文献类型：期刊文献

中文题名：足细胞损伤信号通路在激素抵抗型肾病综合征中的作用及中药干预研究进展

英文题名：Role of podocyte injury signaling pathway in steroid-resistant nephrotic syndrome and research progress in traditional Chinese medicine intervention

作者：于文霞[1];闫文[1];戴恩来[1];田文选[1];党文静[1]

第一作者：于文霞

机构：[1]甘肃中医药大学,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2023

卷号：48

期号：12

起止页码：3246

中文期刊名：中国中药杂志

外文期刊名：China Journal of Chinese Materia Medica

收录：CSTPCD;;Scopus;北大核心:【北大核心2020】；CSCD:【CSCD2023_2024】；PubMed;

基金：国家自然科学基金项目(82160852)。

语种：中文

中文关键词：中药;足细胞损伤;信号通路;激素抵抗型肾病综合征

外文关键词：traditional Chinese medicine(TCM);podocyte injury;signaling pathway;steroid-resistant nephrotic syndrome

摘要：激素抵抗型肾病综合征(steroid-resistant nephrotic sydrome, SRNS)作为导致终末期肾病主要的疾病之一,临床上将产生感染等严重的并发症。当该疾病未得到有效的控制时,将进一步导致肾功能的恶性发展并造成严重的社会和经济负担。既往的研究表明,SRNS的形成多与机体内足细胞损伤即肾小球脏层上皮细胞的损伤有关。磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)信号通路、核转录因子-κB(NF-κB)信号通路、雷帕霉素哺乳靶蛋白(mTOR)/腺苷酸活化蛋白激酶(AMPK)、转化生长因子(TGF)-β1/Smads等信号通路作为与足细胞损伤相关的经典信号通路,通过调控信号通路的表达干预足细胞的损伤,进而改善足细胞足突与肾小球基底膜之间的黏附受损及促进足细胞功能的发挥,达到缓解SRNS临床症状的目的。查阅文献发现,中药在干预足细胞损伤方面具有独特的优势及重要的作用。中药干预足细胞损伤,一方面通过中药具有的多靶点多通路的作用,能够多向调节及干预足细胞损伤,缓解SRNS的临床症状及干预SRNS的进展,体现中药的独特优势;另外一方面,中药通过对以上信号通路的调节,直接或间接抑制足细胞的损伤,不仅可以促进激素及免疫抑制剂的效果及缩短治疗的病程,而且可以减少多种激素及免疫抑制剂引起的毒副反应并发挥中药本身具有的副作用小、价廉等的优势。该文通过中药干预足细胞损伤相关信号通路治疗SRNS的研究现状进行总结,为中药在治疗SRNS的深入研究提供参考依据,也为中药运用于临床,缩短SRNS的治疗病程及延缓向终末期肾病进展提供了理论依据及治疗新方向。
As one of the main diseases leading to end-stage renal disease,steroid-resistant nephrotic syndrome(SRNS)can cause serious complications such as infection.Without effective control,this disease can further lead to the malignant development of the renal function,bringing serious social and economic burdens.As previously reported,the formation of SRNS is mostly related to the podocyte injury in the body,i.e.,the injury of glomerular visceral epithelial cells.Phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)signaling pathway,nuclear transcription factor-kB(NF-kB)signaling pathway,mammalian target of rapamycin(mTOR)/adenosine monophosphate(AMP)-activated protein kinase(AMPK),transforming growth factor(TGF)-β1/Smads,and other signaling pathways are classical signaling pathways related to podocyte injury.By regulating the expression of signaling pathways,podocyte injury can be intervened to improve the adhesion between podocyte foot processes and glomerular basement membrane and promote the function of podocytes,thereby alleviating the clinical symptoms of SRNS.Through the literature review,traditional Chinese medicine(TCM)has unique advantages and an important role in intervening in po locyte injury.In the intervention in podocyte injury,TCM,by virtue of multi-target and muli-pathway role,can regulate and intervene in podocyte injury in many ways,alleviate the clinical symptoms of SRNS,and interfere with the progress of SRNS,reflecting the unique advantages of TCM.On the other hand,TCM can directly or indirectly inhibit podocyte injury by regulating the above signaling pathways,which can not only promote the effect of hormones and immunosuppressants and shorten the course of treatment,but also reduce the toxic and side effects caused by various hormones and immunosuppressants to exert the advantages of small side effects and low price of TCM.This article reviewed TCM in the treatment of SRNS by interfering with podocyte injury-related signaling pathways and is expected to provide a reference for the in-depth study of TCM in the treatment of SRNS,as well as a theoretical basis and a new direction for the clinical application of TCM to shorten the course of treatment of SRNS and delay the progression to end-stage renal disease.