Diabetic nephropathy is a leading cause of end stage renal disease and its occurance is increasing worldwide. The most effective treatment strategy for the condition is intensive treatment to strictly control glycemia and blood pressure using renin-angiotensin system inhibitors. However, a fraction of patients still go on to reach end stage renal disease even under such intensive care. New therapeutic targets for diabetic nephropathy are, therefore, urgently needed. Autophagy is a major catabolic pathway by which mammalian cells degrade macromolecules and organelles to maintain intracellular homeostasis. The accumulation of damaged proteins and organelles is associated with the pathogenesis of diabetic nephropathy. Autophagy in the kidney is activated under some stress conditions, such as oxidative stress and hypoxia in proximal tubular cells, and occurs even under normal conditions in podocytes. These and other accumulating findings have led to a hypothesis that autophagy is involved in the pathogenesis of diabetic nephropathy. Here, we review recent findings underpinning this hypothesis and discuss the advantages of targeting autophagy for the treatment of diabetic nephropathy.
AMP-Activated Protein Kinases ; Anoxia ; Autophagy* ; Blood Pressure ; Caloric Restriction ; Diabetic Nephropathies* ; Homeostasis ; Humans ; Critical Care ; Kidney ; Kidney Failure, Chronic ; Organelles ; Oxidative Stress ; Podocytes ; Renin-Angiotensin System

Single-tooth sandals under new development have special material and shape characteristics. Exercises with single-tooth sandals can increase pressing stimulus on the soles of the feet, thereby suppressing a decline in medial longitudinal arch and elevating sole surface temperature. This study thus aimed to examine the effects of exercise with single-tooth sandals on medial longitudinal arch and sole surface temperature. Sixteen young adults (23 ± 5 years) participated in 20 min of stepping exercise on the spot. They randomly put on a regular normal sandal (N conditions) or a single-tooth sandal (Z conditions) on each left and right side. Before and after exercise, medial longitudinal arch and sole surface temperature were assessed by digital caliper and straightedge and thermography, respectively. No significant differences in baseline parameters were observed between N and Z conditions. After exercise, arch height and arch height ratio significantly reduced in N conditions, but not in Z conditions. Central sole surface temperature in Z conditions also increased significantly, and the changes in surface temperature were significantly higher in Z conditions than in N conditions. Therefore, these findings suggest that exercise with single-tooth sandals has a positive effect on a suppressing decline in medial longitudinal arch and an elevation in sole surface temperature.