Diabetic nephropathy(DN) is the leading cause of end-stage renal failure worldwide. Besides, diabetic nephropathy is associated with cardiovascular disease, and increases mortality of diabetic patients. Several factor...Diabetic nephropathy(DN) is the leading cause of end-stage renal failure worldwide. Besides, diabetic nephropathy is associated with cardiovascular disease, and increases mortality of diabetic patients. Several factors are involved in the pathophysiology of DN, including metabolic and hemodynamic alterations, oxidative stress, and activation of the renin-angiotensin system. In recent years, new pathways involved in the development and progression of diabetic kidney disease have been elucidated; accumulated data have emphasized the critical role of inflammation in the pathogenesis of diabetic nephropathy. Expression of cell adhesion molecules, growth factors, chemokines and pro-inflammatory cytokines are increased in the renal tissues of diabetic patients, and serum and urinary levels of cytokines and cell adhesion molecules, correlated with albuminuria. In this paper we review the role of inflammation in the development of diabetic nephropathy, discussing some of the major inflammatory cytokines involved in the pathogenesis of diabetic nephropathy, including the role of adipokines, and take part in other mediators of inflammation, as adhesion molecules.展开更多
糖尿病肾病是临床常见的糖尿病并发症,是导致终末期肾脏病的主要原因之一,也是糖尿病患者致死的重要因素之一。晚期糖基化终末产物(advanced glycosylation end products,AGEs)-糖基化终末产物受体(receptor of AGEs,RAGE)信号通路是糖...糖尿病肾病是临床常见的糖尿病并发症,是导致终末期肾脏病的主要原因之一,也是糖尿病患者致死的重要因素之一。晚期糖基化终末产物(advanced glycosylation end products,AGEs)-糖基化终末产物受体(receptor of AGEs,RAGE)信号通路是糖尿病肾病发生发展的重要一环,在糖尿病肾病中的作用机制主要有激活核转录因子-κB(nuclear factor-κB,NF-κB),刺激产生血管内皮生长因子(vascular endothelial growthfactor,VEGF),刺激转化生长因子-β1(transforming growth factor-β1,TGF-β1)的产生,诱导单核细胞趋化蛋白-1(monocyte chemotactic protein 1,MCP-1)表达的增强,激活P21肾素-血管紧张素导致细胞功能紊乱,激活烟酰胺腺嘌呤二核苷酸磷酸(nicotinamide adenine dinucleotide phosphate,NADPH)氧化酶引起氧化应激等。中医药治疗糖尿病肾病具有整体调节和多通道、多靶点的优势,可通过阻断AGEs-RAGE信号通路改善糖尿病肾病进展。目前研究存在的问题主要有:AGEs-RAGE下游机制复杂,未完全阐明,其与一些关键因子如NF-κB、VGEF、TGF-β1、MCP-1基因的关系还有待进一步研究证实;单味中药和中药复方的活性成分治疗糖尿病肾病的临床研究和动物实验较多,但针对AGEs-RAGE信号通路的研究较少;目前实验大多于体外进行,其机制和作用靶点尚未明确。今后的研究中,需进一步完善实验设计,深入了解AGEs-RAGE信号通路的作用机制,以期为糖尿病肾病的中西医结合治疗提供一定参考。展开更多
文摘Diabetic nephropathy(DN) is the leading cause of end-stage renal failure worldwide. Besides, diabetic nephropathy is associated with cardiovascular disease, and increases mortality of diabetic patients. Several factors are involved in the pathophysiology of DN, including metabolic and hemodynamic alterations, oxidative stress, and activation of the renin-angiotensin system. In recent years, new pathways involved in the development and progression of diabetic kidney disease have been elucidated; accumulated data have emphasized the critical role of inflammation in the pathogenesis of diabetic nephropathy. Expression of cell adhesion molecules, growth factors, chemokines and pro-inflammatory cytokines are increased in the renal tissues of diabetic patients, and serum and urinary levels of cytokines and cell adhesion molecules, correlated with albuminuria. In this paper we review the role of inflammation in the development of diabetic nephropathy, discussing some of the major inflammatory cytokines involved in the pathogenesis of diabetic nephropathy, including the role of adipokines, and take part in other mediators of inflammation, as adhesion molecules.
