RESUMO
Diabetic kidney disease is an important microvascular complication of diabetes and the leading cause of end-stage renal disease. Its pathological characteristics mainly include epithelial mesenchymal transition(EMT) in glomerulus, podocyte apoptosis and autophagy, and damage of glomerular filtration barrier. Transforming growth factor-ß(TGF-ß)/Smad signaling pathway is specifically regulated by a variety of mechanisms, and is a classic pathway involved in physiological activities such as apoptosis, proliferation and differentiation. At present, many studies have found that TGF-ß/Smad signaling pathway plays a key role in the pathogenesis of diabetic kidney disease. Traditional Chinese medicine has significant advantages in the treatment of diabetic kidney disease for its multi-component, multi-target and multi-pathway characteristics, and some traditional Chinese medicine extracts, traditional Chinese medicines and traditional Chinese medicine compound prescription improve the renal injury of diabetic kidney disease by regulating TGF-ß/Smad signaling pathway. This study clarified the mechanism of TGF-ß/Smad signaling pathway in diabetic kidney disease by expounding the relationship between the key targets of the pathway and diabetic kidney disease, and summarized the research progress of traditional Chinese medicine in the treatment of diabetic kidney disease by interfering with TGF-ß/Smad signaling pathway in recent years, to provide reference for drug research and clinical treatment of diabetic kidney disease in the future.
Assuntos
Diabetes Mellitus , Nefropatias Diabéticas , Humanos , Nefropatias Diabéticas/tratamento farmacológico , Nefropatias Diabéticas/genética , Medicina Tradicional Chinesa , Rim/patologia , Fator de Crescimento Transformador beta/genética , Fator de Crescimento Transformador beta/metabolismo , Transdução de Sinais , Transição Epitelial-Mesenquimal , Proteínas Smad/genética , Proteínas Smad/metabolismo , Fator de Crescimento Transformador beta1/metabolismo , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/genéticaRESUMO
OBJECTIVE: To investigate the effects of Tangzhiping Granule (TZPG) on blood lipids and free fatty acids (FFA) in rats with insulin resistant diabetes (IRD). METHODS: A blank control group consisted of randomly selected normal rats was set up. The remaining rats were established to IRD model by high-fat high-sugar diet feeding and streptozotocin injection. Then the 32 successfully modeled rats were randomized into the model group (treated by saline), the Tangmaikang group (treated with Tangmaikang Granule 1.35 g/kg), and the two TZPG groups treated with high dose (2.70 g/kg) and low dose TZPG (1.35 g/kg) respectively through intragastric infusion for 4 weeks. The body weight (BW), fasting blood glucose (FBG), insulin (INS), blood lipids including triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and FFA were detected, and the insulin sensitivity index (ISI) calculated. RESULTS: Compared with the blank control group, BW, FBG and INS increased while ISI decreased in the model group (P < 0.05 or P < 0.01). All the above-mentioned abnormal indices were improved in the three treated groups (Tangmaikang, high and low dose TZPG group), but the improvements in the high dose TZPG group were more significant than those in the other two groups (P < 0.05 or P < 0.01). Similar outcomes were also seen in blood lipids detection, in which TG, TC, LDL-C and FFA were higher and HDL-C were lower in model rats than those in blank controls, they were improved in the three treated groups (P < 0.05), and the best improvements were seen in the high dose TZPG group (P < 0.05). CONCLUSION: TZPG could reduce levels of BW, FBG, INS, TC, TG, LDL-C and FFA, and increase levels of ISI and HDL-C in rat model of insulin resistant type 2 diabetes, so as to improve the insulin resistance in them.