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肾素-血管紧张素-醛固酮系统(RAAS):其生物学特性及治疗糖尿病肾病的药物靶点

Renin Angiotensin Aldosterone System (RAAS): its biology and drug targets for treating diabetic nephropathy.

作者信息

Zain Maryam, Awan Fazli Rabbi

机构信息

Diabetes and Cardio-Metabolic Disorders (D & C-MD) Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Jhang Road, Faisalabad, Pakistan / Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad, Pakistan.

出版信息

Pak J Pharm Sci. 2014 Sep;27(5):1379-91.

Abstract

Diabetes mellitus is a multifactorial disorder of hyperglycemia caused by a combination of biochemical, molecular and genetic factors, which leads to the dysfunction of various organs including kidneys. Diabetic nephropathy (DN) is one of the microvascular complications of diabetes that results due to poor glycemic control. Several molecular and biochemical pathways have been implicated in the pathogenesis of DN. Of these, the Renin Angiotensin Aldosterone System (RAAS) is considered as a key pathway. RAAS involves various subsystems which contribute to the development of DN. Mutations in several genes of the RAAS pathway have been associated with the development of DN. These genes or their products present them as therapeutic targets for potent drugs to control or prevent DN, and development of new drugs for targeting the RAAS. Drugs in use for DN are mainly the Angiotensin Converting Enzyme (ACE) inhibitors, Angiotensin Receptors Blockers (ARB) and renin inhibitors which play important roles in reducing DN. Hence, the present review is focused on the pathophysiology and genetic factors for DN by exploring the RAAS pathway and emphasizing the benefits of blocking this pathway to control and prevent DN.

摘要

糖尿病是一种由生化、分子和遗传因素共同作用引起的高血糖多因素紊乱疾病,可导致包括肾脏在内的各种器官功能障碍。糖尿病肾病(DN)是糖尿病的微血管并发症之一,由血糖控制不佳所致。多种分子和生化途径与DN的发病机制有关。其中,肾素 - 血管紧张素 - 醛固酮系统(RAAS)被认为是关键途径。RAAS涉及多个子系统,这些子系统都对DN的发展有影响。RAAS途径中多个基因的突变与DN的发生有关。这些基因或其产物成为控制或预防DN的有效药物以及开发针对RAAS的新药的治疗靶点。目前用于治疗DN的药物主要是血管紧张素转换酶(ACE)抑制剂、血管紧张素受体阻滞剂(ARB)和肾素抑制剂,它们在减轻DN方面发挥着重要作用。因此,本综述通过探索RAAS途径并强调阻断该途径对控制和预防DN的益处,重点关注DN的病理生理学和遗传因素。

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