Núcleo de Pós-Graduação e Pesquisa, Hospital Santa Casa de Belo Horizonte, Rua Domingos Vieira 590, Santa Efigênia, Belo Horizonte, MG30150-240, Brazil.
Cell Death Dis. 2018 Jan 25;9(2):119. doi: 10.1038/s41419-017-0135-z.
Chronic or intermittent hyperglycemia is associated with the development of diabetic complications. Several signaling pathways can be altered by having hyperglycemia in different tissues, producing oxidative stress, the formation of advanced glycation end products (AGEs), as well as the secretion of the pro-inflammatory cytokines and cellular death (pathological autophagy and/or apoptosis). However, the signaling pathways that are directly triggered by hyperglycemia appear to have a pivotal role in diabetic complications due to the production of reactive oxygen species (ROS), oxidative stress, and cellular death. The present review will discuss the role of cellular death in diabetic complications, and it will suggest the cause and the consequences between the hyperglycemia-induced signaling pathways and cell death. The signaling pathways discussed in this review are to be described step-by-step, together with their respective inhibitors. They involve diacylglycerol, the activation of protein kinase C (PKC) and NADPH-oxidase system, and the consequent production of ROS. This was initially entitled the "dangerous metabolic route in diabetes". The historical usages and the recent advancement of new drugs in controlling possible therapeutical targets have been highlighted, in order to evaluate the evolution of knowledge in this sensitive area. It has recently been shown that the metabolic responses to stimuli (i.e., hyperglycemia) involve an integrated network of signaling pathways, in order to define the exact responses. Certain new drugs have been experimentally tested-or suggested and proposed-for their ability to modulate the possible biochemical therapeutical targets for the downregulation of retinopathy, nephropathy, neuropathy, heart disease, angiogenesis, oxidative stress, and cellular death. The aim of this study was to critically and didactically evaluate the exact steps of these signaling pathways and hence mark the indicated sites for the actions of such drugs and their possible consequences. This review will emphasize, besides others, the therapeutical targets for controlling the signaling pathways, when aimed at the downregulation of ROS generation, oxidative stress, and, consequently, cellular death-with all of these conditions being a problem in diabetes.
慢性或间歇性高血糖与糖尿病并发症的发展有关。在不同组织中,高血糖会改变几种信号通路,产生氧化应激、晚期糖基化终产物(AGEs)的形成以及促炎细胞因子的分泌和细胞死亡(病理性自噬和/或细胞凋亡)。然而,由于活性氧(ROS)、氧化应激和细胞死亡的产生,高血糖直接触发的信号通路似乎在糖尿病并发症中起着关键作用。本综述将讨论细胞死亡在糖尿病并发症中的作用,并提出高血糖诱导的信号通路与细胞死亡之间的因果关系。本综述中讨论的信号通路将逐步描述,并附有各自的抑制剂。它们涉及二酰基甘油、蛋白激酶 C(PKC)和 NADPH 氧化酶系统的激活,以及随后 ROS 的产生。这最初被称为“糖尿病中的危险代谢途径”。强调了控制可能的治疗靶点的新药物的历史用途和最新进展,以评估该敏感领域知识的演变。最近表明,对刺激(即高血糖)的代谢反应涉及信号通路的综合网络,以确定确切的反应。某些新药已经过实验测试-或建议并提出-用于其调节可能的生化治疗靶点的能力,以下调视网膜病变、肾病、神经病、心脏病、血管生成、氧化应激和细胞死亡。本研究的目的是批判性和教学性地评估这些信号通路的确切步骤,并因此标记这些药物作用的指定部位及其可能的后果。除其他外,本综述还将强调控制信号通路的治疗靶点,旨在降低 ROS 生成、氧化应激和细胞死亡,所有这些条件都是糖尿病的问题。