摘要
糖尿病肾病(diabetic kidney disease,DKD)是糖尿病常见的微血管并发症之一,也是导致终末期肾衰竭(end stage renal disease,ESRD)的首要病因,是亟待解决的临床问题。高糖诱发氧化应激是DKD的核心发病机制。核因子E2相关因子2(nuclear factor erythroid-2 related factor 2,Nrf2)信号通路是增强机体抗氧化能力、抵御氧化应激损伤的关键信号通路,与DKD的严重程度密切相关。DKD患者Nrf2信号通路受到抑制,机体抗氧化能力下降。调节Nrf2信号通路,可诱导一系列细胞保护基因的转录,发挥血管保护作用,成为DKD的潜在治疗靶点。中医药整体观念、辨证论治的特点,符合DKD个体化治疗、综合治疗的理念,在临床防治DKD中具有明显的优势,且不良反应发生率低。众多的中药提取物、单体以及中药复方已被证实可通过调节Nrf2信号通路,改善DKD肾组织氧化损伤,进而发挥肾脏保护作用,是发现Nrf2激动剂的有效途径。因此,该文阐述Nrf2信号通路与DKD的关系,归纳此信号通路防治DKD的作用机制,总结中医药干预此通路现有的研究成果,以期为促进针对Nrf2信号通路防治DKD的中药新药研发与临床应用提供参考。
Diabetic nephropathy(diabetic kidney disease,DKD)is one of the most common microvascular complications of diabetes,and it is also the primary cause of end-stage renal failure(end stage renal disease,ESRD).High glucose induced oxidative stress is the core pathogenesis of DKD.Nuclear factor erythroid-2 related factor 2(Nrf2)signaling pathway is a key signaling pathway to enhance the body’s antioxidant capacity and resist oxidative stress injury,which is closely related to the severity of DKD.In DKD patients,Nrf2 signaling pathway is inhibited and antioxidant capacity is decreased.The regulation of Nrf2 signaling pathway can induce the transcription of a series of cell protective genes and play the role of vascular protection,which has become a potential therapeutic target for DKD.The overall concept of traditional Chinese medicine and the characteristics of syndrome differentiation and treatment are in line with the concept of individual treatment and comprehensive treatment of DKD.It has obvious advantages in clinical prevention and treatment of DKD,and the incidence of adverse reactions is low.Many traditional Chinese medicine extracts,monomers and traditional Chinese medicine compounds have been proved to be effective ways to discover Nrf2 agonists by regulating Nrf2 signaling pathway and improving renal oxidative damage in DKD.Therefore,this paper expounds the relationship between Nrf2 signaling pathway and DKD,summarizes the mechanism of this signaling pathway in the prevention and treatment of DKD,and summarizes the existing research results of traditional Chinese medicine intervention in this pathway,so as to provide reference for promoting the development and clinical application of new Chinese medicine drugs for the prevention and treatment of DKD by Nrf2 signaling pathway.
作者
张颖
黄奡
张梦婷
宫成军
张兰
ZHANG Ying;HUANG Ao;ZHANG Mengting;GONG Chengjun;ZHANG Lan(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2022年第4期182-186,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
辽宁省自然科学基金项目(2019-ZD-0439)。
关键词
核因子E2相关因子2
糖尿病肾病
中医药
nuclear factor E2 related factor 2
diabetic nephropathy
traditional Chinese medicine
