Broadening horizons in mechanisms, management, and treatment of diabetic kidney disease

足细胞 医学 疾病 肾小球基底膜 肾功能 肾脏疾病 糖尿病 肾单位 生物信息学 内科学 病理 内分泌学 肾小球肾炎 蛋白尿 生物
作者
Adriana Petrazzuolo,Gianmarco Sabiu,Emma Assi,Anna Maestroni,Ida Pastore,Maria Elena Lunati,Laura Montefusco,Cristian Loretelli,Giada Rossi,Moufida Ben Nasr,Vera Usuelli,Yanan Xie,Hari Baskar Balasubramanian,Monica Zocchi,Basset El Essawy,Jun Yang,Francesca D’Addio,Paolo Fiorina
出处
期刊:Pharmacological Research [Elsevier BV]
卷期号:190: 106710-106710 被引量:31
标识
DOI:10.1016/j.phrs.2023.106710
摘要

Diabetic kidney disease (DKD) is the first cause of end-stage kidney disease in patients with diabetes and its prevalence is increasing worldwide. It encompasses histological alterations that mainly affect the glomerular filtration unit, which include thickening of the basement membrane, mesangial cell proliferation, endothelial alteration, and podocyte injury. These morphological abnormalities further result in a persistent increase of urinary albumin-to-creatinine ratio and in a reduction of the estimated glomerular filtration rate. Several molecular and cellular mechanisms have been recognized, up to date, as major players in mediating such clinical and histological features and many more are being under investigation. This review summarizes the most recent advances in understanding cell death mechanisms, intracellular signaling pathways and molecular effectors that play a role in the onset and progression of diabetic kidney damage. Some of those molecular and cellular mechanisms have been already successfully targeted in preclinical models of DKD and, in some cases, strategies have been tested in clinical trials. Finally, this report sheds light on the relevance of novel pathways that may become therapeutic targets for future applications in DKD.
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