文献类型：期刊文献

中文题名：中药调控Nrf2信号通路干预糖尿病肾病研究进展

英文题名：Intervention of Traditional Chinese Medicine in Diabetic Nephropathy by Regulating Nrf2 Signaling Pathway:A Review

作者：张钦媛[1];陈彦旭[1];秦大凯[1];彭金[1];金智生[1]

第一作者：张钦媛

机构：[1]甘肃中医药大学,兰州730000

第一机构：甘肃中医药大学

年份：2025

卷号：31

期号：18

起止页码：277

中文期刊名：中国实验方剂学杂志

外文期刊名：Chinese Journal of Experimental Traditional Medical Formulae

收录：;北大核心:【北大核心2023】；

基金：国家自然科学基金项目(82060854)。

语种：中文

中文关键词：中药;糖尿病肾病;核转录因子E_(2)相关因子2(Nrf2)信号通路;作用机制;研究进展

外文关键词：traditional Chinese medicine;diabetic nephropathy;nuclear factor E2-related factor 2(Nrf2)signaling pathway;mechanism;research progress

摘要：糖尿病肾病(DN)是糖尿病(DM)的严重慢性微血管并发症,也是导致终末期肾病(ESRD)的主要诱因,其特征是肾功能的逐渐和进行性下降,最终导致肾小球硬化、间质纤维化等严重病变。现代医学治疗手段虽能部分缓解症状,但存在治疗效果单一、远期疗效一般及不良反应较多的局限性。中药具有效应范围广、药效持久及安全性高等优势,常在DN临床治疗中获得独特疗效。核因子E2相关因子2(Nrf2)不仅是当下备受关注的抗氧化应激转录因子,还能调控血红素氧合酶-1(HO-1)、NAD(P)H:醌氧化还原酶1(NQO1)、核转录因子-κB(NF-κB)、NOD样受体蛋白3(NLRP3)炎性小体、谷胱甘肽过氧化物酶4(GPX4)、p62等多个上、下游因子,通过干预不同机制发挥细胞保护作用。已有大量研究发现,诸多中药有效成分和复方可通过调节由Nrf2与前述相关因子组成的信号通路,发挥抑制氧化应激、炎症反应、细胞焦亡、凋亡、铁死亡或促进自噬的作用,保护肾脏功能,减少蛋白尿,减轻肾脏纤维化,显著改善DN损伤。该综述简要概述了Nrf2的结构与功能,阐明了Nrf2调控DN的作用机制,并重点归纳总结了近5年来中药有效成分、复方通过靶向激活Nrf2信号通路干预DN的主要相关研究,探讨了Nrf2信号通路作为治疗DN靶点的巨大潜力,旨在为未来开发推广新的临床用药提供参考依据,推动DN治疗方法的创新与发展。
Diabetic nephropathy(DN)is a serious chronic microvascular complication of diabetes mellitus(DM)and a major cause of end-stage renal disease(ESRD).It is characterized by gradual and progressive decline of renal function,which eventually leads to glomerular sclerosis,interstitial fibrosis and other serious lesions.Although modern medical treatment can partially relieve the symptoms,there are limitations such as single therapeutic effect,low long-term therapeutic effect,and severe side effects.Traditional Chinese medicine(TCM),with a wide effect range,lasting efficacy,and high safety,often exerts unique therapeutic effect in the clinical treatment of DN.Nuclear factor E2-related factor 2(Nrf2),an anti-oxidative stress transcription factor,has received much attention.It can regulate multiple upstream and downstream factors such as heme oxygenase-1(HO-1),NAD(P)H:quinone oxidoreductase 1(NQO1),nuclear factor-κB(NF-κB),NOD-like receptor thermal protein domainassociated protein 3(NLRP3)inflammasome,glutathione peroxidase 4(GPX4),and p62,playing a role in cell protection by intervening in different mechanisms.A large number of studies have found that TCM active ingredients and compound prescriptions can inhibit oxidative stress,inflammation,pyroptosis,apoptosis,and ferroptosis or promote autophagy by regulating the signaling pathway composed of Nrf2 and the above-mentioned related factors,thus protecting the kidney function,reducing proteinuria,alleviating kidney fibrosis,and significantly ameliorating DN.This review briefly summarized the structure and function of Nrf2,clarified the regulation mechanism of Nrf2 in DN,focused on the main studies on the intervention of DN by the effective components and compound formulas of TCM through the targeted activation of the Nrf2 signaling pathway in the past five years,and discussed the huge potential of Nrf2 signaling pathway as a target for the treatment of DN.The aim is to provide reference for the development and promotion of new drugs in clinical practice and promote the innovation and development of the treatment methods for DN in the future.