Mineralocorticoid receptor antagonist finerenone in DKD: From molecular structure to the cardio-renal protective mechanism
10.3760/cma.j.cn311282-20240326-00119
- VernacularTitle:盐皮质激素受体拮抗剂非奈利酮在2型糖尿病肾病中的作用：从分子结构到心肾保护作用机制
- Author:
Ruolin LYU
1
;
Lili XU
;
Yunyang WANG
;
Song LIU
;
Zhongchao WANG
;
Wenshan LYU
;
Yangang WANG
;
Bingzi DONG
Author Information
1. 华中科技大学同济医学院附属同济医院心血管内科，武汉 430030
- Keywords:
Mineralocorticoid receptor overactivation;
Finerenone;
Mineralocorticoid receptor antagonist;
Diabetic kidney disease;
Molecular mechanism
- From:
Chinese Journal of Endocrinology and Metabolism
2024;40(7):608-613
- CountryChina
- Language:Chinese
-
Abstract:
Mineralocorticoid receptor(MR) overactivation plays an important role in the development and progression of diabetic kidney disease(DKD) by mediating pro-inflammatory and pro-fibrotic processes, making it a key therapeutic target for DKD. Finerenone, a third-generation, highly selective, novel nonsteroidal mineralocorticoid receptor antagonist(MRA), mitigates MR overactivation through anti-inflammatory and anti-fibrotic effects and by improving the immune-inflammatory environment. This significantly reduces cardiovascular and renal composite endpoints in patients with type 2 diabetes mellitus(T2DM) and chronic kidney disease(CKD), and improve cardiorenal outcomes. Based on its novel molecular structure, Finerenone exhibits a lower incidence of adverse effects compared to the previous MRAs. This article elucidates the molecular structure and pathophysiological role of MR, and explores the molecular mechanisms through which finerenone provides cardiorenal benefits. It also discusses the advantages and safety of finerenone compared to first- and second-generation MRAs from a molecular structure perspective, providing evidence for its clinical application.
