摘要
糖尿病肾病(DKD)是糖尿病的一种严重微血管并发症,是终末期肾衰竭的主要原因,其进展无法通过药物阻断且增加了糖尿病患者的病死率,DKD早期防治是临床的重中之重。足细胞作为肾小球滤过屏障的重要组成部分,其自噬水平的失衡通常发生在DKD早期,其对DKD进展具有潜在价值,哺乳动物雷帕霉素靶蛋白(mTOR)信号通路是调控足细胞自噬的经典通路,作为营养感应途径在糖尿病肾病的发生发展过程中发挥重要作用。中医药在防治糖尿病肾病中具有独特优势和良好前景,益气养阴活血类中药是临床治疗DKD的常用药,其潜在机制的明确有助于向临床提供科学依据,并且指导新药研发,进一步发展中医药新质生产力,推动中国中药现代化进程。文章就中药单体或复方靶向mTOR信号通路调控足细胞自噬水平进而防治糖尿病肾病的相关研究进行概括总结,旨在为中医药在DKD的药理研究及临床应用方面提供一定的参考。
Diabetic kidney disease(DKD)as a severe microvascular complication of diabetes is the major cause of end-stage renal failure.Its progress cannot be delayed by drugs and increases the mortality of diabetes patients.Early prevention and treatment of DKD is a top priority in clinical practice.Podocytes are an important part of the glomerular filtration barrier.The imbalance of their autophagy level usually occurs in the early stage of DKD,which has potential value for the progress of DKD.The mTOR signal pathway is a classic pathway to regulate podocyte autophagy,and plays an important role in the development of diabetes nephropathy as a nutritional sensing pathway.Traditional Chinese medicine has unique advantages and good prospects in the prevention and treatment of DKD.Traditional Chinese medicine for invigorating qi,nourishing yin and activating blood circulation is commonly used in clinical treatment of DKD.The clarification of its potential mechanism will help to provide scientific basis for clinical treatment,guide the research and development of new drugs,and promote the modernization process of traditional Chinese medicine.Therefore,this article reviews the research related to the regulation of podocyte autophagy level by traditional Chinese medicine monomer or compound targeting mTOR signal pathway to prevent and treat diabetes nephropathy,in order to provide a reference for clinical pharmacological research and clinical application of prevention and treatment of DKD by traditional Chinese medicine.
作者
李艳芳
刘佳
黄宇虹
LI Yanfang;LIU Jia;HUANG Yuhong(Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;The Second Affilicated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China)
出处
《天津中医药》
CAS
2024年第8期1075-1082,共8页
Tianjin Journal of Traditional Chinese Medicine
基金
国家自然科学基金青年项目(81903768)
国家新药创制重大专项(2015ZX09101043-009)。
