Effects of Yishenjiangzhuo granules on immunity and bone metabolism in patients with stage 3-4 chronic kidney disease

Objective

To determine the effects of Yishenjiangzhuo granules (YJG) on bone metabolism and to explore the changes in levels of bone Gla protein (BGP), tartrate-resistant acid phosphatase (TRAP), as well as their relationships with levels of B cells, regulatory T cells (Treg) and interleukin (IL)-17 in patients with stage 3-4 chronic kidney disease (CKD) before and after treatment.

Methods

Fifty-three stage 3-4 CKD patients were divided randomly into two groups: YJG treatment and control. Peripheral blood was taken from two groups of CKD patients and 21 healthy subjects in the normal group. The parameters determined were the levels of CD4 +, CD19 +, CD19 + CD69 +, CD19 + AV, Treg (CD4 + CD25 + CD127^l°), BGP, TRAP, IL-17, calcium, phosphate, blood urea nitrogen, serum creatinine (SCr), hemoglobin (Hb) in peripheral blood, and urinary creatinine. Calcium-phosphate products and endogenous creatinine clearance rate (CCr) were calculated according to standard protocols.

Results

In YJG and control groups, SCr levels were lowered (P<0.01) after treatment, whereas CCr (P<0.05) as well as Hb and albumin levels (P< 0.01) were increased. The changes in levels of CCr and SCr in the YJG group were more significant. After treatment, CD19+CD69+ and Treg levels in the two groups varied (P<0.01) compared with those of the normal group; the level of CD19+ increased but the levels of CD4 + and CD19 + AV decreased (P< 0.01) in both groups. Compared with the control group, the changes of CD19+ and CD19+AV in the YJG group were more apparent (P<0.05). Compared with the normal group, levels of IL-17 in both groups increased significantly (P<0.01), and the difference in the control group was more significant (P<0.05). After treatment, the TRAP level increased (P<0.05), but the difference in BGP level (P>0.05) was not significant.

Conclusion

In stage 3-4 CKD patients, B cells and IL-17 participated in the induction of osteoclast activation. YJG could also elevate the level of B cells and decrease their apoptosis, but showed no significant effects on active B cells, IL-17 or osteoclast activity.