (5) Shendibushen group. Three groups had UUO surgically induced-the model, Niaoduqing, and Shendibushen groups. The sham control group received sham surgery, and the blank control group received no surgery. The Shendibushen and Niaoduqing groups received the relevant capsules once a day at a fixed time, for a total of 28 days.

Outcome Measures: The levels of serum creatinine, blood urea nitrogen, microalbuminuria, serum soluble CD146, and urinary soluble CD146 were measured on the 14th and 28th days after modeling the rats. The degree of renal interstitial fibrosis was examined by hematoxylin and eosin (HE) staining and Masson trichrome staining. The changes at transcriptome level were obtained by target tissue sequencing. The KEGG database was used to analyze the potential pathway activated by the Shendibushen treatment. The GeneNetwork analysis was used to validate the correlation and identify the connections between CD146 and the key genes of the potential pathways.

Results: Shendibushen capsules decreased the degree of renal interstitial fibrosis in the UUO rat model and reduced the serum creatinine, blood urea nitrogen, microalbumin, serum sCD146, and urinary sCD146 significantly compared to the model group (P < .05). Upon analysis of the metabolic pathways activated by Shendibushen, the study further verified, through use of the KEGG database, that CD146 activated the nuclear factor kappa B1 (NF-κB1) and transforming growth factor beta 1 (TGF-β1)/ SMAD family member 2 (SMAD2) pathways.

Conclusions: CD146 could become an early indicator in clinical monitoring. CD146 has a function related to the NF-κB1and TGF-β1/ SMAD2 pathways under Shendibushen treatment.