Yan Jiayi, Li Xueling, Liu Ni, He John Cijiang, Zhong Yifei
Division of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Biomedicines. 2023 Jul 3;11(7):1889. doi: 10.3390/biomedicines11071889.
Diabetic nephropathy (DN) is the leading cause of end-stage kidney disease. Increasing evidence has suggested that inflammation is a key microenvironment involved in the development and progression of DN. Studies have confirmed that macrophage accumulation is closely related to the progression to human DN. Macrophage phenotype is highly regulated by the surrounding microenvironment in the diabetic kidneys. M1 and M2 macrophages represent distinct and sometimes coexisting functional phenotypes of the same population, with their roles implicated in pathological changes, such as in inflammation and fibrosis associated with the stage of DN. Recent findings from single-cell RNA sequencing of macrophages in DN further confirmed the heterogeneity and plasticity of the macrophages. In addition, intrinsic renal cells interact with macrophages directly or through changes in the tissue microenvironment. Macrophage depletion, modification of its polarization, and autophagy could be potential new therapies for DN.
糖尿病肾病（DN）是终末期肾病的主要原因。越来越多的证据表明，炎症是参与DN发生和发展的关键微环境。研究证实，巨噬细胞积聚与人类DN的进展密切相关。巨噬细胞表型受糖尿病肾脏周围微环境的高度调节。M1和M2巨噬细胞代表同一群体中不同的、有时共存的功能表型，它们的作用与病理变化有关，如与DN阶段相关的炎症和纤维化。最近对DN中巨噬细胞进行单细胞RNA测序的结果进一步证实了巨噬细胞的异质性和可塑性。此外，肾固有细胞直接或通过组织微环境的变化与巨噬细胞相互作用。巨噬细胞耗竭、其极化的改变以及自噬可能是DN潜在的新疗法。
