Intervention of Traditional Chinese Medicine in Diabetic Nephropathy by Regulating Nrf2 Signaling Pathway： A Review
10.13422/j.cnki.syfjx.20250538
- VernacularTitle:中药调控Nrf2信号通路干预糖尿病肾病研究进展
- Author:
Qinyuan ZHANG
1
;
Yanxu CHEN
1
;
Dakai QIN
1
;
Jin PENG
1
;
Zhisheng JIN
1
Author Information
1. Gansu University of Chinese Medicine，Lanzhou 730000，China
- Publication Type:Journal Article
- Keywords:
traditional Chinese medicine;
diabetic nephropathy;
nuclear factor E2-related factor 2 （Nrf2） signaling pathway;
mechanism;
research progress
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2025;31(18):277-285
- CountryChina
- Language:Chinese
-
Abstract:
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 domain-associated 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.
