Zhao Hui, Guo Jia
Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, Henan, 450052, China.
Int J Biol Sci. 2025 Jul 11;21(10):4647-4662. doi: 10.7150/ijbs.112737. eCollection 2025.
Diabetic kidney disease (DKD), a common microvascular complication of diabetes, has emerged as the leading cause of end-stage renal disease (ESRD), with its prevalence increasing annually, thereby constituting a global epidemiological crisis. Despite this, the search for effective therapeutic strategies remains challenging, underscoring the urgent need for innovative treatments. In recent years, numerous studies have highlighted the role of inflammation in DKD progression, with fibrosis serving as a critical mechanism driving DKD towards ESRD. Intervening in these core processes may reveal new avenues for the etiology and management of DKD. Macrophages, immune cells derived from monocytes, possess phagocytic and digestive functions and play integral roles in tissue and organ development, homeostasis, as well as tissue repair and regeneration. Emerging research suggests that macrophages are crucial in DKD progression and renal injury, thus attracting significant academic attention. This review highlights the role and mechanisms of macrophages in the inflammatory and fibrotic processes in DKD. It also explores current therapeutic approaches targeting macrophages. In light of recent research, we propose that macrophages-focused interventions present a promising therapeutic avenue for DKD.
糖尿病肾病（DKD）是糖尿病常见的微血管并发症，已成为终末期肾病（ESRD）的主要原因，其患病率逐年上升，从而构成了一场全球流行病学危机。尽管如此，寻找有效的治疗策略仍然具有挑战性，这凸显了对创新治疗方法的迫切需求。近年来，大量研究强调了炎症在DKD进展中的作用，纤维化是推动DKD发展为ESRD的关键机制。干预这些核心过程可能会为DKD的病因学和管理揭示新的途径。巨噬细胞是源自单核细胞的免疫细胞，具有吞噬和消化功能，在组织和器官发育、内环境稳态以及组织修复和再生中发挥着不可或缺的作用。新出现的研究表明，巨噬细胞在DKD进展和肾损伤中至关重要，因此引起了学术界的广泛关注。本综述重点介绍了巨噬细胞在DKD炎症和纤维化过程中的作用及机制。还探讨了目前针对巨噬细胞的治疗方法。鉴于最近的研究，我们认为以巨噬细胞为重点的干预措施为DKD提供了一条有前景的治疗途径。
