一篇迷你综述:AMP 激活的蛋白激酶 (AMPK) 信号通路在肥胖相关性肾损伤中的作用。
A minireview: Role of AMP-activated protein kinase (AMPK) signaling in obesity-related renal injury.
机构信息
Department of Nephropathy, The Second Hospital of Jilin University, Changchun 130041, China.
Department of Nephropathy, The First Hospital of Jilin University, Changchun 130021, China.
出版信息
Life Sci. 2021 Jan 15;265:118828. doi: 10.1016/j.lfs.2020.118828. Epub 2020 Nov 28.
Emerging evidence shows that the AMP-activated protein kinase (AMPK), a critical energy-sensing switch, plays an important role in the pathogenesis and development of obesity-related renal injury. In this review, we summarized the mechanisms underlying the protective effects of AMPK activation against obesity-related renal injury in preclinical studies, with the main purposes of increasing the understanding of AMPK and providing new insights into the future clinical therapeutic strategies. The renoprotective effects of AMPK mainly act by modulating lipid metabolism and autophagy and suppressing oxidative stress, inflammation, and fibrosis. More importantly, we discussed the recent advances in this field that require further investigation. Firstly, the inhibitory effect of AMPK on ferroptosis is a potential mechanism for its protection against renal injury. Secondly, the effect of AMPK on lipolysis is complex: AMPK induces basal lipolysis but also inhibits stimulated lipolysis. Thirdly, statins may play a renoprotective role by activating AMPK. Fourthly, some microRNAs targeting AMPK mRNA have been implicated in diabetic nephropathy in type 2 diabetes. Further, AMPK can regulate the expression of some microRNAs, suggesting that the stable renoprotective effects of AMPK may benefit from its epigenetic regulation. Lastly, several natural compounds and synthetic drugs have been recognized to protect against obesity-related renal injury by activating AMPK and its downstream pathways in animal models. It remains to be seen if combination of newly identified drugs with traditional renoprotective medicine will have any synergistic therapeutic benefits without adding to side effects.
新出现的证据表明, AMP 激活的蛋白激酶(AMPK),一种关键的能量感应开关,在肥胖相关肾损伤的发病机制和发展中起着重要作用。在这篇综述中,我们总结了 AMPK 激活对肥胖相关肾损伤的保护作用的机制,主要目的是增加对 AMPK 的认识,并为未来的临床治疗策略提供新的见解。AMPK 的肾保护作用主要通过调节脂质代谢和自噬,抑制氧化应激、炎症和纤维化来发挥作用。更重要的是,我们讨论了这一领域的最新进展,这些进展需要进一步研究。首先,AMPK 对铁死亡的抑制作用是其保护肾损伤的潜在机制。其次,AMPK 对脂肪分解的作用是复杂的:AMPK 诱导基础脂肪分解,但也抑制刺激脂肪分解。第三,他汀类药物可能通过激活 AMPK 发挥肾保护作用。第四,一些针对 AMPK mRNA 的 microRNAs 已被认为与 2 型糖尿病中的糖尿病肾病有关。此外,AMPK 可以调节某些 microRNAs 的表达,这表明 AMPK 的稳定肾保护作用可能受益于其表观遗传调控。最后,一些天然化合物和合成药物已被证明可通过在动物模型中激活 AMPK 及其下游途径来预防肥胖相关肾损伤。新发现的药物与传统的肾保护药物联合使用是否会产生协同治疗效果而不增加副作用,还有待观察。