George Washington University School of Medicine, Washington, DC, USA.
Loyola University Stritch School of Medicine, Maywood, IL, USA.
Curr Hypertens Rep. 2016 Jan;18(1):8. doi: 10.1007/s11906-015-0612-7.
Diabetic nephropathy, or diabetic kidney disease (DKD), is the most serious complication of diabetes mellitus (DM). Despite recent advances in therapy, DKD still often progresses to end-stage renal disease (ESRD). Recent studies have suggested that pentoxifylline (PTX) may be efficacious in the treatment of DKD. PTX is a rheologic modifier approved for use in the USA for the symptomatic relief of claudication. It competitively inhibits phosphodiesterase (PDE), resulting in increased intracellular cyclic AMP (cAMP), activation of protein kinase A (PKA), inhibition of interleukin (IL) and tumor necrosis factor (TNF) synthesis, and reduced inflammation. PTX improves red blood cell deformability, reduces blood viscosity, and decreases platelet aggregation. In combination with renin-angiotensin-aldosterone (RAAS) blockers, PTX may help prevent progression to ESRD in patients with DKD. This review focuses on the possible mechanisms of action of PTX in DKD and studies suggesting possible efficacy of this old drug for a new indication.
糖尿病肾病（DN），又称糖尿病肾脏疾病（DKD），是糖尿病（DM）最严重的并发症之一。尽管近年来治疗取得了进展，但 DKD 仍常进展为终末期肾病（ESRD）。最近的研究表明，己酮可可碱（PTX）可能对 DKD 的治疗有效。PTX 是一种流变学修饰剂，在美国被批准用于缓解间歇性跛行的症状。它竞争性抑制磷酸二酯酶（PDE），导致细胞内环腺苷酸（cAMP）增加，蛋白激酶 A（PKA）激活，白细胞介素（IL）和肿瘤坏死因子（TNF）合成抑制，炎症减少。PTX 可改善红细胞变形性，降低血液黏度，并减少血小板聚集。PTX 与肾素-血管紧张素-醛固酮（RAAS）阻滞剂联合使用，可能有助于预防 DKD 患者进展为 ESRD。本文主要综述了 PTX 在 DKD 中的可能作用机制，并探讨了该药治疗新适应证的可能疗效。
