Huixia Liu,1,* Hao Yan,2,* Yujuan Li,1 Ye Yao,1 Chun Zhang,1 Jing Xiong1 

1Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China; 2Department of Gynecologic Oncology, Hubei Cancer Hospital, Wuhan, Hubei, 430070, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jing Xiong, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China, Tel +862785726713, Email jingxiong@hust.edu.cn

Background: Colquhounia root tablet (CRT) has been in treatment of autoimmune and inflammatory diseases for decades, but large-scale clinical observations are lacking. The novelty of this study lies in providing the first large-scale real-world clinical data to evaluate the effectiveness and safety of CRT on chronic glomerulopathy and to explore potential molecular mechanisms.
Methods: This is a single-arm retrospective study in the real-world. Data analysis included descriptive statistics, t-tests, non-parametric tests, and analysis of variance, with P < 0.05 considered as the standard for statistical significance. Predicting molecular targets and pathways of CRT through network pharmacology and validating through molecular docking.
Results: (1) Among 317 patients, 74.8% experienced a significant decrease in proteinuria (P < 0.001), particularly in IgA nephropathy (IgAN), type 2 diabetes mellitus-related chronic kidney disease (T2DM related-CKD) and membranous nephropathy (MN). (2) CRT works quickly in reducing proteinuria. 76.7% patients had obvious effect at first visit (P < 0.001). (3) CRT had no obvious effect on creatinine and albumin. (4) Subgroup analysis showed regardless of level of proteinuria and eGFR, CRT had significant efficacy. (5) CRT has good security and low incidence of adverse reactions. (6) Bioinformatics analysis suggested that CRT acts on chronic glomerulopathy by infections, metabolism, Th17 cell differentiation and C-type lectin signaling pathways. The core targets are IL-6, TNF, AKT1, IL-1β and ALB.
Conclusion: CRT treatment for chronic glomerulopathy is safe and effective, which can significantly reduce proteinuria. Network pharmacology results suggest the mechanism of CRT in chronic glomerulopathy may involve Th17 cell differentiation and CLR signaling pathway.
Plain Language Summary: This study evaluated the safety and effectiveness of a medication called Colquhounia root tablet (CRT) for treating chronic glomerulopathy. We discovered that CRT not only significantly reduces proteinuria, but also has a low risk of side effects. Our findings suggest that CRT’s beneficial effects might be due to its impact on Th17 cell differentiation and a specific signaling pathway, C-type lectin signaling pathways, which are involved in the body’s immune response. This insight could pave the way for new treatment strategies for patients suffering from chronic glomerulopathy.

Keywords: chronic glomerulopathy, colquhounia root tablet, network pharmacology, molecular docking