Holistic Health Articles and Research Related to Herbal Medicines, Foods and Phytochemicals

Tuesday, 3 December 2013

Nephritis: Glomerulonephritis - The Risk Factors

Nephritis: Glomerulonephritis - The Causes

Nephritis is defined as a condition of inflammation of the nephrons in the kidneys.
Glomerulonephritis is defined as the condition of inflammation of the tiny filters in kidneys (glomeruli), which filter blood by removing excess fluid, electrolytes and waste and pass them through urination.

B.1. Causes
1. Infections
In the study of Glomerulonephritis causing acute renal failure during the course of bacterial infections of of four male patients, aged 53-71 years, who developed GN and ARF following bacterial infections, showed that
a. The first two patients developed GN with immunoglobulin A (IgA) deposits after infections with hospital-acquired methicillin resistant Staphylococcus aureus (MRSA). Clinical, serologic and histological features, classification of GN and treatment differed between the two patients.
b. The third patient developed simultaneous acute rheumatic fever and post-streptococcal GN causing severe ARF requiring hemodialysis. Complete recovery of ARF and migratory polyarthritis followed initiation of corticosteroids.
c. The fourth patient developed ARF and cerebral vasculitis following a prolonged course of Streptococcus mutans endocarditis with delayed diagnosis. He also developed multiple serological abnormalities including elevated titers of antineutrophil cytoplasmic antibodies (ANCA), antinuclear antibodies (ANA), anti-phospholipid antibodies, rheumatoid factor, and modest hypocomplementemia(6).

2. Lupus
In the study of Distinct roles for complement in glomerulonephritis and atherosclerosis revealed in mice with a combination of lupus and hyperlipidemia by Dr. Lewis MJ and the research team at the Imperial College London showed that accelerated atherosclerosis and renal inflammation in SLE are closely linked via immune complex formation and systemic complement depletion. However, whereas hyperlipidemia will enhance renal immune complex-mediated complement activation and the development of nephritis, accelerated atherosclerosis is, instead, related to complement depletion and a reduction in the uptake of apoptotic/necrotic debris(7).

3. Goodpasture's disease
In the study of the Progression from Goodpasture's disease to membranous glomerulonephritis, according to the research team at the Department of Renal Medicine, Concord Hospital, Sydney, thwew is report of an unusual case of a patient with Goodpasture's disease presenting with hemoptysis, severe iron deficiency anemia and microscopic hematuria and proteinuria.... Nine months after presentation he developed nephrotic range proteinuria and a repeat renal biopsy revealed membranous glomerulonephritis with no evidence of his original disease(8).

4. IgA nephropathy
IgA nephropathy is an autoimmune disease, affecting the kidneys
IgA nephropathy, the most common cause of glomerulonephritis, is linked to 6q22-23(9).

5. Polyarteritis nodosa (PAN)
Polyarteritis nodosa (PAN) is defined as a vasculitis of medium & small-sized arteries
There is a report of a 53-year-old man with hepatitis C virus (HCV) infection underwent cholecystectomy for presumed cholecystitis. Gallstones were not present, and histological examination demonstrated medium-sized arteritis, consistent with polyarteritis nodosa (PAN). The patient later developed rapidly progressive glomerulonephritis. Kidney biopsy demonstrated cryoglobulinemic glomerulonephritis(10).

6. Polyangiitis (Wegener's granulomatosis)
Polyangiitis is defined as a vasculitis of small-sized blood vessels. Granulomatosis with polyangiitis (GPA), is the recently proposed, new alternative name for Wegener's granulomatosis. It defines a systemic small-vessels vasculitis, characterized by frequent involvement of upper and lower respiratory tract. According to Dr. Karras A, and the research team at hôpital Européen Georges-Pompidou, service de néphrologie(11).

