Chen Yan-Xu, Jiang Xiao-Xue, Zhang Qin-Yuan, Xu Chang-Qing, Hu Yao-Mu, Jin Cai-Yun, Zhang Bo-Ling, Fu Yao-Qin, Jin Zhi-Sheng
Gansu University of Chinese Medicine Lanzhou 730000, China.
Gansu University of Chinese Medicine Lanzhou 730000, China Affiliated Hospital of Gansu University of Chinese Medicine Lanzhou 730000, China.
Zhongguo Zhong Yao Za Zhi. 2023 May;48(10):2630-2638. doi: 10.19540/j.cnki.cjcmm.20221114.401.
Diabetic kidney disease is an important microvascular complication of diabetes and the leading cause of end-stage renal disease. Its pathological characteristics mainly include epithelial mesenchymal transition(EMT) in glomerulus, podocyte apoptosis and autophagy, and damage of glomerular filtration barrier. Transforming growth factor-β(TGF-β)/Smad signaling pathway is specifically regulated by a variety of mechanisms, and is a classic pathway involved in physiological activities such as apoptosis, proliferation and differentiation. At present, many studies have found that TGF-β/Smad signaling pathway plays a key role in the pathogenesis of diabetic kidney disease. Traditional Chinese medicine has significant advantages in the treatment of diabetic kidney disease for its multi-component, multi-target and multi-pathway characteristics, and some traditional Chinese medicine extracts, traditional Chinese medicines and traditional Chinese medicine compound prescription improve the renal injury of diabetic kidney disease by regulating TGF-β/Smad signaling pathway. This study clarified the mechanism of TGF-β/Smad signaling pathway in diabetic kidney disease by expounding the relationship between the key targets of the pathway and diabetic kidney disease, and summarized the research progress of traditional Chinese medicine in the treatment of diabetic kidney disease by interfering with TGF-β/Smad signaling pathway in recent years, to provide reference for drug research and clinical treatment of diabetic kidney disease in the future.
糖尿病肾病是糖尿病重要的微血管并发症，也是终末期肾病的主要病因。其病理特征主要包括肾小球上皮-间质转化（EMT）、足细胞凋亡与自噬以及肾小球滤过屏障损伤。转化生长因子-β（TGF-β）/Smad信号通路受到多种机制的特异性调控，是参与凋亡、增殖和分化等生理活动的经典信号通路。目前，许多研究发现TGF-β/Smad信号通路在糖尿病肾病发病机制中起关键作用。中药因其多成分、多靶点、多途径的特点在糖尿病肾病治疗中具有显著优势，一些中药提取物、单味中药及中药复方制剂通过调节TGF-β/Smad信号通路改善糖尿病肾病的肾损伤。本研究通过阐述该信号通路关键靶点与糖尿病肾病之间的关系，阐明TGF-β/Smad信号通路在糖尿病肾病中的作用机制，并总结近年来中药通过干预TGF-β/Smad信号通路治疗糖尿病肾病的研究进展，为今后糖尿病肾病的药物研究及临床治疗提供参考。
