摘要
糖尿病肾病(DN)是糖尿病的严重并发症,是慢性肾衰竭和终末期肾病的主要危险因素,也是糖尿病患者发病和死亡的主要原因和全球最主要的非传染性死亡原因,而细胞焦亡和炎性小体激活与DN的发生发展有着密切的关系,可以介导足细胞足突丢失和融合、炎症因子表达增加、巨噬细胞浸润、肾小球基质扩张和尿白蛋白与肌酐比值增加等多种病理变化,最终导致肾单位丢失和肾损伤。据研究报道,传统草药或经典处方中的多种活性成分在DN治疗中发挥着降糖、降脂、改善胰岛素抵抗、抗炎、抗氧化应激、调节免疫等多种作用,并且可以通过抑制炎症小体的激活,抑制肾细胞焦亡,拮抗DN炎症诱导的损伤,改善肾功能,减缓DN进展,疗效明确。中药干预DN具有多靶点、多信号通路、多系统等特点和作用,在防治DN上具有广阔前景。目前体内外关于中医药干预DN的研究众多,但是缺乏系统的、全面地对中医药干预DN模型实验研究的整理、概括和总结,该文就细胞焦亡和炎性小体的研究进展及在DN中的作用机制及中医药干预研究进展进行综述,以期为DN相关防治药物的研发提供思路和参考。
Diabetic nephropathy(DN)is a serious complication of diabetes,a major risk factor for chronic renal failure and end-stage renal disease,a major cause of deaths of diabetic patients,and a major cause of noncommunicable disease-associated deaths in the world.Pyroptosis and inflammasome activation are closely associated with the occurrence and development of DN.They can mediate a variety of pathological changes such as the loss and fusion of podocytes,up-regulated expression of inflammatory cytokines,macrophage infiltration,glomerular mesangial matrix expansion,and increased urinary albumin-to-creatinine ratio,eventually leading to nephron loss and kidney injury.The available studies have reported that the active ingredients in Chinese medicinal herbs or classical prescriptions play a role in the treatment of DN by lowering blood glucose and lipid levels,mitigating insulin resistance,reducing inflammation,alleviating oxidative stress,and regulating immunity.Moreover,the active ingredients can inhibit the activation of inflammasomes and the pyroptosis of renal cells,repair the inflammation-induced damage,improve renal function,and slow the progression of DN,demonstrating definite therapeutic effect.Chinese medicines can treat DN in a multi-target,multi-pathway,and multi-system manner,possessing broad prospects in the prevention and treatment of DN.Despite the extensive studies about the traditional Chinese medicine(TCM)intervention of DN in vivo and in vitro,a comprehensive summary of experimental studies on the TCM intervention of DN model remains to be carried out.This paper reviews the research progress in pyroptosis,inflammasomes,roles of pyroptosis and inflammasomes in DN,and TCM intervention of DN,aiming to provide ideas and reference for the research and development of drugs for this disease.
作者
李晓晨
杨鹏
王晓萌
吴丽丽
秦灵灵
刘铜华
LI Xiaochen;YANG Peng;WANG Xiaomeng;WU Lili;QIN Lingling;LIU Tonghuang(Shaanxi University of Chinese Medicine,Xianyang 712046,China;Key Laboratory of Health Cultivation of the Ministry of Education,Beijing University of Chinese Medicine,Beijing 100029,China;Key Laboratory of Health Cultivation of Beijing,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Science and Technology,Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2023年第13期273-282,共10页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金青年基金项目(82004338)
教育部中医药防治糖尿病及其并发症创新引智基地项目(B20055)。
关键词
糖尿病肾病
细胞焦亡
炎性小体
信号通路
作用机制
diabetic nephropathy
pyroptosis
inflammasome
signaling pathway
mechanism of action
