Gong Yu Xin
Heilongjiang University of Chinese Medicine, Harbin, China.
J Ethnopharmacol. 2025 May 28;348:119874. doi: 10.1016/j.jep.2025.119874. Epub 2025 Apr 23.
Apoptosis of renal tubular epithelial cells (RTECs) is a critical pathological feature of diabetic kidney disease (DKD), a primary contributor to end-stage renal disease (ESRD). Traditional Chinese medicine (TCM) has shown potential in modulating RTECs apoptosis and alleviating DKD progression, making it a promising area for further investigation.
This study aims to summarize the apoptotic pathways implicated in DKD, analyze existing research on the effects of TCM monomers and compounds on RTECs apoptosis, and elucidate the molecular mechanisms underlying these effects. Additionally, this study emphasizes the significant role of TCM in mitigating DKD progression.
Relevant literature was systematically retrieved from ancient Chinese medicine texts and modern scientific databases, including CNKI, Web of Science, and PubMed, using keywords such as "Traditional Chinese Medicine", "Diabetic Kidney Disease", "Diabetic Nephropathy", "Renal Tubular Epithelial Cells", and "Apoptosis". The collected information was synthesized and analyzed.
This review systematically analyzed 187 relevant studies, focusing on the mechanisms and clinical applications of 16 TCM monomers and 20 TCM compounds in DKD treatment. Key bioactive compounds, such as berberine, astragaloside IV, and tanshinone IIA, have demonstrated renoprotective effects by mitigating oxidative stress and inflammation, as well as regulating critical signaling pathways, including PI3K/Akt, NF-κB, and TGF-β/Smad, to suppress RTECs apoptosis and decelerate DKD progression. Additionally, several TCM compounds have shown significant efficacy in clinical studies, reducing proteinuria and enhancing renal function, thereby reinforcing the therapeutic potential of TCM in DKD management.
RTECs apoptosis is a critical pathological feature of DKD. TCM exhibits significant therapeutic potential by intervening in this process through multiple pathways. This study highlights the ability of TCM to exert anti-apoptotic and renoprotective effects by modulating oxidative stress, inflammatory responses, and multiple cellular signaling pathways. The multi-component and multi-target characteristics of TCM offer a promising avenue for the development of novel therapeutic strategies. However, further rigorous research and high-quality clinical trials are required to validate its efficacy and elucidate its mechanisms of action.
肾小管上皮细胞（RTECs）凋亡是糖尿病肾病（DKD）的关键病理特征，是终末期肾病（ESRD）的主要促成因素。中药在调节RTECs凋亡和缓解DKD进展方面已显示出潜力，使其成为一个有前景的进一步研究领域。
本研究旨在总结DKD中涉及的凋亡途径，分析现有关于中药单体和化合物对RTECs凋亡影响的研究，并阐明这些作用的分子机制。此外，本研究强调了中药在减轻DKD进展中的重要作用。
使用“中药”、“糖尿病肾病”、“糖尿病性肾病”、“肾小管上皮细胞”和“凋亡”等关键词，从古代中医文献和现代科学数据库（包括中国知网、科学网和PubMed）中系统检索相关文献。对收集到的信息进行综合分析。
本综述系统分析了187项相关研究，重点关注16种中药单体和20种中药化合物在DKD治疗中的作用机制和临床应用。关键生物活性化合物，如黄连素、黄芪甲苷IV和丹参酮IIA，已通过减轻氧化应激和炎症以及调节关键信号通路（包括PI3K/Akt、NF-κB和TGF-β/Smad）显示出肾脏保护作用，以抑制RTECs凋亡并减缓DKD进展。此外，几种中药化合物在临床研究中显示出显著疗效，可减少蛋白尿并增强肾功能，从而加强了中药在DKD管理中的治疗潜力。
RTECs凋亡是DKD的关键病理特征。中药通过多种途径干预这一过程显示出显著的治疗潜力。本研究强调了中药通过调节氧化应激、炎症反应和多种细胞信号通路发挥抗凋亡和肾脏保护作用的能力。中药的多成分和多靶点特性为开发新的治疗策略提供了一条有前景的途径。然而，需要进一步严格的研究和高质量的临床试验来验证其疗效并阐明其作用机制。
