Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
China-Japan Friendship Hospital, Institute of Medical Science, Beijing, China.
Front Endocrinol (Lausanne). 2023 Aug 10;14:1142276. doi: 10.3389/fendo.2023.1142276. eCollection 2023.
Diabetic kidney disease (DKD) is a major microvascular complication of diabetes and a leading cause of end-stage renal disease worldwide. Autophagy plays an important role in maintaining cellular homeostasis in renal physiology. In DKD, the accumulation of advanced glycation end products induces decreased renal autophagy-related protein expression and transcription factor EB (TFEB) nuclear transfer, leading to impaired autophagy and lysosomal function and blockage of autophagic flux. This accelerates renal resident cell injury and apoptosis, mediates macrophage infiltration and phenotypic changes, ultimately leading to aggravated proteinuria and fibrosis in DKD. Natural polyphenols show promise in treating DKD by regulating autophagy and promoting nuclear transfer of TFEB and lysosomal repair. This review summarizes the characteristics of autophagy in DKD, and the potential application and mechanisms of some known natural polyphenols as autophagy regulators in DKD, with the goal of contributing to a deeper understanding of natural polyphenol mechanisms in the treatment of DKD and promoting the development of their applications. Finally, we point out the limitations of polyphenols in current DKD research and provide an outlook for their future research.
糖尿病肾病（DKD）是糖尿病的一种主要微血管并发症，也是全球范围内导致终末期肾病的主要原因。自噬在维持肾脏生理的细胞内稳态方面起着重要作用。在 DKD 中，糖基化终产物的积累会导致肾脏自噬相关蛋白表达和转录因子 EB（TFEB）核转移减少，从而导致自噬和溶酶体功能受损以及自噬流阻断。这加速了肾脏固有细胞的损伤和凋亡，介导了巨噬细胞浸润和表型变化，最终导致 DKD 患者蛋白尿和纤维化加重。天然多酚类化合物通过调节自噬和促进 TFEB 的核转移以及溶酶体修复，在治疗 DKD 方面显示出良好的应用前景。本综述总结了自噬在 DKD 中的特征，以及一些已知天然多酚类化合物作为自噬调节剂在 DKD 中的潜在应用和机制，旨在帮助深入了解天然多酚类化合物在 DKD 治疗中的作用机制，并促进其应用的发展。最后，我们指出了多酚类化合物在当前 DKD 研究中的局限性，并对其未来的研究进行了展望。
