Department of Nephrology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.
Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Front Endocrinol (Lausanne). 2023 Jul 14;14:932649. doi: 10.3389/fendo.2023.932649. eCollection 2023.
Diabetic nephropathy (DN) is one of the most serious chronic microvascular abnormalities of diabetes mellitus and the major cause of uremia. Accumulating evidence has confirmed that fibrosis is a significant pathological feature that contributes to the development of chronic kidney disease in DN. However, the exact mechanism of renal fibrosis in DN is still unclear, which greatly hinders the treatment of DN. Chinese herbal medicine (CHM) has shown efficacy and safety in ameliorating inflammation and albuminuria in diabetic patients. In this review, we outline the underlying mechanisms of renal fibrosis in DN, including oxidative stress (OS) generation and OS-elicited ASK1-p38/JNK activation. Also, we briefly summarize the current status of CHM treating DN by improving renal fibrosis. The treatment of DN by inhibiting ASK1 activation to alleviate renal fibrosis in DN with CHM will promote the discovery of novel therapeutic targets for DN and provide a beneficial therapeutic method for DN.
糖尿病肾病(DN)是糖尿病最严重的慢性微血管病变之一,也是导致尿毒症的主要原因。越来越多的证据证实,纤维化是导致 DN 慢性肾脏病发展的重要病理特征。然而,DN 中肾脏纤维化的确切机制仍不清楚,这极大地阻碍了 DN 的治疗。中药(CHM)在改善糖尿病患者的炎症和蛋白尿方面显示出疗效和安全性。在这篇综述中,我们概述了 DN 中肾脏纤维化的潜在机制,包括氧化应激(OS)的产生和 OS 引发的 ASK1-p38/JNK 激活。此外,我们还简要总结了 CHM 通过改善肾脏纤维化来治疗 DN 的现状。用 CHM 抑制 ASK1 激活来减轻 DN 中的肾脏纤维化,将促进为 DN 发现新的治疗靶点,并为 DN 提供有益的治疗方法。