糖尿病肾纤维化信号通路研究进展

Research progress of renal fibrosis signaling pathway involved in diabetes

糖尿病肾脏病(DKD)是一种危害性极大的糖尿病(DM)微血管并发症,糖尿病肾纤维化是DKD的一个关键病理改变,会显著增加晚期DKD患者的死亡率。近年来对DKD的研究进展迅速,但是引起糖尿病肾纤维化的具体机制尚未完全阐明。目前研究发现有许多信号通路与糖尿病肾纤维化的发生关系密切,包括TGF-β/Smad、Wnt/β-catenin、PI3k/Akt、p38MAPK、JAK/STAT、Notch等。这些信号通路通过调节靶基因的转录,触发细胞外基质(ECM)的积累和肾小球、肾小管上皮-间充质转化(EMT)的形成,进而导致肾脏纤维化,加快DKD的进展。本文综述糖尿病肾纤维化发生的信号通路,为DKD进行预防和早期诊治提供帮助。

Diabetes nephropathy(DKD)is a very harmful microvascular complication of diabetes.Diabetic renal fibrosis is a key pathological change of DKD,which significantly increases the mortality of patients with advanced DKD.In recent years,the research on DKD has made a rapid progress,although the specific mechanism underlying renal fibrosis in diabetes patients has not been fully clarified.At present,many signaling pathways have been found to be closely related to the development of diabetic renal fibrosis in diabetes,including the transforming growth factor beta(TGF-β)/Smad,Wnt/β-Catenin,phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt),p38 Mitogen activated protein kinases(p38MAPK),Janus kinases(JAK)/signal transducer and activator of transcription(STAT),and Notch signaling pathways.They trigger the accumulation of extracellular matrix(ECM)and the formation of glomerular and tubular epithelial mesenchymal transformation(EMT)by regulating the transcription of target genes,thus leading to renal fibrosis and accelerating the progress of DKD.This article reviews the signaling pathways involved in diabetic renal fibrosis,which can help to the prevention and early diagnosis of DKD.