7. Other causes
a. Homozygous C1q deficiency
According to the study of in mice, Dr. Botto M and the research team at the Imperial College School of Medicine, indicated that among mice without glomerulonephritis, there were significantly greater numbers of glomerular apoptotic bodies in C1q-deficient mice compared with controls. The phenotype associated with C1q deficiency was modified by background genes. These findings are compatible with the hypothesis that C1q deficiency causes autoimmunity by impairment of the clearance of apoptotic cells(12).

b. Deficiency of factor H
Factor H is a member of the regulators of complement activation family, a complement control protein. Factor H, the main regulator of this activation, prevents formation and promotes dissociation of the C3 convertase enzyme, and, together with factor I, mediates the proteolytic inactivation of C3b. Factor H deficiency, described in 29 individuals from 12 families and in pigs, allows unhindered activation of fluid-phase C3 and severe depletion of plasma C3 (ref. 11). Membranoproliferative glomerulonephritis (MPGN) occurs in factor H-deficient humans and pigs(13).
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Sources
(6) http://www.ncbi.nlm.nih.gov/pubmed/18247152
(7) http://www.ncbi.nlm.nih.gov/pubmed/22392450
(8) http://www.ncbi.nlm.nih.gov/pubmed/8532389
(9) http://www.ncbi.nlm.nih.gov/pubmed/11062479
(10) http://www.ncbi.nlm.nih.gov/pubmed/16775442
(11) http://www.ncbi.nlm.nih.gov/pubmed/22902722
(12) http://www.ncbi.nlm.nih.gov/pubmed/9590289
(13) http://www.ncbi.nlm.nih.gov/pubmed/12091909

Nephritis: Glomerulonephritis - Signs and Symptoms

Glomerulonephritis is defined as the condition of inflammation of the tiny filters in kidneys (glomeruli), which filter blood by removing excess fluid, electrolytes and waste and pass them through urination.
A. Signs and Symptoms
A.1. Acute Glomerulonephritis
According to the study by Movchan EA, in the study of Evolutionary trends in symptoms of acute glomerulonephritis in adult population of the Novosibirsk region, indicated that AGN occurs not often but with stable rate. It is encountered more frequently in young men. The last decade is characterized by higher morbidity after streptococcal infection, high percentage of women at reproductive age, aggravation of the clinical course with marked edemas, severe arterial hypertension, renal dysfunction (acute renal failure in 10.4%), cases of left ventricular failure (5.2%) and eclampsia (1.7%) not registered earlier(1).

A.2. Chronic Glomerulonephritis
In the study of Incidence and characteristics of the hypertension syndrome in chronic glomerulonephritis, by Dr. Stefanov G. showed that in the random group, 65.1 per cent had renoparenchymal hypertension (RPH), 34.8 per cent of the patients had RPH among the patients with normal renal function, and with various degrees of chronic renal insufficiency (ChRI) - 95.4 per cent..... In 48 per cent but patients with ChGN without RPH also had the same complaints--26 per cent. Complaints as dizziness, tinnitus and insomnia were rare. The hypertension was with a short duration (according to anamnestic data)--in 2/3 less than three years and 40 per cent of the patients had hypertonic crises or/and acute left cardiac insufficiency in spite of the relatively little alterations in ECG and fundus of the eye(2).

3. Other symptoms include
a. Hematuria
Hematuria is condition of the presence of red blood cells in the urine.
There is a report of a a 16 year old male with a history of recurrent synpharyngitic macroscopic hematuria presented with severe loin pain, macroscopic hematuria and oliguric acute renal failure, according to the study by Dr. Kincaid-Smith P and the research team(3).

b. Proteinuria (The presence of an excess of proteins in the urine)
Proteinuria is the most important predictor of outcome in glomerulonephritis and experimental data suggest that the tubular cell response to proteinuria is an important determinant of progressive fibrosis in the kidney(4)

c. Cold sweating, general fatigue, and somnolence
There is a report of a 66-year-old woman, who has been under hemodialysis due to antineutrophil cytoplasm autoantibody (ANCA)-associated glomerulonephritis since 2003, was hospitalized because of cold sweating, general fatigue, and somnolence, According to the research team at the Divisions of Endocrinology and Metabolism(5).
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/11588787
(2) http://www.ncbi.nlm.nih.gov/pubmed/7164407
(3) http://www.ncbi.nlm.nih.gov/pubmed/6851258
(4) http://www.ncbi.nlm.nih.gov/pubmed/20976140
(5) http://www.ncbi.nlm.nih.gov/pubmed/21437150
(6) http://www.ncbi.nlm.nih.gov/pubmed/18247152

Nephritis - The Types

Nephritis is defined as a condition of inflammation of the nephrons in the kidneys.

