118
VOLUME 9 NUMBER 3 • SEPTEMBER 2012
REVIEW
SA JOURNAL OF DIABETES & VASCULAR DISEASE
There are various mechanisms by which reno-protection may be
achieved, including modulation of AGEs, of the polyol pathway, and
of the PKC pathway, and anti-oxidative properties. For example,
morroniside isolated from
Corni fructus
has shown reno-protection
in experimental diabetes through a reduction in the production of
AGEs.
64
Additionally, some plants have been shown to cause an
improvement in renal function in experimental diabetes mellitus
through inhibition of ET-1 and TGF-
β
1
and the endothelin-1 receptor
A (ETRA).
65
Available evidence suggests that some herbal extracts interfere
with the concentrating and diluting mechanisms of tubular
transport processes in the proximal and distal tubules and/or on
other components of tubular cell membranes. Therefore we
speculate that oleanolic acid influences renal fluid and electrolyte
handling by altering the structural integrity and function of tubular
epithelial cells to affect reabsorption and secretion.
Modification of risk factors in diabetes has an impressive impact
on morbidity and mortality in diabetic patients. An overview of some
of some medicinal plants currently used in diabetic hypertension
and kidney disease, together with the possible mechanism(s) is
summarised in Table 1.
Conclusion
We describe the therapeutic and pharmacological evidence in
support of some of the medicinal plant extracts used in the
management of hypertension and kidney disease in diabetes
mellitus. Some of these medicinal plant extracts are a potential
source of anti-diabetic drugs because of their therapeutic efficacy
and anti-diabetic mechanisms reported in experimental animals.
However, at present, the cellular/molecular mechanisms of action
of these plant extracts remain to be established.
Future researchdirectedat the identificationof active components
is the only viable option for supporting the efficacy claims for all
herbs. In the absence of such standardisation, health practitioners
and consumers alike should remain optimistic but wary. Research
funding to investigate potentially beneficial effects of medicinal
plants is critically important for optimal patient care and safety.
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