足细胞自噬在糖尿病肾病中的发病机制及药物治疗的研究进展  

Research Progress on Pathogenesis and Drug Treatment of Podocyte Autophagy in Diabetic Nephropathy

作　　者：周杨洋(综述)[1] 尹能品(审校) ZHOU Yangyang;YIN Nengpin(The Affiliated Dazu's Hospital of Chongging Medical Universiny,Chongqing 402360,China)

机构地区：[1]重庆医科大学附属大足医院肾内科,重庆402360

出　　处：《微循环学杂志》2025年第1期83-88,96,共7页Chinese Journal of Microcirculation

基　　金：重庆市大足区科技发展项目(DZKJ2023JSYJ-KWXM1031)。

摘　　要：糖尿病肾病(DN)是糖尿病常见且严重的微血管并发症。足细胞自噬在DN发病机制中起关键作用。足细胞损伤是DN产生蛋白尿的关键,而自噬在维持足细胞稳态中起重要作用。自噬存在于足细胞分化及损伤修复过程,主要以巨自噬为主,受多种蛋白激酶复合体和自噬相关蛋白调控。在DN中,高血糖致营养感知通路异常,抑制肾脏自噬,损伤足细胞,p62积聚又加重自噬抑制,形成恶性循环。mTOR、AMPK、Sirt1、JAK/STAT等信号通路与足细胞自噬密切相关。目前,针对足细胞自噬的药物治疗研究取得一定进展,如雷帕霉素、达格列净等可通过调节这些信号通路影响足细胞自噬,改善足细胞功能,延缓DN进展。本文旨在系统阐述足细胞自噬在DN发病机制中的作用,并总结相关药物治疗进展,为DN的防治提供新思路。Diabetic nephropathy(DN)represents a common and severe microvascular complication associated with diabetes.Podocyte autophagy plays a crucial role in the pathogenesis of DN.Podocyte injury is the key factor for the emergence of proteinuria in DN,and autophagy plays a significant role in maintaining the homeostasis of podocytes.Autophagy exists during the process of podocyte differentiation and injury repair,mainly in the form of macroautophagy,and is regulated by multiple protein kinase complexes and autophagy-related proteins.In DN,hyperglycemia induces abnormalities in nutrient sensing pathways,inhibits renal autophagy,and damages podocytes.The accumulation of p62 further exacerbates the inhibition of autophagy,forming a vicious cycle.Signal pathways such as mTOR,AMPK,Sirt1,JAK/STAT,etc.,are closely related to podocyte autophagy.Currently,certain advancements have been made in the research on drug therapy targeting podocyte autophagy.Various drugs such as rapamycin and dapagliflozin can influence podocyte autophagy by regulating these signal pathways,and can improve podocyte function and retard the progression of DN by regulating autophagic flux.This article aims to systematically expound on the role of podocyte autophagy in the pathogenesis of DN and summarize the progress of related drug treatments,providing novel ideas for the prevention and treatment of DN.

关 键 词：糖尿病肾病 足细胞 自噬 治疗 

分 类 号：R587.2[医药卫生—内分泌]