Prospective analysis of the efficacy of beraprost sodium combined with alprostadil on diabetic nephropathy and influence on rennin-angiotensin system and TNF-α

Xu,Xinwei; Pan,Xiaojing; Li,Song

doi:10.3892/etm.2019.8265

Prospective analysis of the efficacy of beraprost sodium combined with alprostadil on diabetic nephropathy and influence on rennin-angiotensin system and TNF-α

Authors:
- Xinwei Xu
- Xiaojing Pan
- Song Li
View Affiliations

Affiliations: Department of Nephrology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China, Department of Blood Purification, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
Published online on: December 2, 2019 https://doi.org/10.3892/etm.2019.8265
Pages: 639-645
Copyright: © Xu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Efficacy of beraprost sodium (BPS) combined with alprostadil on diabetic nephropathy (DN) and its influence on renin angiotensin system (RAS) and TNF-α were investigated. One hundred and two patients with type 2 diabetic nephropathy admitted to Weifang People's Hospital from July 2017 to January 2019 were selected and divided into two groups according to the treatment plan. Fifty patients with alprostadil were the control group and 52 patients with alprostadil combined with BPS were the combined group. Related indexes of fasting blood glucose, hemorheology, coagulation function, renal function, urine routine, liver function, renin angiotensin system and changes of TNF-α (ELISA) were observed, and the occurrence of adverse reactions of patients were recorded. The fasting blood glucose of patients in the two groups after treatment was lower than that before treatment (P<0.05). After treatment, blood viscosity, plasma viscosity and erythrocyte deformation exponent of patients in the two groups decreased (P<0.05), and the combined group was lower than the control group (P<0.05). After treatment, the average volume of fibrinogen (FIB), D dimer and platelets of the patients in the two groups decreased (P<0.05), and the combined group was lower than the control group (P<0.05). After treatment, UACR, CysC, β2-MG and α1-MG of patients decreased in the two groups (P<0.05), and the combined group was lower than the control group (P<0.05). After treatment, renin and angiotensin Ⅱ of patients decreased in both groups (P<0.05). TNF-α of patients in both groups decreased after treatment (P<0.05), and the combined group was lower than the control group (P<0.05). In conclusion, compared with alprostadil, BPS combined with alprostadil can effectively improve hemodynamics, coagulation function and renal function of DN patients, and inhibit expression of RAS-related factors and TNF-α, which is a more effective method for DN treatment.

