Ma Leilei, Li Jing, Zhang Xiaotian, Zhang Wei, Jiang Chen, Yang Bo, Yang Hongtao
Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Front Pharmacol. 2024 May 13;15:1360179. doi: 10.3389/fphar.2024.1360179. eCollection 2024.
Diabetic kidney disease (DKD) is one of the chronic microvascular complications caused by diabetes, which is characterized by persistent albuminuria and/or progressive decline of estimated glomerular filtration rate (eGFR), and has been the major cause of dialysis around the world. At present, although the treatments for DKD including lifestyle modification, glycemic control and even using of Sodium-glucose cotransporter 2 (SGLT2) inhibitors can relieve kidney damage caused to a certain extent, there is still a lack of effective treatment schemes that can prevent DKD progressing to ESRD. It is urgent to find new complementary and effective therapeutic agents. Growing animal researches have shown that mitophagy makes a great difference to the pathogenesis of DKD, therefore, exploration of new drugs that target the restoration of mitophagy maybe a potential perspective treatment for DKD. The use of Chinese botanical drugs (CBD) has been identified to be an effective treatment option for DKD. There is growing concern on the molecular mechanism of CBD for treatment of DKD by regulating mitophagy. In this review, we highlight the current findings regarding the function of mitophagy in the pathological damages and progression of DKD and summarize the contributions of CBD that ameliorate renal injuries in DKD by interfering with mitophagy, which will help us further explain the mechanism of CBD in treatment for DKD and explore potential therapeutic strategies for DKD.
糖尿病肾病（DKD）是糖尿病引起的慢性微血管并发症之一，其特征为持续性蛋白尿和/或估算肾小球滤过率（eGFR）进行性下降，并且一直是全球范围内透析的主要原因。目前，尽管DKD的治疗方法包括生活方式改变、血糖控制以及使用钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂等，在一定程度上可以缓解肾脏损伤，但仍然缺乏能够阻止DKD进展为终末期肾病（ESRD）的有效治疗方案。迫切需要寻找新的补充性有效治疗药物。越来越多的动物研究表明，线粒体自噬在DKD的发病机制中起重要作用，因此，探索靶向恢复线粒体自噬的新药可能是DKD潜在的治疗新方向。已证实使用中药（CBD）是DKD的一种有效治疗选择。人们越来越关注CBD通过调节线粒体自噬治疗DKD的分子机制。在这篇综述中，我们重点介绍了目前关于线粒体自噬在DKD病理损伤和进展中的作用的研究结果，并总结了CBD通过干扰线粒体自噬改善DKD肾损伤的作用，这将有助于我们进一步解释CBD治疗DKD的机制，并探索DKD的潜在治疗策略。
