Kitada Munehiro, Ogura Yoshio, Monno Itaru, Koya Daisuke
Department of Diabetology and Endocrinology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
Division of Anticipatory Molecular Food Science and Technology, Medical Research Institute, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
Curr Diab Rep. 2017 Jul;17(7):53. doi: 10.1007/s11892-017-0879-y.
Autophagy promotes cellular health in response to various cellular stresses and to changes in nutrient conditions. In this review, we focus on the role of autophagy in the pathogenesis of diabetic nephropathy and discuss the regulation of autophagy as a new therapeutic target for the suppression of diabetic nephropathy.
Previous studies have indicated that autophagy deficiency or insufficiency in renal cells, including podocytes, mesangial cells, endothelial cells and tubular cells, contributes to the pathogenesis of diabetic nephropathy. Alterations in the nutrient-sensing pathways, including mammalian target of rapamycin complex1 (mTORC1), AMP-activated kinase (AMPK) and Sirt1, due to excess nutrition in diabetes are implicated in the impairment of autophagy. Maintaining both basal and adaptive autophagy against cellular stress may protect the kidney from diabetes-induced cellular stresses. Therefore, the activation of autophagy through the modulation of nutrient-sensing pathways may be a new therapeutic option for the suppression of diabetic nephropathy.
自噬可响应各种细胞应激和营养状况变化,促进细胞健康。在本综述中,我们重点关注自噬在糖尿病肾病发病机制中的作用,并讨论将自噬调节作为抑制糖尿病肾病的新治疗靶点。
先前的研究表明,包括足细胞、系膜细胞、内皮细胞和肾小管细胞在内的肾细胞中自噬缺陷或不足,会导致糖尿病肾病的发病机制。糖尿病中由于营养过剩导致的营养感应通路改变,包括哺乳动物雷帕霉素靶蛋白复合物1(mTORC1)、AMP激活的蛋白激酶(AMPK)和沉默调节蛋白1(Sirt1),与自噬受损有关。维持基础自噬和适应性自噬以应对细胞应激,可能保护肾脏免受糖尿病诱导的细胞应激。因此,通过调节营养感应通路激活自噬,可能是抑制糖尿病肾病的一种新治疗选择。