Background: Owing to the multiple causative factors, the current advances in medication for diabetic nephropathy (DN) do not appear to have improved therapies for patients. Furthermore, use of multiple synthetic medications has shown various adverse effects and ultimately leads to deterioration of the condition. Medicinal plants and their bioactive constituents are considered to be safer and more effective than synthetic medicines against various chronic diseases. Therefore, the use of natural products in the management of DN has been suggested. In this article, we review medicinal plants and their specific bioactive phytochemicals that regulate the various cellular processes involved in the initiation of DN. A wide range of literature on phytochemicals and medicinal plants that may ameliorate DN was explored from the online available English works in various electronic databases, including Embase, Google Scholar, PubMed, Scopus, and Science Direct.
Results: Medicinal plants possess various bioactive constituents, which may slow or ameliorate the progression of DN and improve renal function through the targeting of multiple pathological causes via different pathways, including p38MAPK, JNK, ERK, TGF-β, RhoA, NF-κB, Wnt, JAK-STAT, AMPK, mTOR, Akt, and TXNIP. Depletion or inhibition of these accelerating factors may provide a significant treatment for DN.
Conclusion: Based on various experimental studies, traditional herbs and their bioactive constituents regulate the cellular processes involved in the initiation of DN owing to their significant pharmacological activities; however, the efficacy in animal models and humans has not yet been explored. Therefore, studies should be performed to evaluate the nephroprotective effects of medicinal plants in preclinical animal models and in humans.
Keywords: Advanced glycation end products; Diabetic nephropathy; End-stage renal disease; Glomerular filtration rate; Medicinal plants; Mitogen-activated protein kinases.
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