Cardiovascular and Metabolic Disorders Signature Research Program, Duke-NUS Medical School, 8 College Road, 169857 Singapore.
Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan.
Nat Rev Nephrol. 2018 Jan;14(1):48-56. doi: 10.1038/nrneph.2017.142. Epub 2017 Oct 24.
Diabetic nephropathy (DN) is a leading cause of end-stage renal disease in the developed world. Accordingly, an urgent need exists for new, curative treatments as well as for biomarkers to stratify risk of DN among individuals with diabetes mellitus. A barrier to progress in these areas has been a lack of animal models that faithfully replicate the main features of human DN. Such models could be used to define the pathogenesis, identify drug targets and test new therapies. Owing to their tractability for genetic manipulation, mice are widely used to model human diseases, including DN. Questions have been raised, however, about the general utility of mouse models in human drug discovery. Standard mouse models of diabetes typically manifest only modest kidney abnormalities, whereas accelerated models, induced by superimposing genetic stressors, recapitulate key features of human DN. Incorporation of systems biology approaches and emerging data from genomics and metabolomics studies should enable further model refinement. Here, we discuss the current status of mouse models for DN, their limitations and opportunities for improvement. We emphasize that future efforts should focus on generating robust models that reproduce the major clinical and molecular phenotypes of human DN.
糖尿病肾病(DN)是发达国家终末期肾病的主要病因。因此,迫切需要新的治疗方法和生物标志物来对糖尿病患者的 DN 风险进行分层。在这些领域取得进展的一个障碍是缺乏能够真实再现人类 DN 主要特征的动物模型。这些模型可用于定义发病机制、确定药物靶点和测试新疗法。由于其遗传操作的可处理性,小鼠被广泛用于模拟人类疾病,包括 DN。然而,人们对小鼠模型在人类药物发现中的普遍适用性提出了质疑。典型的糖尿病标准小鼠模型仅表现出轻微的肾脏异常,而通过叠加遗传应激诱导的加速模型则再现了人类 DN 的关键特征。系统生物学方法的结合以及来自基因组学和代谢组学研究的新兴数据应能进一步改进模型。在这里,我们讨论了用于 DN 的小鼠模型的现状、它们的局限性和改进的机会。我们强调,未来的工作应集中在生成能够再现人类 DN 主要临床和分子表型的稳健模型上。