A Glimpse of Inflammation and Anti-Inflammation Therapy in Diabetic Kidney Disease.

A Glimpse of Inflammation and Anti-Inflammation Therapy in Diabetic Kidney Disease.
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糖尿病肾病的炎症与抗炎治疗初探

DOI:
10.3389/fphys.2022.909569
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发表时间:
2022
影响因子:
4
通讯作者:
--
中科院分区:
医学2区
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糖尿病肾病(DKD)是糖尿病的常见并发症,也是终末期肾病(ESKD)的主要原因。DKD的发病机制非常复杂,尚未完全了解。近年来,越来越多的体内外研究表明,炎症在DKD的发病和发展中起着重要作用。目前已知多种促炎细胞因子及相关信号通路参与了DKD的发病过程。此外,一些有效缓解DKD进展的降糖药和盐皮质激素受体拮抗剂(MRA)具有抗炎特性,可能对延缓DKD进展具有有益作用。然而,目前缺乏系统的概览。本文就DKD发生发展过程中新的促炎信号通路,包括核因子κ B(NF-κB)信号通路、Toll样受体(TLR)和髓样分化初级反应88进行综述(TLR/MyD 88)信号通路,腺苷5′-单磷酸活化蛋白激酶(AMPK)信号通路,炎性小体激活,线粒体DNA(mtDNA)释放以及缺氧诱导因子-1(HIF-1)信号通路。并对二甲双胍、非那利酮、钠依赖性葡萄糖转运蛋白2(SGLT 2)抑制剂、二肽基肽酶-4(DPP-4)抑制剂、胰高血糖素样肽-1(GLP-1)受体激动剂及中药的相关抗炎机制进行了探讨。
Diabetic kidney disease (DKD) is a common complication of diabetes mellitus and a major cause of end-stage kidney disease (ESKD). The pathogenesis of DKD is very complex and not completely understood. Recently, accumulated evidence from in vitro and in vivo studies has demonstrated that inflammation plays an important role in the pathogenesis and the development of DKD. It has been well known that a variety of pro-inflammatory cytokines and related signaling pathways are involved in the procession of DKD. Additionally, some anti-hyperglycemic agents and mineralocorticoid receptor antagonists (MRAs) that are effective in alleviating the progression of DKD have anti-inflammatory properties, which might have beneficial effects on delaying the progression of DKD. However, there is currently a lack of systematic overviews. In this review, we focus on the novel pro-inflammatory signaling pathways in the development of DKD, including the nuclear factor kappa B (NF-κB) signaling pathway, toll-like receptors (TLRs) and myeloid differentiation primary response 88 (TLRs/MyD88) signaling pathway, adenosine 5′-monophosphate-activated protein kinase (AMPK) signaling pathways, inflammasome activation, mitochondrial DNA (mtDNA) release as well as hypoxia-inducible factor-1(HIF-1) signaling pathway. We also discuss the related anti-inflammation mechanisms of metformin, finerenone, sodium-dependent glucose transporters 2 (SGLT2) inhibitors, Dipeptidyl peptidase-4 (DPP-4) inhibitors, Glucagon-like peptide-1 (GLP-1) receptor agonist and traditional Chinese medicines (TCM).
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