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保护因素作为糖尿病肾病预防和治疗的生物标志物和靶点:从当前的人类证据到未来的可能性。

Protective factors as biomarkers and targets for prevention and treatment of diabetic nephropathy: From current human evidence to future possibilities.

机构信息

Faculty of Medicine, Center for Bioinformatics and Data Analysis, Medical University of Bialystok, Bialystok, Poland.

出版信息

J Diabetes Investig. 2020 Sep;11(5):1085-1096. doi: 10.1111/jdi.13257. Epub 2020 May 6.


DOI:10.1111/jdi.13257
PMID:32196975
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7477513/
Abstract

Although hyperglycemia, high blood pressure and aging increase the risk of developing kidney complications, some diabetes patients exposed to these risk factors do not develop kidney disease, suggesting the presence of endogenous protective factors. There is a growing need to understand these factors determining protection of the kidney in order to improve the design of preventive strategies and to enhance the processes responsible for renoprotection. The aim of this review was to present the existing molecular and epidemiological data on factors showing protective effects in diabetic kidney disease, and to summarize the evidence regarding their potential in the area of future clinical diagnostics, therapeutics and early preventive strategies. These include transcriptomic and proteomic studies regarding the anti-inflammatory, anti-fibrotic and regenerative factors that were associated with slower progression of renal function loss. Another focus is the new evidence regarding the evaluation of alterations in the regulatory epigenome and its involvement in the risk of diabetic kidney disease. Further effort is required to validate and extend these findings, and to define their potential for clinical implementation in the future.

摘要

虽然高血糖、高血压和衰老会增加发生肾脏并发症的风险,但一些接触这些风险因素的糖尿病患者并未发展为肾脏疾病,这表明存在内源性保护因素。越来越需要了解这些决定肾脏保护的因素,以便改进预防策略的设计,并增强负责肾脏保护的过程。本综述的目的是介绍在糖尿病肾病中具有保护作用的因素的现有分子和流行病学数据,并总结关于它们在未来临床诊断、治疗和早期预防策略领域的潜在应用的证据。这些因素包括与肾功能丧失进展较慢相关的抗炎、抗纤维化和再生因子的转录组和蛋白质组研究。另一个重点是关于评估调节表观基因组改变及其在糖尿病肾病风险中的作用的新证据。需要进一步努力来验证和扩展这些发现,并确定它们在未来临床实施中的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f3b/7477513/35e485d9c660/JDI-11-1085-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f3b/7477513/87c85f486a1c/JDI-11-1085-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f3b/7477513/35e485d9c660/JDI-11-1085-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f3b/7477513/87c85f486a1c/JDI-11-1085-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f3b/7477513/35e485d9c660/JDI-11-1085-g002.jpg

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Protective factors as biomarkers and targets for prevention and treatment of diabetic nephropathy: From current human evidence to future possibilities.

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[7]
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[9]
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[10]
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本文引用的文献

[1]
Genome-Wide Association Study of Diabetic Kidney Disease Highlights Biology Involved in Glomerular Basement Membrane Collagen.

J Am Soc Nephrol. 2019-9-19

[2]
SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes: a systematic review and meta-analysis.

Lancet Diabetes Endocrinol. 2019-9-5

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Blocking the histone lysine 79 methyltransferase DOT1L alleviates renal fibrosis through inhibition of renal fibroblast activation and epithelial-mesenchymal transition.

FASEB J. 2019-8-2

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The Prognostic Role of Klotho in Patients with Chronic Kidney Disease: A Systematic Review and Meta-analysis.

Dis Markers. 2019-6-2

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Markers of Collagen Formation and Degradation Reflect Renal Function and Predict Adverse Outcomes in Patients With Type 1 Diabetes.

Diabetes Care. 2019-7-1

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Diabetologia. 2019-6-20

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Diabetes Care. 2019-6-20

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Kidney cytosine methylation changes improve renal function decline estimation in patients with diabetic kidney disease.

Nat Commun. 2019-6-5

[9]
Characterization of Glycolytic Enzymes and Pyruvate Kinase M2 in Type 1 and 2 Diabetic Nephropathy.

Diabetes Care. 2019-5-10

[10]
A signature of circulating inflammatory proteins and development of end-stage renal disease in diabetes.

Nat Med. 2019-4-22

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