基于PI3K/Akt/mTOR信号通路探讨中医药治疗糖尿病肾病的研究进展

Research Progress of Traditional Chinese Medicine in the Treatment of Diabetic Nephropathy Based on PI3K/Akt/mTOR Signaling Pathway

糖尿病肾病(DN)作为糖尿病(DM)最为危重的普遍并发症之一,现已逐渐成为终末期肾病(ESRD)的主要原因。DN发生发展的发病机制是复杂多样的,可能与遗传、自噬、氧化应激、炎症反应等诸多因素有关。磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(PKB,又称Akt)/哺乳动物雷帕霉素靶蛋白(mTOR)信号通路作为细胞内一条至关重要的通路,与DN的发病机制密切相关。基于当下中医药治疗DN的研究现状,笔者结合近几年来国内外的相关研究综述了PI3K/Akt/mTOR信号通路在DN中的作用机制及通过使用中医药抑制PI3K/Akt/mTOR信号通路起到激活自噬、减少炎症反应及减弱氧化应激等作用,为中医药治疗DN的进一步研究提供新思路和新靶点。

Diabetic nephropathy(DN),as one of the most critical and prevalent complications of diabetes mellitus(DM),has gradually become a main cause of end-stage renal disease(ESRD).The pathogenesis of DN development is complex and diverse,which may be related to many factors such as genetics,autophagy,oxidative stress,and inflammatory response.Phosphatidylinositol 3-kinase(PI3K)/protein kinase B(PKB,also known as Akt)/mammalian target of rapamycin(mTOR)signaling pathway,as a crucial intracellular pathway,go hand in hand with pathogenesis of DN.Based on current research status of DN treatment by traditional Chinese medicine(TCM),the authors reviewed the mechanism of PI3K/Akt/mTOR signaling pathway in DN and the TCM role of inhibiting PI3K/Akt/mTOR signaling pathway in activating autophagy,reducing inflammatory response,and attenuating oxidative stress.This paper,therefore,will provide new ideas and targets for further research on the treatment of DN with TCM.