Hu Shiwan, Hang Xing, Wei Yu, Wang Han, Zhang Lili, Zhao Linhua
Institute of Metabolic Diseases, Guang' anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
Beijing University of Chinese Medicine, Beijing, 100029, China.
Cell Commun Signal. 2024 Feb 19;22(1):136. doi: 10.1186/s12964-024-01502-3.
Diabetic kidney disease (DKD) is a long-term and serious complication of diabetes that affects millions of people worldwide. It is characterized by proteinuria, glomerular damage, and renal fibrosis, leading to end-stage renal disease, and the pathogenesis is complex and involves multiple cellular and molecular mechanisms. Among three kinds of intraglomerular cells including podocytes, glomerular endothelial cells (GECs) and mesangial cells (MCs), the alterations in one cell type can produce changes in the others. The cell-to-cell crosstalk plays a crucial role in maintaining the glomerular filtration barrier (GFB) and homeostasis. In this review, we summarized the recent advances in understanding the pathological changes and interactions of these three types of cells in DKD and then focused on the signaling pathways and factors that mediate the crosstalk, such as angiopoietins, vascular endothelial growth factors, transforming growth factor-β, Krüppel-like factors, retinoic acid receptor response protein 1 and exosomes, etc. Furthermore, we also simply introduce the application of the latest technologies in studying cell interactions within glomerular cells and new promising mediators for cell crosstalk in DKD. In conclusion, this review provides a comprehensive and updated overview of the glomerular crosstalk in DKD and highlights its importance for the development of novel intervention approaches.
糖尿病肾病（DKD）是糖尿病的一种长期且严重的并发症，影响着全球数百万人。其特征为蛋白尿、肾小球损伤和肾纤维化，最终导致终末期肾病，发病机制复杂，涉及多种细胞和分子机制。在包括足细胞、肾小球内皮细胞（GECs）和系膜细胞（MCs）在内的三种肾小球内细胞中，一种细胞类型的改变会引起其他细胞的变化。细胞间的相互作用在维持肾小球滤过屏障（GFB）和内环境稳定方面起着关键作用。在本综述中，我们总结了在理解DKD中这三种细胞类型的病理变化及相互作用方面的最新进展，然后重点关注介导这种相互作用的信号通路和因子，如血管生成素、血管内皮生长因子、转化生长因子-β、Krüppel样因子、视黄酸受体应答蛋白1和外泌体等。此外，我们还简要介绍了最新技术在研究肾小球内细胞间相互作用方面的应用以及DKD中细胞间相互作用的新的有前景的介质。总之，本综述全面且更新地概述了DKD中的肾小球相互作用，并强调了其对开发新型干预方法的重要性。
