Mechanism underlying treatment of diabetic kidney disease using Traditional Chinese Medicine based on theory of Yin and Yang balance

IF 2 4区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Journal of Traditional Chinese Medicine Pub Date : 2018-10-01 DOI:10.1016/S0254-6272(18)30921-X
Piao Yuanlin , Yin Dehai
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引用次数: 9

Abstract

The pathogenic mechanism of diabetic kidney disease (DKD) is complex. The development of DKD cannot be fully explained by a single mechanism. Traditional Chinese Medicine (TCM) has been applied extensively for the treatment of DKD in China. However, studying the mechanism of DKD using theories and methods that are appropriate for TCM characteristics and searching for theoretical bases for TCM clinical application are topics that still need to be explored and researched. Activation of the transforming growth factor (TGF)-β1/Smad and PI3K/Akt/mTOR signaling pathways functions as a self-protection mechanism against renal microinflammation in DKD. However, the persistent abnormal overactivation of reactions causes secondary cell dysfunction, cell apoptosis, increased extracellular matrix (ECM) secretion, and eventually renal fibrosis. During this process, the dysregulation of self-balance among a variety of signaling pathways and the loss of self-feedback regulatory mechanisms downstream of these signaling pathways are critical causes of the occurrence and development of DKD. TCM may both inhibit the expression or activation of “hyperactive” signaling pathways (NFB, Smad3, and PI3K/Akt/mTOR) and increase the expression or activation of “deficient” signaling pathways (Smad7 and PTEN) to restore balance to cells with an abnormal pathophysiological status and achieve the goal of DKD treatment.

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基于阴阳平衡理论的中医治疗糖尿病肾病的机制
糖尿病肾病(DKD)的发病机制复杂。DKD的发展不能完全用单一的机制来解释。中医药在中国广泛应用于DKD的治疗。然而,运用适合中医特点的理论和方法研究DKD的作用机制,为中医临床应用寻找理论依据,仍是有待探索和研究的课题。激活转化生长因子(TGF)-β1/Smad和PI3K/Akt/mTOR信号通路可作为DKD患者肾脏微炎症的自我保护机制。然而,持续的异常过度激活反应会导致继发性细胞功能障碍、细胞凋亡、细胞外基质(ECM)分泌增加,最终导致肾纤维化。在这一过程中,多种信号通路之间的自我平衡失调以及这些信号通路下游自反馈调节机制的缺失是DKD发生发展的关键原因。中药既可以抑制“过活跃”信号通路(NFB、Smad3、PI3K/Akt/mTOR)的表达或激活,又可以增加“缺失”信号通路(Smad7、PTEN)的表达或激活,使病理生理异常的细胞恢复平衡,达到治疗DKD的目的。
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来源期刊
Journal of Traditional Chinese Medicine
Journal of Traditional Chinese Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
2.40
自引率
3.80%
发文量
32269
审稿时长
2 months
期刊介绍: Journal of Traditional Chinese Medicine(JTCM) is devoted to clinical and theortical research on the use of acupuncture and Oriental medicine. The main columns include Clinical Observations, Basic Investigations, Reviews, Questions and Answers, an Expert''s Forum, and Discussions of Clinical Cases. Its key topics include acupuncture and electro-acupuncture, herbal medicine, homeopathy, masseotherapy, mind-body therapies, palliative care, and other CAM therapies.
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