Types of Nephritis
Depending to the locations of inflammation, Nephritis can be classified as follows
I. Glomerulonephritis
Glomerulonephritis is defined as the condition of inflammation of the tiny filters in kidneys (glomeruli), which filter blood by removing excess fluid, electrolytes and waste and pass them through urination.
1.. Acute Glomerulonephritis
A sudden onset of inflammation of glomeruli.
2. Chronic Glomerulonephritis
This is a graduated progression of kidney diseases. It can be primary or as a result of certain diseases

II. Interstitial nephritis (Tubulo-interstitial nephritis)
Interstitial nephritis is defined as a condition of inflammation of the spaces between renal tubules, affecting the interstitium of the kidneys and kidney function in wast removal.
1, Acute Interstitial nephritis
A sudden onset of the inflammation of the diseases
2. Chronic Interstitial nephritis
In most case, it ends in kidney failure

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Gallstone Treatment In Traditional Chinese medicine perspective

A gallstone formed within the gallbladder as a result of changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Gallstones can cause blockage the flow of bile through the bile ducts that can lead to inflammatory causes of acute cholecystitis. Gallstones are most common among older adults, women, overweight people, etc.
Treatments
In traditional Chinese perpective
1. Traditional Chinese herbs for nourishing the liver (Yanggan Lidan Granule (YGLDG))
In the study of Eighty guinea pigs randomly divided into four groups, which were normal control group, untreated group, nourishing-liver Chinese drug (NLCD) group and ursodeoxycholic acid (UDCA) group, with 20 guinea pigs in each group, gallstones were induced in the guinea pigs of the latter 3 groups by the feed of diet inducing cholelithiasis with high cholesterol, while the corresponding medicines were used in NLCD group and UDCA group for prevention and treatment for 7 weeks, showed that the [Ca(2+)]i in gallbladder cells is the important factor for contractile function of gallbladder and the information of gallstones. Traditional Chinese herbs for nourishing the liver may significantly increase the [Ca(2+)]i in gallbladder cells to facilitate contraction of the smooth muscle cells of gallbladder and relieve the cholestatis(17).
Other study to explore the effects of Yanggan Lidan Granule (YGLDG), a compound traditional Chinese herbal medicine for nourishing liver and improving choleresis, on the rate of gallstone formation and content of plasma cholecystokinin in guinea pigs with induced cholesterol gallstones. indicated that YGLDG can significantly decrease the rate of gallstone formation in guinea pigs. It may be related to elevating the content of CCK in the plasma(18).

2. Ingredients of Yanggan Lidan Granule (YGLDG)
a. Bai Shao tonifies liver Yin,
b. Chen Pi,
c. Gao Qi Zi tonifies liver Yin
d. He shou wu tonifies liver Yin
e. Gan Cao
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Sources
(17) http://www.ncbi.nlm.nih.gov/pubmed/17352876
(18) http://www.ncbi.nlm.nih.gov/pubmed/18405610

Gallstone Treatment In Herbal medicine perspective

Treatments
F.2. In herbal medicine perspective
1. Fenugreek seeds and onion
In the study to evaluate the antilithogenic effect of a combination of dietary fenugreek seeds and onion, researchers at the Central Food Technological Research Institute, found that hepatic lipid peroxides were reduced by 19-22% and 39-45% with fenugreek, onion and their combination included in the diet along with the HCD. Increased accumulation of fat in the liver and inflammation of the gallbladder membrane produced by HCD were reduced by fenugreek, onion and their combination. The antilithogenic influence was highest with fenugreek alone, and the presence of onion along with it did not further increase this effect(15).

