收稿日期: 2026-04-28
网络出版日期: 2026-07-14
基金资助
湖北省自然科学基金联合基金项目(2023AFD181);湖北省中医药管理局中医药青年人才项目(ZY2025Q022)
Mechanism of moshen formula in treating idiopathic membranous nephropathy by regulating autophagy via the TRPC6 signaling pathway
Received date: 2026-04-28
Online published: 2026-07-14
目的 研究膜肾方通过瞬时受体电位阳离子通道6(TRPC6)信号通路调控自噬治疗特发性膜性肾病的作用机制。 方法 40只雄性SD大鼠,随机选取8只为对照组,其余32只大鼠均采用阳离子化牛血清白蛋白诱导造模,分为模型组、膜肾方组、TRPC6抑制剂组及膜肾方+TRPC6激动剂组,每组8只。对照组及模型组予等量生理盐水灌胃,其余3组予相应药物处理4周。观察大鼠一般情况;检测血肌酐、血白蛋白及24 h尿蛋白水平;苏木素-伊红(HE)染色观察肾小球基底膜增厚及炎性细胞浸润情况;免疫荧光检测肾小球IgG沉积情况;透射电镜观察肾小球基底膜、足突、自噬体的情况;Western blot(WB)检测各组大鼠肾组织TRPC6、微管相关蛋白1轻链3-Ⅱ(LC3-Ⅱ)、磷酸化细胞外信号调节激酶1/2(p-ERK1/2)、磷酸化哺乳动物雷帕霉素靶蛋白(p-mTOR)、泛素结合蛋白p62、足突蛋白podocin、磷脂酶A2受体(PLA2R)表达水平。 结果 与对照组相比,模型组大鼠精神萎靡、食少便溏、毛发枯槁,伴血肌酐升高、血白蛋白降低、24 h尿蛋白增加(P 0.01),TRPC6、p-ERK1/2、p-mTOR、p62及PLA2R表达水平升高(P 0.01),LC3-Ⅱ及podocin表达水平下降(P 0.01),肾小球基底膜明显增厚、间质炎性浸润,IgG沉积显著增加,电镜下足突广泛融合、线粒体嵴断裂、自噬水平低下;与模型组相比,膜肾方组大鼠一般状态、生化指标及病理损伤均改善,自噬流恢复,TRPC6、p-ERK1/2、p-mTOR及p62表达水平下降(P 0.01),LC3-Ⅱ及podocin表达水平升高(P 0.01);与膜肾方组相比,TRPC6抑制剂组TRPC6、p-mTOR、p62表达下降更显著(P 0.05),但生化指标及podocin、LC3-Ⅱ表达差异无统计学意义(P 0.05);膜肾方联用TRPC6激动剂后,通路调控及自噬改善作用减弱(P 0.05)。 结论 膜肾方可有效改善特发性膜性肾病大鼠的一般状态、生化指标及肾组织病理损伤,其机制可能与抑制TRPC6信号通路下调ERK/mTOR恢复自噬流及上调podocin有关;基于综合表型,膜肾方与TRPC6抑制剂疗效相当,而激活TRPC6减弱膜肾方保护效应,揭示TRPC6是膜肾方发挥肾保护作用的关键靶点。
关键词: 膜肾方; 特发性膜性肾病; 瞬时受体电位阳离子通道6信号通路; 自噬
丁秀 , 李颖霞 , 李慧 , 邹新蓉 . 基于TRPC6信号通路探讨膜肾方调控自噬治疗特发性膜性肾病的作用机制[J]. 实用医学杂志, 2026 , 42(13) : 2371 -2380 . DOI: 10.3969/j.issn.1006-5725.2026.13.013
Objective To investigate the mechanism by which Moshen Formula treats idiopathic membranous nephropathy (IMN) through the regulation of autophagy via the TRPC6 signaling pathway. Methods Forty male SD rats were randomly divided into a control group (n = 8) and a model group (n = 32). The model group was induced by cationic bovine serum albumin and then further divided into four subgroups: the model subgroup, the Moshen Formula subgroup, the TRPC6 inhibitor subgroup, and the Moshen Formula + TRPC6 agonist subgroup, with 8 rats in each subgroup. The control group and the model subgroup were administered normal saline by gavage, whereas the other three subgroups were given corresponding drugs for 4 weeks. The general condition of the rats was observed. The levels of serum creatinine, serum albumin, and 24-hour urinary protein were measured. Hematoxylin-eosin (HE) staining was carried out to observe the thickening of the glomerular basement membrane and the infiltration of inflammatory cells. Immunofluorescence was employed to detect the deposition of IgG in the glomeruli. Transmission electron microscopy was utilized to observe the glomerular basement membrane, foot processes, and autophagosomes. Western blot was conducted to detect the expression levels of transient receptor potential cation channel 6 (TRPC6), microtubule-associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ), phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2), phosphorylated mammalian target of rapamycin (p-mTOR), ubiquitin-binding protein p62, podocin, and phospholipase A2 receptor (PLA2R) in renal tissues. Results Compared with the control group, the rats in the model group exhibited lethargy, a reduction in food intake, loose stools, and dull hair. Additionally, there were significant increases in serum creatinine, a decrease