细胞焦亡参与糖尿病肾病发生和发展的研究进展

Research Progress on the Role of Cell Pyroptosis in the Occurrence and Development of Diabetic Nephropathy

糖尿病肾病(diabetic nephropathy, DN)是糖尿病的主要并发症和死亡原因。随着人们对糖的摄入量的增多,糖尿病患者人数快速增长,DN的发病率也呈逐年上升的趋势,在一些国家或地区已经成为终末期肾病(end stage renal disease, ESRD)的首位原因,DN除了是发生ESRD的重要原因外,还会大幅增加糖尿病患者脑血管疾病发生的风险以及全因死亡风险,总的来说如果管理不佳,会严重影响患者的生活质量、家人的幸福指数以及给社会医疗体系带来巨大的负担。早期的DN治疗方法主要是降压、降糖等,晚期的DN治疗主要以是血液透析、腹膜透析、肾脏移植等肾脏替代治疗方法,但治疗效果并不理想。DN的发病机制复杂,目前尚未明确。因此深入了解DN发生发展的各个环节,发现新的治疗靶点显得尤为重要。既往认为DN是由代谢和血流动力学改变引起的,近年来的深入研究表明DN的病因是多因素的,炎症机制在DN的发展过程中也起着关键作用。细胞焦亡作为一个新发现的程序性细胞死亡方式近年来被广泛报道参与多种炎症性疾病的发生发展,同样被认为是DN发生发展的重要因素,近年来受到广泛关注。在这篇综述中,就细胞焦亡的特征、分子机制和与DN的关系,阐明其作为DN潜在治疗靶点的研究价值。

Diabetes nephropathy is the main complication and death cause of diabetes. With the increase of people’s sugar intake, the number of diabetes patients has increased rapidly, and the incidence rate of diabetes nephropathy has also increased year by year. In some countries or regions, diabetes nephropathy has become the leading cause of end-stage renal disease. In addition to being an important cause of end-stage renal disease, it will also significantly increase the risk of cerebrovascular disease and all-cause death in diabetes patients. In general, poor management will seriously affect the quality of life of patients, the happiness index of their families and bring a huge burden to the social medical system. The early treatment of diabetes nephropathy is mainly to reduce blood pressure and glucose, while the late treatment of diabetes nephropathy is mainly renal replacement therapy such as hemodialysis, peritoneal dialysis and kidney transplantation, but the treatment effect is not ideal. The pathogenesis of diabetes nephropathy is complex, and it is not clear yet. Therefore, it is particularly important to deeply understand the occurrence and development of diabetes nephropathy and find new therapeutic targets. In the past, it was thought that diabetes nephropathy was caused by metabolic and hemodynamic changes. In recent years, in-depth studies have shown that the etiology of diabetes nephropathy is multifactorial, and the inflammatory mechanism also plays a key role in the development of diabetes nephropathy. As a newly discovered programmed cell death mode, pyroptosis has been widely reported to participate in the occurrence and development of a variety of inflammatory diseases in recent years. It is also considered to be an important factor in the occurrence and development of diabetes nephropathy, and has been widely concerned in recent years. In this review, the characteristics, molecular mechanism of cell death and its relationship with diabetes nephropathy were discussed to clarify its research value as a potential therapeutic target for diabetes nephropathy.