# Traditional Chinese medicine for lupus nephritis: modulation of autoimmune pathogenesis

## TL;DR

This paper reviews how traditional Chinese medicine may help treat lupus nephritis by modulating immune responses and protecting the kidneys.

## Contribution

The paper systematically summarizes herbal formulas and phytochemicals in TCM that modulate immune and kidney cells in lupus nephritis.

## Key findings

- Thirty-one studies were reviewed, identifying seven herbal formulas and 18 phytochemicals with potential therapeutic effects for lupus nephritis.
- TCM modulates immune cell activation, differentiation, and apoptosis, while supporting renal protection and immune homeostasis.
- The review highlights the need for future research on standardizing and clinically translating TCM treatments for lupus nephritis.

## Abstract

Lupus nephritis (LN) is an immune complex glomerulonephritis commonly associated with systemic lupus erythematosus. Traditional Chinese medicine (TCM) has emerged as a promising adjuvant therapy for LN, due to its low toxicity and diverse therapeutic effects for long-term management.

A comprehensive search of PubMed and Web of Science was conducted up to 7 June 2024, using keywords related to lupus nephritis, traditional Chinese medicine, immune cells, and kidney resident cells. Study quality were assessed based on Good Automated Manufacturing Practice guidelines, with evaluations jointly conducted by two authors.

This review includes 31 research papers and summarizes seven herbal formulas and 18 phytochemicals that modulate the autoimmune pathogenesis of LN. Their mechanisms involve regulating immune cells activation, differentiation, apoptosis, as well as influencing resident kidney cells to support renal protection and immune homeostasis. Since TCM exhibit bidirectional regulation, they activate regulatory immune cells while suppress pathogenic factors. Inconsistent or inconclusive findings are discussed.

This review summarizes current research on herbal formulas and phytochemicals in immune cells and kidney resident cells in LN, highlighting the potential and significance of TCM treatment. It also addresses the limitations of existing studies and suggests that future research should focus on exploring the immunosuppressive and kidney-protective effects of herbal formulas and phytochemicals, as well as enhancing the clinical translation and standardization of TCM.