View Figures

View References

1	Mayer-Davis EJ, Lawrence JM, Dabelea D, Divers J, Isom S, Dolan L, Imperatore G, Linder B, Marcovina S, Pettitt DJ, et al SEARCH for Diabetes in Youth Study, : Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012. N Engl J Med. 376:1419–1429. 2017. View Article : Google Scholar : PubMed/NCBI
2	John S: Complication in diabetic nephropathy. Diabetes Metab Syndr. 10:247–249. 2016. View Article : Google Scholar : PubMed/NCBI
3	Keri KC, Samji NS and Blumenthal S: Diabetic nephropathy: Newer therapeutic perspectives. J Community Hosp Intern Med Perspect. 8:200–207. 2018. View Article : Google Scholar : PubMed/NCBI
4	Magee C, Grieve DJ, Watson CJ and Brazil DP: Diabetic nephropathy: A tangled web to unweave. Cardiovasc Drugs Ther. 31:579–592. 2017. View Article : Google Scholar : PubMed/NCBI
5	Donate-Correa J, Martín-Núñez E, Muros-de-Fuentes M, Mora-Fernández C and Navarro-González JF: Inflammatory cytokines in diabetic nephropathy. J Diabetes Res. 2015:9484172015. View Article : Google Scholar : PubMed/NCBI
6	Yeo ES, Hwang JY, Park JE, Choi YJ, Huh KB and Kim WY: Tumor necrosis factor (TNF-alpha) and C-reactive protein (CRP) are positively associated with the risk of chronic kidney disease in patients with type 2 diabetes. Yonsei Med J. 51:519–525. 2010. View Article : Google Scholar : PubMed/NCBI
7	Chen S, Xie S, He W, Wei D, Li S and Chen W: Beneficial effect of beraprost sodium plus aspirin in the treatment of acute ischemic stroke. Med Sci Monit. 23:4401–4407. 2017. View Article : Google Scholar : PubMed/NCBI
8	Tanaka S, Akaike T, Wu J, Fang J, Sawa T, Ogawa M, Beppu T and Maeda H: Modulation of tumor-selective vascular blood flow and extravasation by the stable prostaglandin 12 analogue beraprost sodium. J Drug Target. 11:45–52. 2003. View Article : Google Scholar : PubMed/NCBI
9	Li S, Wang Y, Chen L, Wang Z, Liu G, Zuo B, Liu C and Sun D: Beraprost sodium mitigates renal interstitial fibrosis through repairing renal microvessels. J Mol Med (Berl). 97:777–791. 2019. View Article : Google Scholar : PubMed/NCBI
10	Wang XF, Zhang BH, Lu XQ and Wang P: Beraprost sodium, a stable analogue of PGI2, inhibits the renin-angiotensin system in the renal tissues of rats with chronic renal failure. Kidney Blood Press Res. 43:1231–1244. 2018. View Article : Google Scholar : PubMed/NCBI
11	Wei W, An XR, Jin SJ, Li XX and Xu M: Inhibition of insulin resistance by PGE1 via autophagy-dependent FGF21 pathway in diabetic nephropathy. Sci Rep. 8:92018. View Article : Google Scholar : PubMed/NCBI
12	Zhang JZ, Kang XJ, Gao Y, Zheng YY, Wu TT, Li L, Liu F, Yang YN, Li XM, Ma YT, et al: Efficacy of alprostadil for preventing of contrast-induced nephropathy: A meta-analysis. Sci Rep. 7:10452017. View Article : Google Scholar : PubMed/NCBI
13	Goya K, Otsuki M, Xu X and Kasayama S: Effects of the prostaglandin I2 analogue, beraprost sodium, on vascular cell adhesion molecule-1 expression in human vascular endothelial cells and circulating vascular cell adhesion molecule-1 level in patients with type 2 diabetes mellitus. Metabolism. 52:192–198. 2003. View Article : Google Scholar : PubMed/NCBI
14	Qin L, Qin W, Wang J and Lin L: Combined treatment of diabetic nephropathy with alprostadil and calcium dobesilate. Exp Ther Med. 14:5012–5016. 2017.PubMed/NCBI
15	Gabir MM, Hanson RL, Dabelea D, Imperatore G, Roumain J, Bennett PH and Knowler WC: Plasma glucose and prediction of microvascular disease and mortality: Evaluation of 1997 American Diabetes Association and 1999 World Health Organization criteria for diagnosis of diabetes. Diabetes Care. 23:1113–1118. 2000. View Article : Google Scholar : PubMed/NCBI
16	Shaw JE, Sicree RA and Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 87:4–14. 2010. View Article : Google Scholar : PubMed/NCBI
17	Tanabe K, Maeshima Y, Sato Y and Wada J: Antiangiogenic therapy for diabetic nephropathy. BioMed Res Int. 2017:57240692017. View Article : Google Scholar : PubMed/NCBI
18	Atkins RC: The epidemiology of chronic kidney disease. Kidney Int Suppl. 94:S14–S18. 2005. View Article : Google Scholar
19	Shima A, Miyamoto M, Kubota Y, Takagi G and Shimizu W: Beraprost sodium protects against diabetic nephropathy in patients with arteriosclerosis obliterans: A prospective, randomized, open-label study. J Nippon Med Sch. 82:84–91. 2015. View Article : Google Scholar : PubMed/NCBI
20	Luo C, Li T, Zhang C, Chen Q, Li Z, Liu J and Wang Y: Therapeutic effect of alprostadil in diabetic nephropathy: Possible roles of angiopoietin-2 and IL-18. Cell Physiol Biochem. 34:916–928. 2014. View Article : Google Scholar : PubMed/NCBI
21	Mathiesen ER, Hommel E, Olsen UB and Parving HH: Elevated urinary prostaglandin excretion and the effect of indomethacin on renal function in incipient diabetic nephropathy. Diabet Med. 5:145–149. 1988. View Article : Google Scholar : PubMed/NCBI
22	Chen Y, Wan JX, Jiang DW, Fu BB, Cui J and Li GF: Clinical efficacy and safety of sequential treatment with alprostadil and beraprost sodium for chronic renal failure induced by chronic glomerulonephritis. Nan Fang Yi Ke Da Xue Xue Bao. 33:1521–1524. 2013.(In Chinese). PubMed/NCBI
23	Santos RA, Ferreira AJ, Verano-Braga T and Bader M: Angiotensin-converting enzyme 2, angiotensin-(1–7) and Mas: New players of the renin-angiotensin system. J Endocrinol. 216:R1–R17. 2013. View Article : Google Scholar : PubMed/NCBI
24	Raebel MA: Hyperkalemia associated with use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Cardiovasc Ther. 30:e156–e166. 2012. View Article : Google Scholar : PubMed/NCBI
25	Miyamori I, FitzGerald GA, Brown MJ and Lewis PJ: Prostacyclin stimulates the renin angiotensin aldosterone system in man. J Clin Endocrinol Metab. 49:943–944. 1979. View Article : Google Scholar : PubMed/NCBI
26	Navarro-González JF and Mora-Fernández C: The role of inflammatory cytokines in diabetic nephropathy. J Am Soc Nephrol. 19:433–442. 2008. View Article : Google Scholar : PubMed/NCBI
27	Navarro-González JF, Jarque A, Muros M, Mora C and García J: Tumor necrosis factor-alpha as a therapeutic target for diabetic nephropathy. Cytokine Growth Factor Rev. 20:165–173. 2009. View Article : Google Scholar : PubMed/NCBI
28	Liu CP and Yu ZJ: Study on L-ornithine-L-aspartate in the treatment of acute-on-chronic liver failure. Zhonghua Gan Zang Bing Za Zhi. 19:63–64. 2011.(In Chinese). PubMed/NCBI
29	Deng J, Feng J, Liu T, Lu X, Wang W, Liu N, Lv Y, Liu Q, Guo C and Zhou Y: Beraprost sodium preconditioning prevents inflammation, apoptosis, and autophagy during hepatic ischemia-reperfusion injury in mice via the P38 and JNK pathways. Drug Des Devel Ther. 12:4067–4082. 2018. View Article : Google Scholar : PubMed/NCBI
30	Ho Y: Glucose metabolism and diabetes. Patient-Specific Controller for an Implantable Artificial Pancreas. Springer; Singapore: pp. 11–17. 2019, View Article : Google Scholar
31	Nitulescu GM, Van De Venter M, Nitulescu G, Ungurianu A, Juzenas P, Peng Q, Olaru OT, Grădinaru D, Tsatsakis A, Tsoukalas D, et al: The Akt pathway in oncology therapy and beyond (Review). Int J Oncol. 53:2319–2331. 2018.PubMed/NCBI
32	Takenaga M, Ishihara T, Niimi J, Hamaguchi A, Asano T, Tsuchiya R, Ohta Y, Mizushima T and Yudoh K: Nano PGE1 enhances phosphorylation of ERK1/2 and Akt to promote recovery from motor dysfunction and muscle atrophy induced by sciatic nerve injury. Preprints 2019. https://www.preprints.org/manuscript/201901.0250/v1