Doublier Sophie, Lupia Enrico, Catanuto Paola, Elliot Sharon J
Department of Genetics, Biology and Biochemistry and Research Center on Experimental Medicine (Ce.R.M.S.), University of Turin, via Santena 5/bis, Turin, Italy.
Curr Diabetes Rev. 2011 Jan;7(1):28-34. doi: 10.2174/157339911794273982.
It is generally accepted that estrogens affect and modulate the development and progression of chronic kidney diseases (CKD) not related to diabetes. Clinical studies have indeed demonstrated that the severity and rate of progression of renal damage tends to be greater among men, compared with women. Experimental studies also support the notion that female sex is protective and male sex permissive, for the development of CKD in non-diabetics, through the opposing actions of estrogens and testosterone. However, when we consider diabetes-induced kidney damage, in the setting of either type 1 or type 2 diabetes, the contribution of gender to the progression of renal disease is somewhat uncertain. Previous studies on the effects of estrogens in the pathogenesis of progressive kidney damage have primarily focused on mesangial cells. More recently, data on the effects of estrogens on podocytes, the cell type whose role may include initiation of progressive diabetic renal disease, became available. The aim of this review will be to summarize the main clinical and experimental data on the effects of estrogens on the progression of diabetes-induced kidney injury. In particular, we will highlight the possible biological effects of estrogens on podocytes, especially considering those critical for the pathogenesis of diabetic kidney damage.
人们普遍认为，雌激素会影响和调节与糖尿病无关的慢性肾脏病（CKD）的发生发展。临床研究确实表明，与女性相比，男性肾损伤的严重程度和进展速度往往更高。实验研究也支持这样的观点，即对于非糖尿病患者CKD的发生，雌激素和睾酮的相反作用使得女性具有保护作用而男性更易患病。然而，当我们考虑1型或2型糖尿病引发的肾损伤时，性别对肾脏疾病进展的影响尚不确定。以往关于雌激素在进行性肾损伤发病机制中作用的研究主要集中在系膜细胞。最近，有了关于雌激素对足细胞作用的数据，足细胞在进行性糖尿病肾病发病中可能起起始作用。本综述的目的是总结雌激素对糖尿病性肾损伤进展影响的主要临床和实验数据。特别是，我们将重点介绍雌激素对足细胞可能产生的生物学效应，尤其是那些对糖尿病肾病发病机制至关重要的效应。
