Yang Min, Zhang Chun
Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
J Pharm Anal. 2024 Jan;14(1):39-51. doi: 10.1016/j.jpha.2023.09.003. Epub 2023 Sep 9.
Diabetic nephropathy (DN) is an enduring condition that leads to inflammation and affects a substantial number of individuals with diabetes worldwide. A gradual reduction in glomerular filtration and emergence of proteins in the urine are typical aspects of DN, ultimately resulting in renal failure. Mounting evidence suggests that immunological and inflammatory factors are crucial for the development of DN. Therefore, the activation of innate immunity by resident renal and immune cells is critical for initiating and perpetuating inflammation. Toll-like receptors (TLRs) are an important group of receptors that identify patterns and activate immune responses and inflammation. Meanwhile, inflammatory responses in the liver, pancreatic islets, and kidneys involve inflammasomes and chemokines that generate pro-inflammatory cytokines. Moreover, the activation of the complement cascade can be triggered by glycated proteins. This review highlights recent findings elucidating how the innate immune system contributes to tissue fibrosis and organ dysfunction, ultimately leading to renal failure. This review also discusses innovative approaches that can be utilized to modulate the innate immune responses in DN for therapeutic purposes.
糖尿病肾病(DN)是一种持续性疾病,会引发炎症,影响全球大量糖尿病患者。肾小球滤过逐渐降低以及尿液中出现蛋白质是DN的典型特征,最终会导致肾衰竭。越来越多的证据表明,免疫和炎症因素对DN的发展至关重要。因此,肾脏固有细胞和免疫细胞激活固有免疫对于启动和维持炎症至关重要。Toll样受体(TLR)是识别模式并激活免疫反应和炎症的重要受体组。同时,肝脏、胰岛和肾脏中的炎症反应涉及炎性小体和趋化因子,它们会产生促炎细胞因子。此外,糖化蛋白可触发补体级联反应的激活。本综述重点介绍了最近的研究发现,阐明了固有免疫系统如何导致组织纤维化和器官功能障碍,最终导致肾衰竭。本综述还讨论了可用于调节DN中固有免疫反应以达到治疗目的的创新方法。