Promising therapeutic mechanism for Chinese herbal medicine in ameliorating renal fibrosis in diabetic nephropathy

Front Endocrinol (Lausanne). 2023 Jul 14:14:932649. doi: 10.3389/fendo.2023.932649. eCollection 2023.

Abstract

Diabetic nephropathy (DN) is one of the most serious chronic microvascular abnormalities of diabetes mellitus and the major cause of uremia. Accumulating evidence has confirmed that fibrosis is a significant pathological feature that contributes to the development of chronic kidney disease in DN. However, the exact mechanism of renal fibrosis in DN is still unclear, which greatly hinders the treatment of DN. Chinese herbal medicine (CHM) has shown efficacy and safety in ameliorating inflammation and albuminuria in diabetic patients. In this review, we outline the underlying mechanisms of renal fibrosis in DN, including oxidative stress (OS) generation and OS-elicited ASK1-p38/JNK activation. Also, we briefly summarize the current status of CHM treating DN by improving renal fibrosis. The treatment of DN by inhibiting ASK1 activation to alleviate renal fibrosis in DN with CHM will promote the discovery of novel therapeutic targets for DN and provide a beneficial therapeutic method for DN.

Keywords: ASK1; Chinese herbal medicine; diabetic nephropathy; oxidative stress; renal fibrosis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus* / metabolism
  • Diabetic Nephropathies* / drug therapy
  • Diabetic Nephropathies* / etiology
  • Diabetic Nephropathies* / metabolism
  • Drugs, Chinese Herbal* / pharmacology
  • Drugs, Chinese Herbal* / therapeutic use
  • Fibrosis
  • Humans
  • Kidney / metabolism
  • Oxidative Stress

Substances

  • Drugs, Chinese Herbal

Grants and funding

This work was supported by the Medical Service and Guarantee Capacity Improvement Subsidy Funds (Major and Difficult Diseases, grant number CYW2019079, to QC) and the National Natural Science Foundation of China (81460728 to JZ).