Yi-Shen-Hua-Shi regulates intestinal microbiota dysbiosis and protects against proteinuria in patients with chronic kidney disease: a randomized controlled study

Context Yi-Shen-Hua-Shi (YSHS) is a traditional Chinese medicine that treats chronic kidney disease (CKD). However, its efficacy in reducing proteinuria and underlying mechanisms is unknown.Objective This single-center randomized controlled trial explored whether YSHS could improve proteinuria and m...

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Main Authors: Xingtong Dong, Jialing Zhang, Wen Li, Yinping Li, Linpei Jia, Zhaohui Liu, Wenjing Fu, Aihua Zhang
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Pharmaceutical Biology
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Online Access:https://www.tandfonline.com/doi/10.1080/13880209.2024.2345080
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author Xingtong Dong
Jialing Zhang
Wen Li
Yinping Li
Linpei Jia
Zhaohui Liu
Wenjing Fu
Aihua Zhang
author_facet Xingtong Dong
Jialing Zhang
Wen Li
Yinping Li
Linpei Jia
Zhaohui Liu
Wenjing Fu
Aihua Zhang
author_sort Xingtong Dong
collection DOAJ
description Context Yi-Shen-Hua-Shi (YSHS) is a traditional Chinese medicine that treats chronic kidney disease (CKD). However, its efficacy in reducing proteinuria and underlying mechanisms is unknown.Objective This single-center randomized controlled trial explored whether YSHS could improve proteinuria and modulate the gut microbiota.Materials and methods 120 CKD patients were enrolled and randomized to receive the renin-angiotensin-aldosterone system (RAAS) inhibitor plus YSHS (n = 56) or RAAS inhibitor (n = 47) alone for 4 months, and 103 patients completed the study. We collected baseline and follow-up fecal samples and clinical outcomes from participants. Total bacterial DNA was extracted, and the fecal microbiome was analyzed using bioinformatics.Results Patients in the intervention group had a significantly higher decrease in 24-h proteinuria. After 4 months of the YSHS intervention, the relative abundance of bacteria that have beneficial effects on the body, such as Faecalibacterium, Lachnospiraceae, Lachnoclostridium, and Sutterella increased significantly, while pathogenic bacteria such as the Eggerthella and Clostridium innocuum group decreased. However, we could not find these changes in the control group. Redundancy analysis showed that the decline in 24-h proteinuria during follow-up was significantly correlated with various taxa of gut bacteria, such as Lachnospiraceae and the Lachnoclostridium genus in the YSHS group. KEGG analysis also showed the potential role of YSHS in regulating glycan, lipid, and vitamin metabolism.Discussion and conclusion The YSHS granule reduced proteinuria associated with mitigating intestinal microbiota dysbiosis in CKD patients. The definite mechanisms of YSHS to improve proteinuria need to be further explored.Trial registration ChiCTR2300076136, retrospectively registered.
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spelling doaj-art-ac001bcca2f24b718096a4eab233bce12024-12-09T07:41:45ZengTaylor & Francis GroupPharmaceutical Biology1388-02091744-51162024-12-0162135636610.1080/13880209.2024.2345080Yi-Shen-Hua-Shi regulates intestinal microbiota dysbiosis and protects against proteinuria in patients with chronic kidney disease: a randomized controlled studyXingtong Dong0Jialing Zhang1Wen Li2Yinping Li3Linpei Jia4Zhaohui Liu5Wenjing Fu6Aihua Zhang7Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaContext Yi-Shen-Hua-Shi (YSHS) is a traditional Chinese medicine that treats chronic kidney disease (CKD). However, its efficacy in reducing proteinuria and underlying mechanisms is unknown.Objective This single-center randomized controlled trial explored whether YSHS could improve proteinuria and modulate the gut microbiota.Materials and methods 120 CKD patients were enrolled and randomized to receive the renin-angiotensin-aldosterone system (RAAS) inhibitor plus YSHS (n = 56) or RAAS inhibitor (n = 47) alone for 4 months, and 103 patients completed the study. We collected baseline and follow-up fecal samples and clinical outcomes from participants. Total bacterial DNA was extracted, and the fecal microbiome was analyzed using bioinformatics.Results Patients in the intervention group had a significantly higher decrease in 24-h proteinuria. After 4 months of the YSHS intervention, the relative abundance of bacteria that have beneficial effects on the body, such as Faecalibacterium, Lachnospiraceae, Lachnoclostridium, and Sutterella increased significantly, while pathogenic bacteria such as the Eggerthella and Clostridium innocuum group decreased. However, we could not find these changes in the control group. Redundancy analysis showed that the decline in 24-h proteinuria during follow-up was significantly correlated with various taxa of gut bacteria, such as Lachnospiraceae and the Lachnoclostridium genus in the YSHS group. KEGG analysis also showed the potential role of YSHS in regulating glycan, lipid, and vitamin metabolism.Discussion and conclusion The YSHS granule reduced proteinuria associated with mitigating intestinal microbiota dysbiosis in CKD patients. The definite mechanisms of YSHS to improve proteinuria need to be further explored.Trial registration ChiCTR2300076136, retrospectively registered.https://www.tandfonline.com/doi/10.1080/13880209.2024.2345080Yi-Shen-Hua-Shiproteinuriachronic kidney diseasegut floramicrobiota dysbiosis
spellingShingle Xingtong Dong
Jialing Zhang
Wen Li
Yinping Li
Linpei Jia
Zhaohui Liu
Wenjing Fu
Aihua Zhang
Yi-Shen-Hua-Shi regulates intestinal microbiota dysbiosis and protects against proteinuria in patients with chronic kidney disease: a randomized controlled study
Pharmaceutical Biology
Yi-Shen-Hua-Shi
proteinuria
chronic kidney disease
gut flora
microbiota dysbiosis
title Yi-Shen-Hua-Shi regulates intestinal microbiota dysbiosis and protects against proteinuria in patients with chronic kidney disease: a randomized controlled study
title_full Yi-Shen-Hua-Shi regulates intestinal microbiota dysbiosis and protects against proteinuria in patients with chronic kidney disease: a randomized controlled study
title_fullStr Yi-Shen-Hua-Shi regulates intestinal microbiota dysbiosis and protects against proteinuria in patients with chronic kidney disease: a randomized controlled study
title_full_unstemmed Yi-Shen-Hua-Shi regulates intestinal microbiota dysbiosis and protects against proteinuria in patients with chronic kidney disease: a randomized controlled study
title_short Yi-Shen-Hua-Shi regulates intestinal microbiota dysbiosis and protects against proteinuria in patients with chronic kidney disease: a randomized controlled study
title_sort yi shen hua shi regulates intestinal microbiota dysbiosis and protects against proteinuria in patients with chronic kidney disease a randomized controlled study
topic Yi-Shen-Hua-Shi
proteinuria
chronic kidney disease
gut flora
microbiota dysbiosis
url https://www.tandfonline.com/doi/10.1080/13880209.2024.2345080
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