Efficacy and Safety of Colquhounia Root Tablet for Chronic Glomerulopathy: A Real-World Survey With Bioinformatics Insights.

Abstract

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.