Mingquan Li

Ferroptosis plays a significant role in the pathological mechanism of acute kidney injury (AKI) for many etiologies. The characteristics of ferroptosis involve many aspects, including iron metabolism, lipid metabolism, and glutathione metabolism. In terms of iron metabolism, ferroptosis involves the accumulation of labile iron; in terms of lipid metabolism, ferroptosis involves the peroxidation of lipids, especially certain phospholipids; in terms of glutathione metabolism, ferroptosis involves the reduction of reduced glutathione (GSH) levels, leading to a decrease in the activity of glutathione peroxidase 4 (GPX4). A lot of traditional Chinese medicines (TCMs) have been reported to have a protective effect against AKI, and many of these TCMs have shown a close association with regulating ferroptosis in ameliorating AKI. While the mechanisms through which these TCMs regulate ferroptosis associated with AKI are intricate, many of their targets are linked to the inhibition of lipid peroxidation or the regulation of iron metabolism. This article discusses some aspects of AKI and ferroptosis, and reviews some research progress on the regulation of AKI-related ferroptosis by TCMs.

Rationale: Systemic lupus erythematosus (SLE) is frequently accompanied by neuropsychiatric (NP) manifestations. However, typical symptoms of catatonia are uncommon. Neuropsychiatric SLE or its “mimickers” may cause NP symptoms, making differential diagnosis a significant challenge in clinical practice. Patient concerns: A 68-year-old female with SLE was hospitalized for edema, lung infection, and recurrent fungal mouth ulcers after multiple courses of cortisol and immunosuppressive therapy. Five days after admission, stupor, immobility, mutism, and rigidity were observed. Diagnosis: “Mimickers”: catatonic disorder due to a general medical condition. Intervention: Initially, relevant laboratory tests, imaging studies, and the disease activity index score were performed. A survey of the causes of the disease was conducted among the patient’s relatives. Subsequently, we discontinued moxifloxacin, corticosteroids, fluconazole, and other medications and inserted a gastric tube for nutritional support. During this process, traditional Chinese medicine and acupuncture have been utilized. Outcomes: After 3 days, the patient recovered and only complained of fatigue. Conclusion: When SLE presents with NP symptoms, it is essential to make a correct diagnosis in order to guide appropriate treatment by actively searching for inducers and clinical, laboratory, and neuroradiological characteristics that can aid in the differential diagnosis. When treatment options are limited, it can be beneficial to try a variety of combination strategies, such as traditional Chinese medicine and acupuncture.

Acute kidney injury (AKI) is a common clinical critical illness, and ischemic kidney injury is the main type. The mortality rate of ischemic kidney injury is high, because the efficacy of treatment is limited due to symptomatic and supportive treatment. Establishing a reliable animal model of ischemic AKI is an important prerequisite for conducting research on physiological, pathological and pharmacological researches, so as to explore effective prevention methods and strategies. In recent years, the establishment methods of animal models of ischemic AKI have been continuously improved. The article summarizes the common methods and model characteristics of animal models of ischemic AKI in order to provide a reference for researchers to choose a reasonable modeling method.