Huangqi Jiuni decoction prevents acute kidney injury induced by severe burns by inhibiting activation of the TNF/NF-κB pathway

Ethnopharmacological relevance: Huangqi Jiuni decoction (HQJND) is a prescription for the treatment of severe burns provided based on traditional Chinese and Western medicine, which is created by the First Affiliated Hospital of Anhui Medical University. It consists of 12 herbs and has been used clinically for decades. It has greatly shortened the course of the disease, but the mechanism by which HQJND treats the disease still remains unclear. Aim of the study: Hence, the objective of this investigation was to utilize modern pharmacological tools to demonstrate the efficacy and mechanism of HQJND in the treatment of acute kidney injury (AKI) caused by severe burns. Materials and methods: In this study, the chemical constituents in HQJND were first examined using liquid chromatography tandem mass spectrometry (LC-MS/MS). Then, by using network pharmacology, we screened the targets of drug and disease action, and predicted the signaling pathways acting in the course of drug treatment of disease. Finally, we attempted to verify the efficacy of the drug and explored its therapeutic mechanism after the establishment of an animal model, herbal gavage treatment, collection of rat kidneys and serum for renal function, quantitative real-time Polymerase Chain Reaction (RT-qPCR), Western Blotting (WB), Hematoxylin and eosin (HE) staining and Immunohistochemistry (IHC). Results: The 14 important active ingredients in HQJND was analyzed by liquid chromatography tandem mass spectrometry, while network pharmacology screening was performed to identify 353 disease-associated marker genes and 286 drug targets, finally identifying the TNF/NF-kappa B (tumor necrosis factor/nuclear factor kappa-B) signaling site: the key pathway of burn-induced acute kidney injury when HQJND intervened. The serum renal function and histopathology of rats demonstrated that the use of HQJND significantly improved the renal function in severe burns. RT-qPCR and WB confirmed that the TNF/NF-kappa B signaling pathway was activated in the Model group of rats, and HQJND could curb the signaling pathway because it moderated the expressions of key proteins in the process. Conclusion: Based on modern pharmacology, we explored an effective herbal preparation to ameliorate the impairment of renal function after severe burns, which is most likely to function through the TNF/NF-kappa B signaling pathway.