糖尿病肾病内皮细胞损伤机制的研究进展

Research progress on the mechanism of endothelial cells injury in diabetic nephropathy

糖尿病肾病是糖尿病微小血管并发症之一,其主要表现为进行性的蛋白尿和肾功能衰退,最终发展为终末期肾病。肾小球内皮细胞是肾小球滤过屏障的重要组成部分,其结构及功能的完整性与肾小球滤过功能关系密切。肾小球内皮细胞功能障碍对糖尿病肾病的发生、发展起着重要作用,导致内皮功能障碍的经典机制除糖代谢紊乱、氧化应激、异常血管新生、炎症及内皮转分化等,还包括细胞间通讯、表观遗传学及外泌体等新机制。该文就肾小球内皮细胞在糖尿病肾病中损伤的相关机制研究进展进行了综述。

Diabetic nephropathy(DN)is one of the diabetic microvascular complications characterized by progressive protein uria and renal failure,which may eventually develop into end-stage renal disease(ESRD).Glomerular endothelial cells are one of the important components of glomerular filtration barrier.The structural and functional integrity of these cells are closely related to the maintenance of glomerular filtration function.Dysfunction of glomerular endothelial cells can lead to proteinuria,glomerulosclerosis and interstitial fibrosis,further damaging renal function and accelerating the progression of DN.The mechanisms leading to endothelial dysfunction include glucose metabolism disorder,oxidative stress,abnormal angiogenesis,inflammation and endothelial transdifferentiation.In recent years,it has been proposed that mechanisms such as intercellular communication,epigenetics and exosomes may be involved in the injury of diabetic nephropathy.In present paper,the research progress of related mechanisms was reviewed on the damage of glomerular endothelial cells in DN.