长链非编码 RNA:在糖尿病和糖尿病肾病中的新兴角色。

Long noncoding RNA: an emerging player in diabetes and diabetic kidney disease.

机构信息

Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

Division of Kidney Disease and Hypertension, Brown Medical School, Providence, RI 02903, U.S.A.

出版信息

Clin Sci (Lond). 2019 Jun 20;133(12):1321-1339. doi: 10.1042/CS20190372. Print 2019 Jun 28.

Abstract

Diabetic kidney disease (DKD) is among the most common complications of diabetes mellitus (DM), and remains the leading cause of end-stage renal diseases (ESRDs) in developed countries, with no definitive therapy yet available. It is imperative to decipher the exact mechanisms underlying DKD and identify novel therapeutic targets. Burgeoning evidence indicates that long non-coding RNAs (lncRNAs) are essential for diverse biological processes. However, their roles and the mechanisms of action remain to be defined in disease conditions like diabetes and DKD. The pathogenesis of DKD is twofold, so is the principle of treatments. As the underlying disease, diabetes is the root cause of DKD and thus a primary focus of therapy. Meanwhile, aberrant molecular signaling in kidney parenchymal cells and inflammatory cells may directly contribute to DKD. Evidence suggests that a number of lncRNAs are centrally involved in development and progression of DKD either via direct pathogenic roles or as indirect mediators of some nephropathic pathways, like TGF-β1, NF-κB, STAT3 and GSK-3β signaling. Some lncRNAs are thus likely to serve as biomarkers for early diagnosis or prognosis of DKD or as therapeutic targets for slowing progression or even inducing regression of established DKD. Here, we elaborated the latest evidence in support of lncRNAs as a key player in DKD. In an attempt to strengthen our understanding of the pathogenesis of DKD, and to envisage novel therapeutic strategies based on targeting lncRNAs, we also delineated the potential mechanisms of action as well as the efficacy of targeting lncRNA in preclinical models of DKD.

摘要

糖尿病肾病(DKD)是糖尿病(DM)最常见的并发症之一,在发达国家仍然是终末期肾脏疾病(ESRDs)的主要原因,目前尚无明确的治疗方法。阐明 DKD 的确切发病机制并确定新的治疗靶点至关重要。越来越多的证据表明,长链非编码 RNA(lncRNA)对多种生物过程至关重要。然而,它们在糖尿病和 DKD 等疾病条件下的作用和作用机制仍有待确定。DKD 的发病机制是双重的,治疗原则也是如此。作为基础疾病,糖尿病是 DKD 的根本原因,因此是治疗的主要焦点。同时,肾脏实质细胞和炎症细胞中异常的分子信号可能直接导致 DKD。有证据表明,许多 lncRNA 通过直接致病作用或作为某些肾病途径(如 TGF-β1、NF-κB、STAT3 和 GSK-3β 信号通路)的间接介质,在 DKD 的发生和进展中起核心作用。因此,一些 lncRNA 可能作为 DKD 的早期诊断或预后的生物标志物,或作为减缓进展甚至诱导已建立的 DKD 消退的治疗靶点。在这里,我们详细阐述了支持 lncRNA 作为 DKD 关键参与者的最新证据。为了加强我们对 DKD 发病机制的理解,并根据靶向 lncRNA 设想新的治疗策略,我们还描述了靶向 DKD 临床前模型中 lncRNA 的潜在作用机制和疗效。

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