2. Capsaicin and curcumin
In the study of the efficacy of capsaicin and curcumin in cholesterol gallstones induced by feeding mice a high-cholesterol (0.5%) diet for 10 weeks, found that the capsaicin and curcumin combination did not have an additive influence in reducing the incidence of cholesterol gallstones in mice, their combination nevertheless was more beneficial in enhancing the activity of hepatic antioxidant enzyme ─ glutathione reductase in the lithogenic situation. The antioxidant effects of dietary spice compounds are consistent with the observed reduction in cholesterol gallstones formed under lithogenic condition(16).

3. Garlic and onion
The Central Food Technological Research Institute has reported the study of the health beneficial potential of dietary garlic and onion in reducing the incidence and severity of cholesterol gallstone (CGS)with the induced CGS in mice with a lithogenic diet for 10 weeks, they were maintained on basal diets containing 0.6% dehydrated garlic or 2% dehydrated onion for a further 10 weeks(26). Others suggested that dietary allium spices exerted antilithogenic influence by decreasing the cholesterol hyper-secretion into bile and increasing the bile acid output thus decreasing the formation of lithogenic bile in experimental mice(27).

4. Milk thistle
There is a study indicated that after intake of milk thistle bile duct hyperplasia were significantly decreased in 50,000 ppm males and in all exposed groups of females, and the incidence of mixed inflammatory cell infiltration was significantly decreased in 50,000 ppm males(28).

5. Etc.

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Sources

Gallstone Treatment In conventional medicine perspective

A gallstone formed within the gallbladder as a result of changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Gallstones can cause blockage the flow of bile through the bile ducts that can lead to inflammatory causes of acute cholecystitis. Gallstones are most common among older adults, women, overweight people, etc.
Treatment
F.1. In conventional medicine perspective
1. Cholecystectomy
No treatment for people who have developed galldtones but with no system, otherwise, surgery to remove the gallbladder may be necessary. Cholecystectomy is the surgical removal of the symptomatic gallbladder. In the sugery, It is the most common method for treating symptomatic gallstones, other surgeries include the laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.

2. Others
a. Some researchers suggested for the treatment of gallstones in patients with normal stonefree bile ducts, new modalities have been developed besides the classical cholecystectomy and the oral litholysis. The interventional procedures (local litholysis, extracorporeal shockwave lithotripsy, combination of shockwave lithotripsy and local litholysis, cholecystostomy and extra- or intracorporeal lithotripsy) do not need a narcosis and can be applied even in high-risk patients. Because the gallbladder itself is not removed, the recurrence rate after all these interventions is rather high. The new operative procedures (laparoscopic cholecystectomy, mini-laparotomy cholecystectomy) are definitive solutions for stone disease, but must be performed mostly in narcosis(13).

b. Today, cholecystectomy was still the most frequent method of treatment for symptomatic cholecystolithiasis (n = 1369) with low morbidity (4.3%) and lethality (0.28%). Probably less than 20% of all cases fulfill the strict selection criteria for extracorporeal shock wave lithotripsy (ESWL). All alternative methods of treatment in which the gallbladder is preserved have an increased risk for gall stone recurrence. Only after the long-term follow-up results of ESWL are known, the recurrence rate can be assessed. In most cases, bile duct stones (n = 417) were removed by endoscopy, if necessary in combination with ESWL (n = 310, stone removal: 95%, lethality: 0.3%). However, in low risk patients with concurrent cholecystolithiasis surgery was still the method of choice (n = 107, stone removal: 96%, lethality: 0/107)(14).

Chinese Secrets To Fatty Liver And Obesity Reversal
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Optimal Health And Loose Weight

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Sources
(13) http://www.ncbi.nlm.nih.gov/pubmed/2028140
(14) http://www.ncbi.nlm.nih.gov/pubmed/2721300
(15) http://www.ncbi.nlm.nih.gov/pubmed/21756271