糖基化终产物在糖尿病肾病中的作用概述  

Overview of the Role of Advanced Glycation End Products in Diabetic Kidney Disease

作　　者：陆依萍 马迪 段凤梅 段秋言 陈龙满 王霞 LU Yiping;MA Di;DUAN Fengmei;DUAN Qiuyan;CHEN Longman;WANG Xia(Yunnan University of Chinese Medicine,Kunming,Yunnan,China,650500;The First Affiliated Hospital of Yunnan University of Chinese Medicine,Kunming,Yunnan,China,650021)

机构地区：[1]云南中医药大学,云南昆明650500 [2]云南中医药大学第一附属医院,云南昆明650021

出　　处：《河南中医》2025年第5期778-787,共10页Henan Traditional Chinese Medicine

基　　金：云南省高层次中医药学科带头人培养项目(第二批)[云财社(2024)103号];北京医学奖励基金会课题项目(YXJL-2024-1324-0384)。

摘　　要：糖尿病肾病是糖尿病患者常见的微血管并发症,糖基化终产物(advanced glycation end products,AGEs)在其发病机制中扮演着重要角色。AGEs通过多种途径导致肾脏损伤,包括直接损伤、与RAGE受体结合、促进炎症反应和氧化应激、促进纤维化和足细胞损伤等,有可能成为糖尿病肾病的早期诊断标志物。现有研究表明,针对AGEs的治疗策略主要包括抑制AGEs的形成和拮抗AGEs受体,包括氨基胍、植物成分、ACE抑制剂、sRAGE、抗RAGE抗体等。此外,抗氧化剂、改善饮食结构和生活方式等干预策略也有助于减轻AGEs的负面影响。目前,作用于AGEs的药物在动物实验中均取得较好效果,但在临床试验中的结果却不如人意,今后,需更深入研究AGEs的相关机制以加速临床药物的研制。其次,中医辨证分型尚缺乏统一标准,治疗方法个体差异性较大,需从中医理法方药理论体系着手,建立一套公认的辨证分型方案,加强对个体差异、疗效标准的研究及规范。再者,单纯依赖药物治疗可能无法全面解决AGEs相关疾病的复杂性,通过配合生活方式的干预将能更有效应对AGEs相关的疾病。未来的研究应聚焦于AGEs的临床应用及其作为潜在治疗靶点的可行性,制定更为精准的治疗方案。Diabetic kidney disease(DKD)is a common microvascular complication in diabetic patients,and advanced glycation end products(AGEs)play a critical role in its pathogenesis.AGEs induce renal injury through multiple pathways,including direct damage,binding to the RAGE receptor,promoting inflammatory responses and oxidative stress,and accelerating fibrosis and podocyte injury.AGEs detection holds promise as an early diagnostic biomarker for DKD.Current therapeutic strategies targeting AGEs primarily focus on inhibiting their formation and antagonizing AGEs receptors,including agents such as aminoguanidine,plant-derived compounds,ACE inhibitors,soluble RAGE(sRAGE),and anti-RAGE antibodies,etc.Additionally,interventions such as antioxidants,dietary modifications,and lifestyle adjustments may help mitigate the adverse effects of AGEs.Although drugs targeting AGEs have shown promising results in animal experiments,their efficacy in clinical trials remains unsatisfactory.Therefore,further research into the mechanisms of AGEs is needed to accelerate the development of clinical therapies.Moreover,TCM lacks a standardized syndrome differentiation classification system,and treatment approaches vary significantly among individuals.It is essential to establish a universally recognized TCM diagnostic framework based on its theoretical system of principles,methods,formulas,and herbs,while strengthening research on individualized differences and standardized efficacy criteria.Furthermore,relying solely on pharmacological interventions may not fully address the complexity of AGEs-related diseases;integrating lifestyle interventions could enhance therapeutic outcomes.Future research should focus on the clinical application of AGEs and their feasibility as potential therapeutic targets to develop more precise treatment strategies.

关 键 词：糖基化终产物 糖尿病肾病 肾脏损伤 炎症反应 氧化应激 

分 类 号：R259.872[医药卫生—中西医结合]