Combination of Tripterygium wilfordii Hook F and angiotensin receptor blocker synergistically reduces excretion of urinary podocytes in patients with type 2 diabetic kidney disease

Figures & data

Table 1. Comparison of physiological and biochemical indices of patients with diabetes.

Items	Control group	DI group	DTI group
n	10	20	20
Age	58.07 ± 5.33	57.40 ± 6.4	57.0 ± 5.1
gender (male/female)	5/5	10/10	11/9
BMI (kg/m^2)	21.80 ± 1.9	23.9 ± 2.2	22.7 ± 1.4
DM history (years)	0	13.9 ± 2.1*	13.8 ± 3.0*
Proteinuria history (years)	0	2.9 ± 0.8*	3.0 ± 0.7*
FBG (mmol/L)	4.97 ± 0.33	6.4 ± 1.00*	6.9 ± 0.57*
HbA1c (%)	5.04 ± 0.4	7.6 ± 1.3*	7.5 ± 1.3*
MAP (mmHg)	93.41 ± 4.3	98.4 ± 3.0	96.4 ± 5.7
Scr (μmol/L)	96.53 ± 12.3	104.4 ± 14.6	106.5 ± 12.4
Ccr (min/ml)	84.17 ± 6.1	79.36 ± 4.5	78.1 ± 3.7
TG (mmol/L)	0.98 ± 0.4	2.4 ± 0.3*	2.4 ± 0.5*
CH (mmol/L)	4.82 ± 0.8	5.5 ± 0.2	5.4 ± 0.3
Proteinuria (g/d)	0.016 ± 0.05	2.6 ± 1.3*	2.7 ± 1.5*
WBC (×109/L)	6.26 ± 1.3	6.1 ± 1.1	5.8 ± 1.0
ALT (U/L)	36.67 ± 12.7	28.7 ± 12.4	29.8 ± 9.7
AST (U/L)	22.50 ± 5.5	20.8 ± 5.9	22.5 ± 7.3

Note: Compared with the control group, *P < 0.05. The DI group received irbesartan treatment alone and the DTI group received TwHF/irbesartan combination.

Abbreviations: BMI – body mass index; DM – diabetes mellitus; FBG – fasting blood glucose; HbA1c – glycosylated haemoglobin; MAP – mean aortic pressure; Scr – serum creatinine; Ccr – creatinine clearance; TG – triglyceride; CH – cholesterol; WBC – white blood cell; ALT – alanine aminotransferase; AST – aspartate aminotransferase.

Figure 1. Immunofluorescence staining of podocytes in urine from normal controls (A) and DKD patients (B). Fluorescence indicated podocalyxin-positive cells (200 ×).

Figure 2. Urinary levels of CTGF (A) and TGF-β₁ (B) in DKD patients, respectively, positive or negative for podocytes.

Figure 3. Correlation analysis between the urinary excretion of podocytes and proteins and the urinary levels of proteins (A), CTGF (B) and TGF-β₁ (C) in DKD patients.

Figure 4. Effects of drug administration on pathogenic changes in DKD patients. Note: A 12 week period of irbesartan administration alone (DI) or combination treatment with TwHF/irbesartan (DTI). The urinary excretion of proteins (A) and podocytes (B) and the ratio of podocytes/serum creatinine (Scr) were detected before and after drug administration.

Figure 5. Synergistic effects of combined TwHF/irbesartan treatment on urinary levels of CTGF (A) and TGF-β1 (B); DKD patients before drug administration (DKD), DKD patients treated with irbesartan alone (DI); DKD patients treated with TwHF/irbesartan combination (DTI).