Department of Nephrology and Endocrinology, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China.
Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing 100053, China.
Oxid Med Cell Longev. 2022 May 24;2022:3959390. doi: 10.1155/2022/3959390. eCollection 2022.
Diabetic cardiomyopathy (DCM) is the main factor responsible for poor prognosis and survival in patients with diabetes. The highly complex pathogenesis of DCM involves multiple signaling pathways, including nuclear factor-B (NF-B) signaling pathway, adenosine monophosphate-activated protein kinase (AMPK) signaling pathway, phosphatidylinositol 3-kinase-protein kinase B (Akt) signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway, and transforming growth factor- (TGF-) signaling pathway. Nuclear factor erythroid-2-related factor 2 (Nrf2) seems essential to the amelioration of the progression of DCM, not only through counterbalancing oxidative stress, but also through interacting with other signaling pathways to combat inflammation, the disorder in energy homeostasis and insulin signaling, and fibrosis. It has been evidenced that Chinese herbal monomers could attenuate DCM through the crosstalk of Nrf2 with other signaling pathways. This article has summarized the pathogenesis of DCM (especially in oxidative stress), the beneficial effects of ameliorating DCM via the Nrf2 signaling pathway and its crosstalk, and examples of Chinese herbal monomers. It will facilitate pharmacological research and development to promote the utilization of traditional Chinese medicine in DCM.
糖尿病心肌病（DCM）是导致糖尿病患者预后不良和生存的主要因素。DCM 的发病机制非常复杂，涉及多个信号通路，包括核因子-B（NF-B）信号通路、腺苷单磷酸激活蛋白激酶（AMPK）信号通路、磷酸肌醇 3-激酶蛋白激酶 B（Akt）信号通路、丝裂原激活蛋白激酶（MAPK）信号通路和转化生长因子-（TGF-）信号通路。核因子红细胞 2 相关因子 2（Nrf2）对于改善 DCM 的进展似乎至关重要，它不仅通过平衡氧化应激，还通过与其他信号通路相互作用来对抗炎症、能量稳态和胰岛素信号紊乱以及纤维化。有证据表明，中草药单体可以通过 Nrf2 与其他信号通路的相互作用来减轻 DCM。本文总结了 DCM 的发病机制（尤其是氧化应激）、通过 Nrf2 信号通路及其相互作用改善 DCM 的有益作用，以及中草药单体的例子。这将有助于药理学研究和开发，促进中药在 DCM 中的应用。
