糖尿病肾病发病分子机制

Molecular Mechanisms in the Pathogenesis of Diabetic Nephropathy

糖尿病肾病(DN)是高血糖所导致的一种主要的微血管并发症。在全世界糖尿病病人中,糖尿病肾病都有着非常高的发病率和致死率。并且在中国,糖尿病肾病已经成为一种常见的导致末期肾衰竭的因素。由于糖尿病肾病患者不断增多,传统的单纯通过控制血糖来控制糖尿病肾病并没有取得理想的效果,因此临床上迫切需要一些新的治疗方法来控制糖尿病肾病的发生和发展。最近的研究表明肾素-血管紧张素-醛固酮系统(RAAS)、蛋白激酶-C(PKC)、还原型烟酰胺腺嘌呤二核苷酸磷酸(NADPH)氧化酶、转化生长因子-β(TGF-β)等都单独的或共同的参与了DN的发生和发展过程。这些通路彼此交叉,十分复杂,因此需要对糖尿病肾病发病分子机制进行全面的综合的理解。这篇文章旨在讨论已发现的与糖尿病肾病密切相关的分子机制以及下调通路。

Diabetic nephropathy （DN） is one of common microvascular complications in diabetes mellitus.DN has a high morbidity and mortality in diabetic patients around the world. And in China, DN is one of common cause of end-stage renal failure. As the number of diabetic patients with nephropathy is increasing yearly, glycemic control as a tradition therapeutic to manage diabetic nephropathy remain unsatisfactory. Some ground-breaking therapeutic options are urgent needed to prevent the development and progression of diabetic nephropathy. Recent studies suggested renin-angiotensin aldosterone system （RAAS）, protein kinase C （PKC）, nicotinamide adenine dinucleotide phosphate oxidase （NADPH oxidase）, transforming growth factorβ （TGF-β）, etc. are activated during the course of diabetes mellitus and that these pathways individually or collectively play a role in the induction and progression of diabetic nephropathy. Since these mechanisms are very complicated, a comprehensive understanding of molecular mechanisms involved in the pathogenesis of the disease is necessary. Therefore, the purpose of this paper is to discuss the discovered mechanisms and downstream pathways in the pathogenesis of diabetic nephropathy.