Nagaram Srinivas, Sen Aniruddha, Singh Vijay, Raj Ps Mohan, Dwivedi Shailendra, Bansal Akash
Department of Biochemistry, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, 273008, India.
Curr Gene Ther. 2025 Aug 25. doi: 10.2174/0115665232376803250815065514.
Diabetic Nephropathy (DN) is a leading cause of chronic kidney disease and end-stage renal failure, highlighting the need for improved diagnostic and therapeutic strategies. This review examines the emerging roles of exosomal microRNAs (miRNAs) and epigenetic modifications in disease, with a focus on their diagnostic and therapeutic potential.
A comprehensive analysis of the current literature was conducted, focusing on exosomal miRNAs-particularly miR-21, miR-192, and miR-29-and their impact on inflammatory pathways, such as IL-6 and NF-κB. The role of epigenetic alterations, including DNA methylation, histone modification, and noncoding RNAs, in DN progression is also discussed. Techniques for miRNA detection and exosome isolation are briefly reviewed.
Exosomal miRNAs contribute to DN pathophysiology by promoting oxidative stress, inflammation, and fibrosis. Their stability and noninvasive detectability make them promising early biomarkers. Epigenetic modifications further modulate gene expression relevant to disease progression.
These molecular changes offer novel targets for early diagnosis and therapeutic intervention in DN. The interplay between miRNAs and epigenetic regulation may provide insights into disease heterogeneity and progression. However, limitations exist regarding the standardization of detection techniques and clinical translation, necessitating further research.
Exosomal miRNAs and epigenetic markers present valuable tools for advancing the diagnosis and personalized treatment of DN. Enhancing detection techniques and understanding their molecular roles could pave the way for more effective clinical applications.
糖尿病肾病（DN）是慢性肾脏病和终末期肾衰竭的主要原因，这凸显了改进诊断和治疗策略的必要性。本综述探讨了外泌体微小RNA（miRNA）和表观遗传修饰在该疾病中的新作用，重点关注它们的诊断和治疗潜力。
对当前文献进行了全面分析，重点关注外泌体miRNA——特别是miR-21、miR-192和miR-29——及其对炎症途径（如IL-6和NF-κB）的影响。还讨论了表观遗传改变（包括DNA甲基化、组蛋白修饰和非编码RNA）在DN进展中的作用。简要回顾了miRNA检测和外泌体分离技术。
外泌体miRNA通过促进氧化应激、炎症和纤维化，参与DN的病理生理过程。它们的稳定性和非侵入性可检测性使其成为有前景的早期生物标志物。表观遗传修饰进一步调节与疾病进展相关的基因表达。
这些分子变化为DN的早期诊断和治疗干预提供了新的靶点。miRNA与表观遗传调控之间的相互作用可能为疾病的异质性和进展提供见解。然而，在检测技术的标准化和临床转化方面存在局限性，需要进一步研究。
外泌体miRNA和表观遗传标志物为推进DN的诊断和个性化治疗提供了有价值的工具。加强检测技术并了解它们的分子作用可为更有效的临床应用铺平道路。
