Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland.
Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, 91-738 Lodz, Poland.
Int J Mol Sci. 2020 Dec 20;21(24):9723. doi: 10.3390/ijms21249723.
People with type 1 diabetes have an increased risk of developing microvascular complications, which have a negative impact on the quality of life and reduce life expectancy. Numerous studies in animals with experimental diabetes show that c-peptide supplementation exerts beneficial effects on diabetes-induced damage in peripheral nerves and kidneys. There is substantial evidence that c-peptide counteracts the detrimental changes caused by hyperglycemia at the cellular level, such as decreased activation of endothelial nitric oxide synthase and sodium potassium ATPase, and increase in formation of pro-inflammatory molecules mediated by nuclear factor kappa-light-chain-enhancer of activated B cells: cytokines, chemokines, cell adhesion molecules, vascular endothelial growth factor, and transforming growth factor beta. However, despite positive results from cell and animal studies, no successful c-peptide replacement therapies have been developed so far. Therefore, it is important to improve our understanding of the impact of c-peptide on the pathophysiology of microvascular complications to develop novel c-peptide-based treatments. This article aims to review current knowledge on the impact of c-peptide on diabetic neuro- and nephropathy and to evaluate its potential therapeutic role.
1 型糖尿病患者发生微血管并发症的风险增加，这对生活质量产生负面影响，并降低预期寿命。大量实验性糖尿病动物研究表明，C 肽补充对糖尿病引起的周围神经和肾脏损伤具有有益作用。有大量证据表明，C 肽可对抗细胞水平上高血糖引起的有害变化，如内皮型一氧化氮合酶和钠钾 ATP 酶的活性降低，以及由核因子 kappa-轻链增强子的激活 B 细胞介导的促炎分子的形成：细胞因子、趋化因子、细胞黏附分子、血管内皮生长因子和转化生长因子β。然而，尽管细胞和动物研究取得了积极成果，但迄今为止尚未开发出成功的 C 肽替代疗法。因此，重要的是要提高我们对 C 肽对微血管并发症病理生理学影响的认识，以开发新的基于 C 肽的治疗方法。本文旨在综述 C 肽对糖尿病神经病变和肾病的影响，并评估其潜在的治疗作用。
