间充质干细胞治疗糖尿病肾病的作用与机制

Effect and mechanism of mesenchymal stem cells in the treatment of diabetic nephropathy

背景:糖尿病肾病已经成为终末期肾病的主要原因之一,但临床治疗效果仍然有限。近年来研究结果表明,间充质干细胞对糖尿病肾病具有一定的肾脏保护作用。目的:从糖尿病肾病的发病机制与一般治疗策略、间充质干细胞的特征和临床应用,以及间充质干细胞对糖尿病肾病的肾脏保护作用3个方面进行综述,阐述间充质干细胞治疗糖尿病肾病的研究进展。方法:以"mesenchymal stem cells,MSCs,diabetic nephropathy,diabetic kidney disease"为检索词检索PubMed数据库,筛选相关的研究性论文、综述和论著,并根据纳入标准和排除标准整理出62篇文献进行综述。结果与结论:间充质干细胞在疾病治疗领域的研究已经广泛开展,但间充质干细胞治疗糖尿病肾病的临床试验开展较少,且临床疗效有限。动物实验证实间充质干细胞能够发挥肾脏保护作用并延缓糖尿病肾病进展,具体机制包括减少肾脏细胞凋亡、调节自噬、改善炎症反应、改善氧化应激和抑制纤维化等。

BACKGROUND:Diabetic nephropathy has become one of the main causes of end-stage renal disease,but clinical treatment is still limited.In recent years,studies have found that mesenchymal stem cells exert renal protective effects in diabetic nephropathy.OBJECTIVE:To review the research advances of mesenchymal stem cells in diabetic nephropathy from three aspects:the pathogenesis and general treatment strategies of diabetic nephropathy,the characteristics and clinical application of mesenchymal stem cells,and the renal protective effect of mesenchymal stem cells on diabetic nephropathy.METHODS:Relevant research,reviews and treatises were searched in PubMed database and the search terms included"mesenchymal stem cells,MSCs,diabetic nephropathy,diabetic kidney disease".Totally 62 articles were included for review based on inclusion and exclusion criteria.RESULTS AND CONCLUSION:The research of mesenchymal stem cells in disease treatment has been widely carried out.However,there are few clinical trials of mesenchymal stem cells in the treatment of diabetic nephropathy,and the clinical efficacy is limited.Animal experiments have confirmed that mesenchymal stem cells can play a protective role in kidney and delay the progression of diabetic nephropathy.The mechanisms include reducing renal cell apoptosis,regulating autophagy,ameliorating inflammation,suppressing oxidative stress,and inhibiting fibrosis.