Basic Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2020; 26(43): 6810-6821
Published online Nov 21, 2020. doi: 10.3748/wjg.v26.i43.6810
Effects of Yue-Bi-Tang on water metabolism in severe acute pancreatitis rats with acute lung-kidney injury
Jing Hu, Yu-Mei Zhang, Yi-Fan Miao, Lv Zhu, Xiao-Lin Yi, Huan Chen, Xi-Jing Yang, Mei-Hua Wan, Wen-Fu Tang
Jing Hu, Yi-Fan Miao, Lv Zhu, Xiao-Lin Yi, Huan Chen, Mei-Hua Wan, Wen-Fu Tang, Department of Integrative Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yu-Mei Zhang, Department of Traditional Chinese Medicine, Xiang’an Hospital of Xiamen University, Xiamen 361101, Fujian Province, China
Xi-Jing Yang, Animal Experiment Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Tang WF designed the study; Hu J, Zhang YM, Zhu L, Miao YF, Chen H, Yi XL, Yang XJ, and Wan MH were responsible for the acquisition of data; Hu J and Zhang YM were responsible for the analysis and interpretation of data and the drafting of the paper; Tang WF was responsible for critical revisions of the paper; Tang WF and Wan MH obtained funding and provided study supervision; all authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China (General Program), No. 81873203 and No. 81774160.
Institutional review board statement: The study was approved by the Animal Ethical Committee of West China Hospital.
Institutional animal care and use committee statement: The study was reviewed and approved by the University Guidelines and the Animal Care Committee Guidelines of West China Hospital (Chengdu, China) (protocol number, 2018167A).
Conflict-of-interest statement: None of the authors have any conflicts of interest to declare.
Data sharing statement: No additional data are available.
ARRIVE guidelines statement: The manuscript has been revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wen-Fu Tang, PhD, Professor, Department of Integrative Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China.
Received: May 27, 2020
Peer-review started: May 27, 2020
First decision: July 29, 2020
Revised: August 7, 2020
Accepted: August 26, 2020
Article in press: August 26, 2020
Published online: November 21, 2020
Research background

The complications acute lung injury (ALI) and acute kidney injury (AKI) caused by severe inflammation are the main reasons for high mortality of severe acute pancreatitis (SAP). These two complications can both lead to water metabolism and acid-base balance disorders, which could act as additional critical factors affecting the disease trend. Aquaporins (AQPs), which can regulate the transmembrane water transport, have been proved to participate in the pathophysiological process of SAP and the associated complications, such as ALI and AKI. Thus, exploring herbs that can effectively regulate the expression of AQPs in SAP could benefit the prognosis of this disease.

Research motivation

Our previous studies have demonstrated that SAP rats would be complicated with ALI, AKI, and some other manifestations of fluid metabolism disorders, such as pulmonary edema, pleural effusion, and seroperitoneum. Yue-Bi-Tang (YBT) has been widely used as a diaphoretic decoction to treat edema generated from some respiratory diseases based on the theory of traditional Chinese medicine for ages. In modern Chinese medicine treatments, YBT is directly used to treat some edema diseases resulting from kidney injury, such as acute glomerulonephritis. The question is whether YBT could alleviate ALI and AKI by regulating AQP expression in SAP rats. Therefore, this study aimed to verify the effect of YBT treatment in SAP rats complicated with ALI-AKI and explore the underlying mechanism.

Research objectives

To determine whether YBT can regulate the water metabolism in rats with severe acute pancreatitis via regulating expression of aquaporins.

Research methods

Healthy male Sprague-Dawley rats were randomly divided into a sham-operated group (SOG), model group (MG), and YBT-treatment group (TG), with 12 rats in each group. SAP was induced with 3.5% sodium taurocholate in the MG and TG. Rats in the TG were administered with YBT while SOG and MG rats were given the same volume of saline. Blood and tissue samples were harvested to detect serum inflammatory cytokines, histopathological changes, malondialdehyde and superoxide dismutase in the lung, protein and mRNA expression of kidney injury molecule-1, α-smooth muscle actin, and vimentin in the kidney, protein and mRNA expression of AQP1 and 4 in the lung, pancreas, and kidney.

Research results

The serum IL-10, TNF-α, and creatinine levels in the MG were higher than those in the SOG. Treatment with YBT could decrease TNF-α level. Malondialdehyde level in the lung was higher than that in SAP model rats. Rats of the MG had more serious pathological injury and edema in the pancreas, lung, and kidney, and higher protein expression of AQP4 in the lung and AQP1 in the kidney than those of the other two groups. The expression of vimentin was significantly higher in the MG than in the SOG. The expression of AQP1 mRNA in the lung and kidney, and AQP4 mRNA in the kidney in the MG were all up-regulated compared to that of the SOG.

Research conclusions

YBT might regulate water metabolism to reduce lung and kidney edema in SAP rats via decreasing AQP expression, and alleviate the tissue inflammatory injury.

Research perspectives

As we observed that YBT might regulate water metabolism to reduce lung and kidney edema in SAP rats via decreasing AQP expression, and alleviate the tissue inflammatory injury, further investigation of the underlying molecular mechanisms of YBT in regulating AQP is required to provide experimental evidence for wider clinical usage.