Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
Cells. 2023 Nov 23;12(23):2691. doi: 10.3390/cells12232691.
Diabetic kidney disease (DKD), or diabetic nephropathy (DN), is one of the most prevalent complications of type 2 diabetes mellitus (T2DM) and causes severe burden on the general welfare of T2DM patients around the world. While several new agents have shown promise in treating this condition and potentially halting the progression of the disease, more work is needed to understand the complex regulatory network involved in the disorder. Recent studies have provided new insights into the connection between autophagy, a physiological metabolic process known to maintain cellular homeostasis, and the pathophysiological pathways of DKD. Typically, autophagic activity plays a role in DKD progression mainly by promoting an inflammatory response to tissue damage, while both overactivated and downregulated autophagy worsen disease outcomes in different stages of DKD. This correlation demonstrates the potential of autophagy as a novel therapeutic target for the disease, and also highlights new possibilities for utilizing already available DN-related medications. In this review, we summarize findings on the relationship between autophagy and DKD, and the impact of these results on clinical management strategies.
糖尿病肾病(DKD)或糖尿病肾病(DN)是 2 型糖尿病(T2DM)最常见的并发症之一,给全球 T2DM 患者的整体健康带来了严重负担。虽然有几种新的药物已显示出在治疗这种疾病和可能阻止疾病进展方面的潜力,但仍需要更多的工作来了解参与该疾病的复杂调控网络。最近的研究提供了新的见解,阐明了自噬(一种已知能维持细胞内稳态的生理性代谢过程)与 DKD 的病理生理途径之间的联系。通常,自噬活性在 DKD 进展中起作用主要是通过促进对组织损伤的炎症反应,而过度激活和下调的自噬在 DKD 的不同阶段都会使疾病结果恶化。这种相关性表明自噬作为一种治疗该疾病的新靶点具有潜力,同时也为利用现有的与 DN 相关的药物提供了新的可能性。在这篇综述中,我们总结了自噬与 DKD 之间的关系及其对临床管理策略的影响。
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