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可溶性和膜结合二肽基肽酶-4在糖尿病肾病中的作用。

Role of soluble and membrane-bound dipeptidyl peptidase-4 in diabetic nephropathy.

作者信息

Hasan Ahmed A, Hocher Berthold

机构信息

Institute of Nutritional ScienceUniversity of Potsdam, Potsdam, Germany.

Department of BiochemistryFaculty of Pharmacy, Zagazig University, Zagazig, Egypt.

出版信息

J Mol Endocrinol. 2017 Jul;59(1):R1-R10. doi: 10.1530/JME-17-0005. Epub 2017 Apr 18.

Abstract

Diabetic nephropathy is one of the most frequent, devastating and costly complications of diabetes. The available therapeutic approaches are limited. Dipeptidyl peptidase type 4 (DPP-4) inhibitors represent a new class of glucose-lowering drugs that might also have reno-protective properties. DPP-4 exists in two forms: a plasma membrane-bound form and a soluble form, and can exert many biological actions mainly through its peptidase activity and interaction with extracellular matrix components. The kidneys have the highest DPP-4 expression level in mammalians. DPP-4 expression and urinary activity are up-regulated in diabetic nephropathy, highlighting its role as a potential target to manage diabetic nephropathy. Preclinical animal studies and some clinical data suggest that DPP-4 inhibitors decrease the progression of diabetic nephropathy in a blood pressure- and glucose-independent manner. Many studies reported that these reno-protective effects could be due to increased half-life of DPP-4 substrates such as glucagon-like peptide-1 (GLP-1) and stromal derived factor-1 alpha (SDF-1a). However, the underlying mechanisms are far from being completely understood and clearly need further investigations.

摘要

糖尿病肾病是糖尿病最常见、最具破坏性且花费高昂的并发症之一。现有的治疗方法有限。二肽基肽酶4(DPP-4)抑制剂是一类新型降糖药物,可能还具有肾脏保护特性。DPP-4以两种形式存在:一种是与质膜结合的形式,另一种是可溶性形式,并且主要通过其肽酶活性以及与细胞外基质成分的相互作用发挥多种生物学作用。在哺乳动物中,肾脏的DPP-4表达水平最高。在糖尿病肾病中,DPP-4的表达和尿活性上调,这突出了其作为治疗糖尿病肾病潜在靶点的作用。临床前动物研究和一些临床数据表明,DPP-4抑制剂以不依赖血压和血糖的方式减缓糖尿病肾病的进展。许多研究报道,这些肾脏保护作用可能归因于DPP-4底物如胰高血糖素样肽-1(GLP-1)和基质衍生因子-1α(SDF-1α)半衰期的延长。然而,其潜在机制远未被完全理解,显然需要进一步研究。

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