Effects of Yishenjiangzhuo granules on immunity and bone metabolism in patients with stage 3-4 chronic kidney disease

• Published in: Journal of traditional Chinese medicine Vol. 33; no. 5; p. 620
• Main Authors: Zheng, Jing, Lin, Yingda, Huang, Lu, Chen, Caifeng, Zheng, Xuemin, Wu, Xinhong, Liu, Ciyun
• Format: Journal Article
• Language: English
• Published: China 01.10.2013
• Subjects: Adult; Aged; B-Lymphocytes - drug effects; B-Lymphocytes - immunology; Bone and Bones - drug effects; Bone and Bones - metabolism; Drugs, Chinese Herbal - administration & dosage; Female; Humans; Immunity - drug effects; Interleukin-17 - genetics; Interleukin-17 - immunology; Male; Middle Aged; Osteocalcin - metabolism; Renal Insufficiency, Chronic - drug therapy; Renal Insufficiency, Chronic - immunology; Renal Insufficiency, Chronic - metabolism; T-Lymphocyte Subsets - immunology
• ISSN: 0255-2922
• DOI: 10.1016/S0254-6272(14)60031-5

To determine the effects of Yishenjiangzhuo granules (YJG) on bone metabolism and to explore the changes in levels of bone Gla protein (BGP), tartrate-resistant acid phosphatase (TRAP), as well as their relationships with levels of B cells, regulatory T cells (Treg) and interleukin (IL)-17 in patients with stage 3-4 chronic kidney disease (CKD) before and after treatment. Fifty-three stage 3-4 CKD patients were divided randomly into two groups: YJG treatment and control. Peripheral blood was taken from two groups of CKD patients and 21 healthy subjects in the normal group. The parameters determined were the levels of CD4+, CD19+, CD19+ CD69+, CD19+ av, Treg (CD4 + CD25 + CD127lo), BGP, TRAP, IL-17, calcium, phosphate, blood urea nitrogen, serum creatinine (SCr), hemoglobin (Hb) in peripheral blood, and urinary creatinine. Calcium-phosphate products and endogenous creatinine clearance rate (CCr) were calculated according to standard protocols. In YJG and control groups, SCr levels were lowered (P < 0.01) after treatment, whereas CCr (P < 0.05) as well as Hb and albumin levels (P < 0.01) were increased. The changes in levels of CCr and SCr in the YJG group were more significant. After treatment, CD19+CD69+ and Treg levels in the two groups varied (P < 0.01) compared with those of the normal group; the level of CD19+ increased but the levels of CD4+ and CD19 + AV decreased (P < 0.01) in both groups. Compared with the control group, the changes of CD19+ and CD19 + AV in the YJG group were more apparent (P < 0.05). Compared with the normal group, levels of IL-17 in both groups increased significantly (P < 0.01), and the difference in the control group was more significant (P < 0.05). After treatment, the TRAP level increased (P < 0.05), but the difference in BGP level (P > 0.05) was not significant. In stage 3-4 CKD patients, B cells and IL-17 participated in the induction of osteoclast activation. YJG could also elevate the level of B cells and decrease their apoptosis, but showed no significant effects on active B cells, IL-17 or osteoclast activity.