in serum albumin, and an elevation in 24-hour urinary protein (P 0.01). The expression levels of TRPC6, p-ERK1/2, p-mTOR, p62, and PLA2R were significantly elevated (P 0.01), whereas the expression levels of LC3-Ⅱ and podocin were decreased (P 0.01). Renal pathological examination indicated marked thickening of the glomerular basement membrane, interstitial inflammatory infiltration, an increase in IgG deposition, extensive foot-process fusion, disrupted mitochondrial cristae, and impaired autophagy. Compared with the model group, the rats in the Moshen Formula group showed improvements in their general condition, biochemical indicators, and pathological injury. There was a restoration of autophagic flux, a decrease in the expression levels of TRPC6, p-ERK1/2, p-mTOR, and p62 (P 0.01), and an increase in the expression levels of LC3-II and podocin (P 0.01). Compared with the Moshen Formula group, the TRPC6 inhibitor group demonstrated more significant decreases in the expression of TRPC6, p-mTOR, and p62 (P 0.05). However, there were no significant differences in biochemical parameters, podocin, and LC3-Ⅱ expression (P 0.05). After the combination of the Moshen Formula with a TRPC6 agonist, the pathway-regulating and autophagy-improving effects were attenuated (P 0.05). Conclusions The Moshen Formula effectively enhances the general condition, biochemical parameters, and alleviates renal pathological damage in rats with IMN. Its mechanism might involve the inhibition of the TRPC6 signaling pathway, the down-regulation of ERK/mTOR, the restoration of autophagic flux, and the up-regulation of podocin. Based on comprehensive phenotypes, the Moshen Formula demonstrated comparable efficacy to a TRPC6 inhibitor. In contrast, the activation of TRPC6 diminished the protective effects of the Moshen Formula, indicating that TRPC6 is a crucial target for the renoprotective action of the Moshen Formula.
| [1] | LIN Z, XIE S, WANG W,et al.Changes in the spectrum of kidney diseases: A 14-year single-center retrospective renal biopsy study from southeast China[J].PeerJ,2025,13:e19302.doi:10.7717/peerj.19302 . |
| [2] | 郭晓琴,于为民,任小军.膜性肾病诊断和治疗的研究进展[J].实用医学杂志,2021,37(12):1636-1640.doi:10.3969/j.issn.1006-5725.2021.12.024 . |
| [3] | STAI S, LIOULIOS G, CHRISTODOULOU M,et al.From KDIGO 2012 towards KDIGO 2021 in idiopathic membranous nephropathy guidelines: what has changed over the last 10 years?[J]. J Nephrol,2023,36(2):551-561. doi:10.1007/s40620-022-01493-9 . |
| [4] | VARGAS-BROCHERO M J, LAFAUT E, RADHAKRISHNAN Y,et al.Long-term Outcome of Adult Patients With Membranous Nephropathy Treated With Rituximab[J].Kidney Int Rep,2025,10(8):2630-2641.doi:10.1016/j.ekir.2025.05.013 . |
| [5] | SHANKAR M, LAMECH T M.Treatment burden in glomerular diseases: Advances and challenges in immunosuppressive therapy[J].Front Nephrol,2025,5:1545373.doi:10.3389/fneph.2025. 1545373 . |
| [6] | YANG L, WU Y, LIN S,et al.sPLA2-IB and PLA2R mediate insufficient autophagy and contribute to podocyte injury in idiopathic membranous nephropathy by activation of the p38MAPK/mTOR/ULK1ser757 signaling pathway[J].FASEB J,2021,35(2):e21170.doi:10.1096/fj.202001143R . |
| [7] | PONTICELLI C, REGGIANI F, MORONI G.Autophagy in the Pathogenesis of Membranous Nephropathy[J].Kidney Med,2025,7(11):101101.doi:10.1016/j.xkme.2025.101101 . |
