中医药调控线粒体自噬防治糖尿病肾病的研究进展

Traditional Chinese Medicine Regulates Mitochondrial Autophagy in Prevention and Treatment of Diabetic Kidney Disease:A Review

糖尿病肾病(DKD)是糖尿病最常见且最严重的微血管并发症之一,已成为全球性的公共卫生问题。DKD的发病是诸多因素共同作用的结果,西医学虽主要以控制血糖、血压、血脂及阻断肾素-血管紧张素系统为主,但仍缺乏有效的针对性治疗手段。线粒体自噬是一种广泛存在且高度保守的自我更新和能量代谢过程,通过选择性地降解受损或功能失调的线粒体,在减少炎症反应、抑制活性氧积累、维持细胞能量代谢、调节线粒体动力学等方面发挥重要作用。线粒体自噬参与DKD的发生发展,通过上调线粒体自噬活性而延缓DKD进展。中医药可多效应、多靶点、多途径调控线粒体自噬紊乱。文章围绕线粒体自噬在DKD发生发展的调控机制,探讨中医药干预线粒体自噬与DKD的关系,以期为中医药治疗DKD的药物研发、基础科研及临床应用提供理论依据和新方向。

Diabetic kidney disease(DKD)is one of the most common and serious microvascular complications of diabetes,which has become a global public health problem.The development of DKD is the consequence of a combination of many factors.Modern medicine emphasizes on controlling blood glucose,blood pressure,blood lipids and blocking the renin-angiotensin system,but there is as yet a lack of efficacious targeted treatment.Mitochondrial autophagy is an evolutionarily widespread and highly conserved process of self-renewal and energy metabolism.By selectively degrading damaged or dysfunctional mitochondria,mitochondrial autophagy plays an important role in reducing inflammatory responses,inhibiting the accumulation of reactive oxygen species,maintaining cellular energy metabolism,and regulating mitochondrial dynamics.Several studies have shown that mitochondrial autophagy is engaged in the evolution of DKD,delaying DKD progression by upregulating mitochondrial autophagic activity.Meanwhile,studies revealed that traditional Chinese medicine,with its unique characteristics of multi-effect,multi-target and multi-pathway,regulates mitochondrial autophagy disorder.This article centers on the regulatory mechanism of mitochondrial autophagy in the development of DKD,and explores the relevance between DKD and Chinese medicine intervention of mitochondrial autophagy,aiming to provide theoretical basis and new directions for drug development,basic scientific research and clinical applicability of Chinese medicine in the treatment of DKD.