Management of Cardiorenal Metabolic Syndrome in Diabetes Mellitus: A Phytotherapeutic Perspective

Table 1

Modern research on natural medicines capable of modulating cardiorenal syndrome related pathogenesis.

Herbal medicines	Functions	References
Apocynum venetum (Dogbane)	Modulating effect on SOD and GSH activities. Improving energy metabolism, scavenging oxygen free radicals, and inhibition of PDE-3	[84, 85]
Astragalus membranaceus (Astragalus)	Modulating effect on BUN, SCr, CCr, urine protein, and serum albumin levels. Reducing fasting blood glucose, albuminuria levels, and reversing the glomerular hyperfiltration state	[86, 87]
Ginkgo biloba (Ginkgo)	Downregulating the levels of urinary mALB, alpha1-MG, IgG, TF, RBP, and NAG. Decreasing the levels of vWF, ICAM-1, and VCAM-1. Raise the plasma NO level and improve the endothelium dependent vascular dilating function	[88–92]
Root of Salvia miltiorrhiza (Danshen)	Modulating effect on levels of TGF-𝛽1, collagen IV, ED-1, RAGE, malondialdehyde, LPO and SOD. Upregulating the level of endothelial NO synthase and downregulating the levels of TNF-α, ICAM-1, and VACM-1	[93–96]
Cordyceps sinensis (Cordyceps Mushroom)	Decreasing the levels of FN, collagen-IV, CTGF and PAI-1, and proteinuria and increasing the level of MMP-2	[97–99]
Trigonella foenum-graecum (Fenugreek)	Increasing concentrations of malondialdehyde and level of 8-hydroxy-2′-deoxyguanosine. Decreasing the levels of LPO and increasing the levels of CAT, GST, and GSH	[100–102]
Terminalia arjuna stem bark (Arjuna)	Downregulation in LPO. Upregulating the levels of SOD, catalase, GSH peroxidase, GST, GSH reductase and glucose-6-phosphate dehydrogenase, GSH, and total TSH and NPSH	[103, 104]
Salacia oblonga(Ekanayaka)	Suppressing angiotensin II/AT1 signaling and overexpression of TGF-𝛽1 and 𝛽2	[105–107]
Curcumin from Curcuma longa(Turmeric)	Antagonizing TNF-α-mediated decrease in PPAR-γ and blocked transactivation of NF-κB and repression of PPAR-γ. Attenuating myocardial dysfunction through Akt/GSK-3β signaling pathway	[108, 109]
Crataegus oxyacantha Linn. (Hawthorn)	Attenuating apoptotic incidence by regulating Akt and HIF-1 signaling pathways. Significant attenuation of phosphatase and tensin homolog deleted on chromosome 10 and upregulation of phospho-Akt and c-Raf levels. ACE inhibiting effect	[110, 111]
Mangiferin from Mangifera indica L. (Mango)	Inhibition of glomerular ECM expansion and the levels of TGF-𝛽1 and collagen IV. Decrease in glycosylated hemoglobin and CPK levels	[112, 113]
Silymarin from Silybum marianum (Milk Thistle)	Downregulating the levels of malondialdehyde, NO, and protein carbonyl. Suppression of the neutrophil infiltration and preventing the fall in mean arterial pressure and HR during ischemia-reperfusion	[114, 115]
Panax quinquefolius (North American ginseng)	Downregulating the levels of NF-κB (p65), ECM proteins, vasoactive factors, and Fas. Upregulating the level of Bcl-2	[116, 117]