基于足细胞的保护作用探讨中医药治疗膜性肾病作用机制的实验研究进展

Experimental research progress on the mechanism of traditional Chinese medicine in the treatment of membranous nephropathy based on the protective effect of podocytes

基于足细胞的保护作用探讨中医药治疗膜性肾病作用机制的实验研究进展。膜性肾病的主要病理特征表现为肾小球足细胞上皮下免疫复合物沉积及肾小球基底膜和足细胞损伤。中医药可通过下调PI3K/AKT/mTOR、TLR4/NF-κB、ERK/cPLA2、TGF-β1/Smad等足细胞相关信号通路表达,上调AMPK/mTOR足细胞相关信号通路表达,提升Nephrin、Podocin等足细胞相关蛋白的含量及调控足细胞相关凋亡基因(Bcl-2和Bax)的表达从而减轻蛋白尿,降低炎症因子和改善肾功能和脂质代谢,提升血清白蛋白含量,减轻肾脏纤维化和足细胞损伤,进而延缓肾脏病的进展。作者就近五年来中医药基于足细胞的保护作用治疗膜性肾病的基础实验研究进展展开综述,以期对临床膜性肾病的治疗提供参考。

This paper reviews the experimental research progress on the mechanism of traditional Chinese medicine in the treatment of membranous nephropathy based on the protective effect of podocytes.The main pathological features of membranous nephropathy are the deposition of subcutaneous immune complexes on glomerular podocytes and the injury of glomerular basement membrane and podocytes.Traditional Chinese medicine can down-regulate the expression of PI3K/AKT/mTOR,TLR4/NF-κB,ERK/cPLA2,TGF-β1/Smad and other podocytes related signaling pathways,and up-regulate the expression of AMPK/mTOR podocytes related signaling pathways.Increase the content of podocytes related proteins such as Nephrin and Podocin and regulate the expression of podocytes related apoptosis genes(Bcl-2 and Bax)to reduce proteinuria,reduce inflammatory factors,improve renal function and lipid metabolism,increase serum albumin content,reduce renal fibrosis and podocytes injury,and then delay the progression of kidney disease.In order to provide reference for clinical treatment of membranous nephropathy,this paper reviews the experimental research progress of traditional Chinese medicine based on the protective effect of podocytes in the treatment of membranous nephropathy in the past five years.