自噬与糖尿病肾病的关系及中医药干预机制研究进展

Research progress on the relationship between autophagy and diabetes nephropathy and the intervention mechanism of traditional Chinese medicine

糖尿病肾病(DN)是糖尿病常见的微血管并发症,也是终末期肾脏病的主要病因。DN的发生与自噬密切相关。自噬是细胞内清除受损蛋白质及衰老细胞器的有效途径,是机体自我保护、自我更新的重要机制。自噬的调控受多种信号通路影响,主要涉及哺乳动物雷帕霉素靶蛋白(mTOR)、腺苷酸活化蛋白激酶(AMPK)和沉默信息调节因子1(SIRT1)等营养感应信号通路。中医认为自噬与气虚、痰浊血瘀等有关,越来越多的中药被证实通过调控自噬发挥对DN的治疗作用。从自噬角度阐述DN的发病机制,并对中医药干预措施进行总结,以期为临床治疗DN提供一定的参考。

Diabetes nephropathy(DN) is a common microvascular complication of diabetes and the main cause of end-stage renal disease.Studies have shown that the occurrence of DN is closely related to autophagy.Autophagy is an effective pathway for clearing damaged proteins and aging organelles within cells,and is an important mechanism for the body's self-protection and self-renewal.The regulation of autophagy is influenced by various signaling pathways,mainly involving mammalian rapamycin target proteins(mTOR),adenosine activated protein kinase(AMPK),and silencing information regulatory factor 1(SIRT1) and other nutrient sensing signaling pathways.Traditional Chinese medicine believes that autophagy is related to qi deficiency,phlegm turbidity and blood stasis.More and more traditional Chinese medicine has been proven to exert therapeutic effects on DN by regulating autophagy.This article elaborates on the pathogenesis of DN from the perspective of autophagy and summarizes the intervention measures of traditional Chinese medicine,in order to provide some reference for clinical treatment of DN.