Chen S, Liu YX, Zhao ZB, Tang SQ, Li JH, Zhou XS. Gut microbiota: Unseen conductor of polyherbal efficacy in diabetic neuropathy. World J Diabetes 2026; 17(6): 118936 [DOI: 10.4239/wjd.118936]
Corresponding Author of This Article
Xiao-Shuang Zhou, MD, Doctor, Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Shanxi Provincial People’s Hospital, No. 29 Shuangta Temple Street, Yingze District, Taiyuan 030012, Shanxi Province, China. xiaoshuangzhou69@163.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
review-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Chen S, Liu YX, Zhao ZB, Tang SQ, Li JH, Zhou XS. Gut microbiota: Unseen conductor of polyherbal efficacy in diabetic neuropathy. World J Diabetes 2026; 17(6): 118936 [DOI: 10.4239/wjd.118936]
Si Chen, Yu-Xiang Liu, Zhi-Bo Zhao, Jun-Hu Li, Xiao-Shuang Zhou, Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
Shu-Qin Tang, Department of Nephrology, Dazhou Central Hospital, Dadukou 635000, Sichuan Province, China
Xiao-Shuang Zhou, Medicinal Basic Research Innovation Center of Chronic Kidney Disease, Ministry of Education, Shanxi Medical University, Taiyuan 030012, Shanxi Province, China
Xiao-Shuang Zhou, College III of Clinical Medicine, Shanxi University of Traditional Chinese Medicine, Taiyuan 030024, Shanxi Province, China
Co-corresponding authors: Jun-Hu Li and Xiao-Shuang Zhou.
Author contributions: Zhou XS and Li JH designed the overall framework of the review, and they are co-corresponding authors; Chen S wrote the initial draft of the manuscript; Tang SQ and Li JH were responsible for literature research and data collation; Liu YX and Zhao ZB participated in the revision and polishing of the manuscript; all authors have read and approved the final manuscript.
AI contribution statement: We only used ChatGPT 4.0 to assist with English language polishing, grammar correction, and sentence optimization to improve academic expression and readability. All core scientific content, logic, and viewpoints were fully completed by the authors. We confirm that no AI tools such as ChatGPT, Grammarly, DeepL, or any other similar software were used in the preparation of the response to reviewers or the revision of the manuscript.
Supported by the National Natural Science Foundation of China, No. 82300846; and the Project of the Central Government Guiding Local Technological Development, No. YDZJSX2025B007.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Xiao-Shuang Zhou, MD, Doctor, Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Shanxi Provincial People’s Hospital, No. 29 Shuangta Temple Street, Yingze District, Taiyuan 030012, Shanxi Province, China. xiaoshuangzhou69@163.com
Received: January 15, 2026 Revised: March 17, 2026 Accepted: May 11, 2026 Published online: June 15, 2026 Processing time: 148 Days and 5.4 Hours
Abstract
The recent study provides compelling evidence for the neuroprotective effects of a polyherbal extract (PHE) in a rat model of diabetic neuropathy (DN). While the authors demonstrate significant improvements in metabolic, oxidative, and inflammatory parameters, this review posits that these downstream effects are likely orchestrated by a crucial upstream mechanism: The modulation of the gut microbiota. We argue that DN is intrinsically linked to gut dysbiosis, which promotes a “leaky gut”, systemic inflammation, and a deficit in neuroprotective microbial metabolites like short-chain fatty acids. The complex, poorly absorbed components of the PHE likely act as prebiotics, restoring microbial homeostasis. This single action can mechanistically explain the observed systemic benefits from reduced inflammation to improved neurotrophic support. Recognizing the gut microbiota as the central mediator bridges the multi-component nature of traditional herbal medicine with the complex, multi-system pathology of DN, paving the way for novel, microbiome-targeted therapeutic strategies.
Core Tip: This review proposes a gut-centric theoretical model to explain the broad therapeutic effects of a polyherbal extract (PHE) against diabetic neuropathy. We hypothesize that the PHE acts primarily by remodeling the gut microbiota. This single action restoring a healthy gut ecosystem can mechanistically account for the observed systemic reductions in inflammation, oxidative stress, and metabolic dysfunction. This perspective reframes traditional herbal medicine as a form of ecological intervention, highlighting the gut microbiome as a pivotal and unifying target for treating complex, multi-system diseases.
