Use of Chinese Herbal Medicine to Inhibit Podocyte Damage as Therapeutic Strategy for Membranous Nephropathy

ABSTRACT Membranous nephropathy (MN), one of the most common glomerular diseases, is a noninflammatory autoimmune podocyte disease. In the body, podocytes play an important role in maintaining the stability of the glomerular filtration barrier, and the degree of podocyte damage is a major determinant of MN prognosis because of the limited ability of podocytes to repair and regenerate. Although several therapeutic modalities for inhibiting podocyte damage are currently available, most lead to adverse, nonspecific systemic effects; therefore, newer drugs are necessary to target podocyte damage in MN. Traditional Chinese medicine (TCM) plays an important role in the treatment of primary MN in China. This study reviews the role of podocytes and the mechanisms of podocyte injury in MN glomeruli and summarizes the current status of complement-mediated therapy, the clinical efficacy of TCM in the treatment of primary MN, and the potential mechanisms regulating podocyte injury to support the development of new therapeutic strategies.