Role of Traditional Chinese Medicine for the Treatment of Lupus nephritis: Mechanisms and Applications.

Lupus nephritis (LN), caused by Systemic lupus erythematosus, is a chronic autoimmune renal disease and a key risk factor for morbidity and fatality involving 50% damage to the kidney. LN is associated with aberrant functioning of the immune system, characterized by increased systemic inflammation, altered lymphocyte count, perivascular infiltration of inflammatory cells, and declined organ functioning.Conventional therapies to LN include high-dose glucocorticoids, immunosuppressants, calcineurin inhibitors, immune boosters, and targeted medicines that improve kidney functioning. However, these drugs triggered severe adverse side effects, and their prolonged usage resulted in drug resistance, accentuating LN complications.Hence, safe and functional Traditional Chinese Medicines (TCM), with supporting clinical trials and observational studies, received significant recognition worldwide for the Treatment of LN. In the form of herbal extracts and preparations, TCM proved effective in treating immunodeficient disorders, including LN. Additionally, acupuncture as a TCM appeared promising in reducing LN-induced inflammation and joint pain.The therapeutic mechanisms included reduced antibody generation, pro-inflammatory cytokine release, immune complex formation, complement activation, extracellular matrix damage and proteinuria levels that played vital roles in chronic kidney diseases. They generated immunosuppressive effects by modulating apoptosis, oxidative stress, and inflammatory signaling pathways, such as JAK/STAT, NF-κB, AP-1 and MAPK and their cross-talk in LN and associated renal injury. These therapies improved blood circulation, alleviated renal pathological changes, restored glomerular capillary functioning, and regenerated renal tissues. However, an essential requisite for these therapies for LN included reduced side effects and improved hepatoprotection and detoxification. Clinical studies suggest that TCM formulations may demonstrate therapeutic benefits in alleviating the symptoms of LN, suggesting prospects of combined applications with Western medicine to enhance treatment efficiencies. Overall, TCM is beneficial for treating LN, and may serve as a potential alternative to conventional medicines.