Jiangtang Decoction Ameliorates Diabetic Kidney Disease Through the Modulation of the Gut Microbiota

Jinni Hong; Tingting Fu; Weizhen Liu; Yu Du; Junmin Bu; Guojian Wei; Miao Yu; Yanshan Lin; Cunyun Min; Datao Lin

doi:10.2147/DMSO.S441457

Jiangtang Decoction Ameliorates Diabetic Kidney Disease Through the Modulation of the Gut Microbiota

Diabetes Metab Syndr Obes. 2023 Nov 20:16:3707-3725. doi: 10.2147/DMSO.S441457. eCollection 2023.

Authors

Jinni Hong^{1

2}, Tingting Fu^{1

2}, Weizhen Liu^{1

2}, Yu Du^{1

2}, Junmin Bu^{1

2}, Guojian Wei^{1

2}, Miao Yu^{1

2}, Yanshan Lin^{1

2}, Cunyun Min^{1

2}, Datao Lin³

Affiliations

¹ Department of Traditional Chinese Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, People's Republic of China.
² Guangdong Provincial Institute of Geriatric, Guangzhou, Guangdong, 510080, People's Republic of China.
³ Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China.

Abstract

Purpose: This study aimed to elucidate the impact of Jiangtang decoction (JTD) on diabetic kidney disease (DKD) and its association with alterations in the gut microbiota.

Methods: Using a diabetic mouse model (KK-Ay mice), daily administration of JTD for eight weeks was undertaken. Weekly measurements of body weight and blood glucose were performed, while kidney function, uremic toxins, inflammation factors, and fecal microbiota composition were assessed upon sacrifice. Ultra-structural analysis of kidney tissue was conducted to observe the pathological changes.

Results: The study findings demonstrated that JTD improve metabolism, kidney function, uremic toxins and inflammation, while also exerting a modulatory effect on the gut microbiota. Specifically, the genera Rikenella, Lachnoclostridium, and unclassified_c_Bacilli exhibited significantly increased abundance following JTD treatment, accompanied by reduced abundance of norank_f_Lachnospiraceae compared to the model group. Importantly, Rikenella and unclassified_c_Bacilli demonstrated negative correlations with urine protein levels. Lachnoclostridium and norank_f_Lachnospiraceae were positively associated with creatinine (Cr), indoxyl sulfate (IS) and interleukin (IL)-6. Moreover, norank_f_Lachnospiraceae exhibited positive associations with various indicators of DKD severity, including weight, blood glucose, urea nitrogen (UN), kidney injury molecule-1 (KIM-1) levels, trimethylamine-N-oxide (TMAO), p-cresyl sulfate (pCS), nucleotide-binding oligomerization domain (Nod)-like receptor family pyrin domain-containing 3 (NLRP3) and IL-17A production.

Conclusion: These findings suggested that JTD possess the ability to modulate the abundance of Rikenella, Lachnoclostridium, unclassified_c_Bacilli and norank_f_Lachnospiraceae within the gut microbiota. This modulation, in turn, influenced metabolic processes, kidney function, uremic toxin accumulation, and inflammation, ultimately contributing to the amelioration of DKD.

Keywords: Chinese herbal medicine; diabetic kidney disease; gut microbiota; inflammation; uremic toxins.

Grants and funding

This study was funded by the National Natural Science Foundation of China (No. 82202560), the Guangdong Basic and Applied Basic Research Foundation (No.2022A1515110655), the Traditional Chinese Medicine Bureau of Guangdong Province (Nos. 20231003 and 20223001), the Natural Science Foundation of Guangdong Province (Nos. 2023A1515011458 and 2021A1515220050), and the Science and Technology Program of Guangzhou (No. SL2022A04J00042).