Regulation of Mitochondrial Quality Control in Treatment of Diabetic Kidney Disease by Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

ABSTRACT

Diabetic kidney disease （DKD） is characterized by the hyperfiltration and albuminuria in the early phase which are followed by progressive renal function decline， renal tubular epithelial cell hypertrophy， and tubulointerstitial fibrosis. Thus， it is one of the leading causes of chronic kidney diseases. The currently available therapies mainly aim to control the primary diseases and reduce the risk of kidney injury. Based on syndrome differentiation， traditional Chinese medicine （TCM） relieves the symptoms by excreting water and alleviating edema and eliminates the root cause by tonifying deficiency and supplementing the original Qi， thereby showing therapeutic effect and delaying the progression of DKD. It excels in comprehensively regulating the constitution of patients with little side effects. Among the Zang-fu organs， kidney takes the second place in the content of mitochondria which participate in the metabolism of water and fluid and are the foundation of kidney Yin and kidney Yang. Mitochondria are energy producers within a cell， which carry out cellular respiration， produce reactive oxygen species， and generate adenosine triphosphate by oxidative phosphorylation. Mitochondrial quality control （MQC） is an effective way to maintain mitochondrial dynamic balance， whose imbalances， such as mitochondrial oxidative stress， mitophagy， mitochondrial dynamic changes， and abnormal calcium regulation， are related to the occurrence and development of DKD. It is generally believed that the destruction of mitochondrial structure in the case of metabolic disorder is the main cause of the disease. In recent years， TCM has attracted the attention of both Chinese and foreign researchers for the unique advantages of treating both symptoms and root cause at the same time and multi-target synergy in the treatment of DKD. However， the specific mechanism is still unclear. It has been frequently verified that mitochondria may be one of the targets of TCM in the treatment of DKD. At the moment， no review on the treatment of DKD by TCM through the intervention of MQC is available. Therefore， this paper aims to summarize the research on TCM treatment of DKD by regulating MQC in the past 10 years， which is expected to provide a new direction for the treatment of DKD by TCM.