Nephrotoxicity induced by natural compounds from herbal medicines – a challenge for clinical application

Abstract

Herbal medicines (HMs) have long been considered safe and effective without serious toxic and side effects. With the continuous use of HMs, more and more attention has been paid to adverse reactions and toxic events, especially the nephrotoxicity caused by natural compounds in HMs. The composition of HMs is complex and various, especially the mechanism of toxic components has been a difficult and hot topic. This review comprehensively summarizes the kidney toxicity characterization and mechanism of nephrotoxic natural compounds (organic acids, alkaloids, glycosides, terpenoids, phenylpropanoids, flavonoids, anthraquinones, cytotoxic proteins, and minerals) from different sources. Recommendations for the prevention and treatment of HMs-induced kidney injury were provided. In vitro and in vivo models for evaluating nephrotoxicity and the latest biomarkers are also included in this investigation. More broadly, this review may provide theoretical basis for safety evaluation and further comprehensive development and utilization of HMs in the future.

Keywords:

• HMs
• natural products
• nephrotoxicity
• in vitro and in vivo model
• biomarkers
• toxic component
• toxicity mechanism

Acknowledgments

The authors would like to acknowledge and thank the National Natural Science Foundation of China [82050116, 81803615] for funding this work. The authors would like to thank Binyang Zhang for confirmation of chemical structural formulas in drafting this article. The authors acknowledge the reviewers and the editor for their time and dedication in reviewing the manuscript. Their comments and suggestions made a valuable contribution to the manuscript.

Author contributions

J.R., F.Q., and K.W. conceptualized the idea and drafted the framework for literature collection. J.R.,T.P., N.L. and Y.W. collected all the relevant literature and analyzed the compiled literature for inclusion in the manuscript. J.R. and K.W. wrote the first draft of the manuscript; C.Y., T.P. and Y.W. prepared all the schemes, drew the figures and drafted tables. J.R., F.Q., and K.W. revised the manuscript.

Declaration of interest

The author’s affiliations are as shown on the cover page. The authors have sole responsibility for the writing and content of the paper. The authors have not participated in and do not anticipate participation in any legal, regulatory, or advocacy proceedings related to the contents of the paper. No potential conflict of interest was reported by the author(s). There are no conflicts of interest associated with this publication.

Additional information

Funding

This work is supported by the National Natural Science Foundation of China [82050116, 81803615].