[Potential pathways for traditional Chinese medicine intervention in diabetic kidney disease: macrophage polarization].

Q3 Pharmacology, Toxicology and Pharmaceutics Zhongguo Zhongyao Zazhi Pub Date : 2024-08-01 DOI:10.19540/j.cnki.cjcmm.20240412.708
Wen-Ru Wang, Xin-Hui Wang, Lei Yan, Qin Zeng, Tian Zhan, Jing-Yi Zhan, Ji-Xin Li, Ren-Huan Yu
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Abstract

Diabetic kidney disease(DKD) is a prevalent and severe microvascular complication of type 2 diabetes mellitus(T2DM). Chronic microinflammation is an important factor exacerbating renal tissue damage in DKD individuals. Macrophages play a crucial role in immune-inflammatory responses, and they can transiently and reversibly polarize into the pro-inflammatory M1 phenotype and anti-inflammatory M2 phenotype based on microenvironmental differences. The imbalance in M1/M2 macrophage polarization can exacerbate DKD progression by fostering inflammatory cytokine aggregation in the glomeruli and renal interstitium. Therefore, restoring the balance of macrophage is a pivotal avenue to ameliorate the chronic microinflammation state in DKD. Macrophage polarization is a complex and dynamic process. Various information molecules and cytokines involved in the polarization process play important roles in regulating phenotypes during the progression of DKD. They are closely related to various mechanisms such as metabolism, inflammation, fibrosis, and mitochondrial autophagy in DKD. By coordinating the inflammatory responses through polarization, they play a key role in regulating inflammation in metabolic-related diseases. The complex network of pathways involved in macrophage polarization corresponds well with the multi-pathway, multi-target treatment model of traditional Chinese medicine(TCM). Active ingredients and formulas of TCM can intervene in DKD by regulating macrophage polarization. Studies on relieving renal inflammation, repairing renal tissues, and promoting renal function recovery through macrophage polarization modulation are not uncommon. Therefore, based on exis-ting evidence, this study reviews TCM in targeting M1/M2 macrophage polarization balance to improve DKD, aiming to explore the potential of macrophage polarization in regulating DKD, which is expected to provide evidence support for the clinical diagnosis and treatment of DKD with TCM as well as the exploration of its biological mechanisms.

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[中药干预糖尿病肾病的潜在途径:巨噬细胞极化]。
糖尿病肾病(DKD)是 2 型糖尿病(T2DM)的一种普遍而严重的微血管并发症。慢性微炎症是加重糖尿病肾病患者肾组织损伤的重要因素。巨噬细胞在免疫炎症反应中起着至关重要的作用,它们可根据微环境的差异,瞬时、可逆地极化为促炎的 M1 表型和抗炎的 M2 表型。M1/M2巨噬细胞极化的失衡会促进炎性细胞因子在肾小球和肾间质的聚集,从而加剧DKD的进展。因此,恢复巨噬细胞的平衡是改善DKD慢性微炎症状态的关键途径。巨噬细胞的极化是一个复杂而动态的过程。参与极化过程的各种信息分子和细胞因子在 DKD 进展过程中的表型调节中发挥着重要作用。它们与 DKD 中的新陈代谢、炎症、纤维化和线粒体自噬等各种机制密切相关。它们通过极化作用协调炎症反应,在代谢相关疾病的炎症调节中发挥着关键作用。巨噬细胞极化所涉及的复杂通路网络与传统中药的多通路、多靶点治疗模式十分吻合。中药的有效成分和配方可以通过调节巨噬细胞极化来干预 DKD。通过调节巨噬细胞极化缓解肾脏炎症、修复肾脏组织、促进肾功能恢复的研究并不少见。因此,本研究在现有证据的基础上,综述中医药针对M1/M2巨噬细胞极化平衡改善DKD的作用,旨在探讨巨噬细胞极化在调控DKD中的潜力,以期为中医药临床诊治DKD及其生物学机制的探索提供证据支持。
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来源期刊
Zhongguo Zhongyao Zazhi
Zhongguo Zhongyao Zazhi Pharmacology, Toxicology and Pharmaceutics-Pharmacology, Toxicology and Pharmaceutics (all)
CiteScore
1.50
自引率
0.00%
发文量
581
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