About this Research Topic

Background

Chronic kidney disease (CKD) is a leading cause of life lost worldwide. The contribution factors to CKD progression include parenchymal cell loss, chronic inflammation, fibrosis and reduced regenerative capacity of the kidney. CKD complications such as anemia that are associated with increased risks of death should be promptly monitored. The prevalence and mortality of CKD are rapidly increasing, illustrating the shortcomings of current therapeutic approaches. Research aimed at identifying novel therapies for CKD is still needed to prevent disease progression.

In recent years, herbal medicine has demonstrated its potential as an alternative therapy for treatment of numerous diseases, and remains an important source for the discovery of new drugs that has attracted greater attention recently. There has also been evidence showing that herbal medicine is increasingly popular for promoting healthcare and preventing CKD. For example, Salvia miltiorrhiza, one of the most common herbs, either as a single herb or in an herbal formula, has been reported to exhibit renoprotective and antifibrosis effects in CKD rats, and the mechanisms of which are involved in regulating TGFβ/SMAD signalling and activating Nrf2 pathway. Tanshinone IIA, danshensu and salvianolic acid within S. miltiorrhiza are considered as active ingredients. Shenkang, a mixture of herbal medicine containing S. miltiorrhiza is also widely prescribed to treat CKD patients in China. Moreover, Angelica sinensis has been found to ameliorate CKD-associated anemia in rats via stimulating erythropoietin production and improving iron availability. The application of herbal medicine to control CKD by targeting its contribution factors or complications therefore can be a promising therapeutic agent in treating patients with CKD.

Although the mechanisms of action for certain herbal medicine have been investigated, specific target and effective therapy for CKD are still lacking. As strategies target a single pathogenic process may result in unexpected adverse effect, current therapies for CKD targeting multiple pathogenic pathway are needed to either stop or reverse progression. Multitarget effects have been generally accepted to achieve the pharmacological action of herbal medicine due to its multicompound nature within the herb. Therefore, understanding the multifunctional mechanisms of herbal medicine in retarding CKD progression may provide potential therapeutic strategies in this field. Additionally, certain herbal medicine have demonstrated to be nephrotoxic when incorrectly utilized. Therefore, it is also necessary to investigate the underlying mechanisms contributing to nephrotoxicity of herbal medicine to avoid negative outcomes.

The goal of this Research Topic is to provide a forum to advance research on the molecular and cellular pathway of herbal medicine towards CKD therapies, as well as its safety usage. By focusing and testing on these areas, we can provide further evidence as to the potential use of herbal medicine to treat CKD, and therefore prolonging the survival of patients and reducing the burden of CKD.

Manuscripts including Original Research papers, Reviews and Perspectives to be included in the present Research Topic should aim to:

• Further improve understanding of the mechanisms, novel molecular and cellular pathways that mediate the therapeutic, or otherwise, actions of herbal medicine
• Explore the pharmacological role of herbal medicine in treating complications of CKD, such as anemia and iron deficiency
• Identify the active components in herbal medicine for treating CKD
• Evaluate the potential toxic effects of herbal medicine in treating CKD


For manuscripts dealing with plant extracts or other natural substances/compounds, the composition and the stability of the study material must be described in sufficient detail. In particular, for extracts, chromatograms with characterization of the dominating compound(s) are requested. The level of purity must be proven and included. Please refer to the Four Pillars of Best Practice in Ethnopharmacology, a subset of which concerning general standards in natural product research are applied to all such studies in all sections of Frontiers in Pharmacology.

Keywords: Chronic kidney disease, herbal medicine, mechanism, active components, safety usage

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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