Non-Coding RNAs in Hereditary Kidney Disorders Part 3

9. miRNAs in Fabry Disease

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Jaurretche et al. examined the expression of urinary miRNAs including miR-21, miR- 29, miR-192, miR-200, and miR-433 (the known miRNAs associated with renal fibrosis) in normal individuals and patients with Fabry disease [117]. They found that urinary miR-29 and miR-200 that suppress renal fibrosis are decreased in Fabry disease, whereas the levels of miR-21, miR-192, and miR-433 that promotes renal fibrosis have no significant difference. A linear correlation between urinary miR-21 and urinary albumin/creatinine ratio is also observed in Fabry disease patients [117]. In addition, the circulating miRNA profile in Fabry disease has been studied by performing microRNA sequencing of the serum samples, and 10 miRNAs are differentially expressed in the serum of patients with Fabry disease compared to those in normal individuals [118]. The circulating miR199a-5p and miR-126- 3p are upregulated in Fabry patients, which can be normalized in Fabry patients after ERT [118]. To further determine whether ERT alters the level of circulating miRNAs in Fabry patients, Xiao et al. performed microRNA sequencing for the serum samples from Fabry patients with or without ERT [119]. A total of 145 miRNAs are identified to be regulated by ERT. Among those miRNAs, miR-1307-5p, miR-21-5p, miR-152-5p, and miR-26a-5p were confirmed to be downregulated in the serum of Fabry patients after ERT in a validation cohort [119]. These studies suggested that urinary and circulating miRNAs might be used as biomarkers to assess the disease progression and the efficacy of ERT in Fabry patients. 

10. Conclusions and Future Perspectives

Emerging evidence supports that miRNAs and lncRNAs are important mediators in the pathophysiology of kidney diseases. The discovery of aberrantly expressed miRNAs in PKD has defined new molecular mechanisms of cystogenesis and provided a rationale for translating the miRNAs research into the clinical setting. The pharmaceutical and biotech companies mainly work on two types of products: miRNA mimics and antagomirs. The stability and delivery to the desired site of action are two major challenges of miRNA-based drugs. Although miRNA-based therapeutics have not yet reached a pharmaceutical breakthrough, a recent clinical evaluation of anti-miR-122 therapy has shown encouraging safety and efficacy in patients with HCV infection [120]. The anti-miR-17 treatment in patients with ADPKD, anti-miR-21 treatment in patients with Alport nephropathy, and miRNA mimics in patients with malignant pleural mesothelioma and non-small cell lung cancer are ongoing. The completion of these clinical trials will further support the significance of miRNA-based therapeutics in human kidney diseases. Many studies have focused on the lncRNAs in diabetic nephropathy, acute kidney injury, and renal cell carcinoma, while these studies have remained primarily descriptive. The elucidation of the role of lncRNAs in PKD and other genetic kidney diseases is still in its infancy. The development of kidney-specific ncRNAs as therapeutic targets and biomarkers in hereditary kidney disease might be a fascinating area of research.

According to relevant studies,cistanche is a traditional Chinese herb that has been used for centuries to treat various diseases. It has been scientifically proven to possess anti-inflammatory, anti-aging, and antioxidant properties. Studies have shown that cistanche is beneficial for patients suffering from kidney disease. The active ingredients of cistanche are known to reduce inflammation, improve kidney function and restore impaired kidney cells. Thus, integrating cistanche within a kidney disease treatment plan can offer great benefits to patients in managing their condition.

Cistanche helps to reduce proteinuria, lowers BUN and creatinine levels, and decreases the risk of further kidney damage. In addition, cistanche also helps reduce cholesterol and triglyceride levels which can be dangerous to patients suffering from kidney disease.

Cistanche's antioxidant and anti-aging properties help to protect the kidneys from oxidation and damage caused by free radicals. This improves kidney health and reduces the risks of developing complications. Cistanche also helps to boost the immune system, which is essential in fighting off kidney infections and promoting kidney health.

By combining traditional Chinese herbal medicine and modern western medicine, those suffering from kidney disease can have a more comprehensive approach to treating the condition and improving their quality of life. Cistanche should be used as part of a treatment plan but is not to be used as an alternative to conventional medical treatments.

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