Chu Jiayi, Wang Kewu, Lu Lulu, Zhao Hui, Hu Jibo, Xiao Wenbo, Wu Qian
Department of Radiology, Center of Regenerative and Aging Medicine, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Zhejiang, China.
Department of Nutrition and Toxicology, Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines of Zhejiang Province, School of Public Health, Hangzhou Normal University, Hangzhou, China.
Kidney Int Rep. 2024 Apr 3;9(7):1972-1985. doi: 10.1016/j.ekir.2024.04.012. eCollection 2024 Jul.
Diabetes mellitus presents a significant threat to human health because it disrupts energy metabolism and gives rise to various complications, including diabetic kidney disease (DKD). Metabolic adaptations occurring in the kidney in response to diabetes contribute to the pathogenesis of DKD. Iron metabolism and ferroptosis, a recently defined form of cell death resulting from iron-dependent excessive accumulation of lipid peroxides, have emerged as crucial players in the progression of DKD. In this comprehensive review, we highlight the profound impact of adaptive and maladaptive responses regulating iron metabolism on the progression of kidney damage in diabetes. We summarize the current understanding of iron homeostasis and ferroptosis in DKD. Finally, we propose that precise manipulation of iron metabolism and ferroptosis may serve as potential strategies for kidney management in diabetes.
糖尿病对人类健康构成重大威胁，因为它会扰乱能量代谢并引发各种并发症，包括糖尿病肾病（DKD）。肾脏针对糖尿病所发生的代谢适应性变化会促使DKD的发病机制发展。铁代谢和铁死亡（一种最近定义的因铁依赖性脂质过氧化物过度积累而导致的细胞死亡形式）已成为DKD进展中的关键因素。在这篇全面综述中，我们强调调节铁代谢的适应性和适应不良反应对糖尿病肾损伤进展的深远影响。我们总结了目前对DKD中铁稳态和铁死亡的理解。最后，我们提出精准调控铁代谢和铁死亡可能成为糖尿病肾脏管理的潜在策略。