| [8] | 吴洪銮,安宁,钟珍,等.自噬在膜性肾病补体攻膜复合物所致足细胞损伤中的作用[J].广东医科大学学报,2020,38(5):526-531.DOI:10.3969/j.issn.1005-4057.2020.05.004 . |
| [9] | WANG H, LIU H, CHENG H,et al.Klotho Stabilizes the Podocyte Actin Cytoskeleton in Idiopathic Membranous Nephropathy through Regulating the TRPC6/CatL Pathway[J].Am J Nephrol,2024,55(3):345-360.doi:10.1159/000537732 . |
| [10] | LI Y, FANG Y, LIU J.Downregulation of TRPC6 regulates ERK1/2 to prevent sublytic C5b-9 complement complex-induced podocyte injury through activating autophagy[J].Exp Ther Med,2023,26(6):576.doi:10.3892/etm.2023.12275 . |
| [110] | 丁秀,吴成态,王小琴,等.专利膜肾2号方治疗脾肾阳虚特发性膜性肾病的临床研究[J].中国中西医结合肾病杂志,2024,25(9):821-823.doi:10.3969/j.issn.1009-587X.2024.09.023 . |
| [12] | 丁秀,袁军,邹新蓉,等.基于ERK/cPLA2信号通路探讨膜肾方对膜性肾病大鼠模型的干预作用及其机制[J].时珍国医国药,2021,32(10):2334-2336.doi:10.3969/j.issn.1008-0805. 2021.10.07 . |
| [13] | WANG Y N, MIAO H, HUA M R,et al.Moshen granule ameliorates membranousnephropathy by blocking intrarenal renin-angiotensin system signalling via the Wnt1/β-catenin pathway[J].Phytomedicine,2023,114:154763.doi:10.1016/j.phymed.2023. 154763 . |
| [14] | SHAN W, GUAN H, GU H,et al.Traditional Chinese medicine for idiopathic membranous nephropathy:A systematic reviewand meta analysis[J].Heliyon,2024,10(7):e28836.doi:10.1016/j.heliyon.2024.e28836 . |
| [15] | PONTICELLI C, MORONI G.Targeting autophagy in autoimmune glomerular diseases[J].J Nephrol,2025,38(7):1761-1772.doi:10.1007/s40620-025-02267-9 . |
| [16] | AMAN Y, SCHMAUCK-MEDINA T, HANSEN M,et al.Autophagy in healthy aging and disease[J].Nat Aging,2021,1(8):634-650.doi:10.1038/s43587-021-00098-4 . |
| [17] | RAJENDRAN P, RENU K, ALI E M,et al.Promising and challenging phytochemicals targeting LC3 mediated autophagy signaling in cancer therapy[J].Immun Inflamm Dis,2024,12(10):e70041.doi:10.1002/iid3.70041 . |
| [18] | KLIONSKY D J, ABDEL-AZIZ A K, ABDELFATAH S,et al.Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)[J].Autophagy,2021,17(1):1-382.doi:10.1080/15548627.2020.1797280 . |
| [19] | 张翠,陈卫东,刘磊,等.特发性膜性肾病肾组织中自噬相关蛋白LC3Ⅱ、P62和p-mTOR的表达及临床意义[J].中国中西医结合肾病杂志,2023,24(2):117-120+190.doi:10.3969/j.issn.1009-587X.2023.02.007 . |
| [20] | ZHOU L, WANG X, REN L,et al.TRPC6 inhibition by Z3571:A structure-based strategy to ameliorate glomerular and tubular dysfunction inchronic kidney disease[J].Biochem Pharmacol,2026,243(Pt 2):117557.doi:10.1016/j.bcp.2025.117557 . |
| [21] | PATEL C A, PATEL S, PATEL S,et al.Targeting TRPC6 in podocytopathies: Why clinical translation remains a challenge?[J].Pharmacol Rep,2026,78(1):102-122.doi:10.1007/s43440-025-00766-x . |
| [22] | RAGY O, ABASS W, KANIGICHERLA D A K,et al.PLA2R autoantibodies, a multifaceted biomarker in nephrotic syndrome and membranous nephropathy[J].Nephrol Dial Transplant,2025,40(8):1458-1469.doi:10.1093/ndt/gfaf012 . |
| [23] | 丁秀,李慧,刘会彬,等.膜肾方调控C3a/C3aR通路对特发性膜性肾病大鼠血浆诱导损伤足细胞的影响[J].中医药导报,2026,32(3):1-5.doi:10.13862/j.cn43-1446/r.2026.03.001 . |
| [24] | MA S, CHANG M, CUI Y,et al.Molecular immunopharmacology of traditional Chinese medicine-derived compounds in membranous nephropathy: Mechanistic insights into immune aging and kidney essence deficiency[J].Front Immunol,2026,17:1770018.doi:10.3389/fimmu.2026.1770018 . |
/
| 〈 |
|
〉 |