Research Progress in the Prevention and Treatment of Diabetes Nephropathy by TGF-β1/Smad Signaling Pathway Regulated by Chinese Medicinal Monomers
Transforming growth factor(TGF)-β1/Smad signaling pathway is one of the key signaling pathways of renal fibrosis in dia-betes nephropathy.TGF-β1/Smad signal pathway can regulate the process of renal fibrosis by promoting the accumulation of extracellu-lar matrix(ECM),inhibiting the degradation of ECM,increasing the expression of fibronectin and collagen IV,promoting the release of inflammatory factors,inducing podocyte apoptosis and other aspects.Some Chinese medicinal monomers can regulate TGF-β1/Smad sig-nal pathway,significantly interfere with the occurrence and development of diabetes nephropathy,and achieve good clinical effects.At present,the mechanism of TGF-β1/Smad in the occurrence and development of diabetes nephropathy has been preliminarily clarified,but there are still many problems as follows:(1)The participation and difference of TGF-β1/Smad signal pathway in dry diabetes ne-phropathy and wet diabetes nephropathy are not clear;(2)The direction of the positive and negative regulatory effects of Chinese me-dicinals with different efficacy on the protective pathway of fibrosis is not yet clear;(3)The TGF-β1/Smad signaling pathway can form signal crosstalk with other pathways,and it is necessary to explore the mutual influence mechanisms between each pathway and observe the regulatory mechanisms of each signaling pathway on cells in a microscopic manner;(4)Many Chinese medicinals can not only in-terfere with TGF-β1/Smad signal pathway,but also interfere with other pathways such as autophagy and apoptosis.In the clinical treat-ment of diabetes nephropathy,the core mechanism of its efficacy is to find out certain pathway,and it may need to accurately use target drugs to block and promote the signal pathway,and then observe the changes in efficacy to determine it;(5)The existing clinical stud-ies on the treatment of diabetes nephropathy by regulating TGF-β1/Smad are few,mainly focusing on animal experiments and basic ex-periments,and lack of large sample,multi-center,prospective,long-term high-quality clinical trials;(6)At present,there is a lot of re-search on the effective ingredients of Chinese medicinals,but there are obvious shortcomings in the monomer and monomer combination of Chinese medicinals.In the future,it is necessary to further clarify the participation and difference of TGF-β1/Smad signal pathway in dry diabetes nephropathy and wet diabetes nephropathy,clarify the regulatory effect of different efficacy of Chinese medicinals on the protective pathway of fibrosis,and explore the effective components of Chinese medicinals by molecular docking and other technologies,especially for the monomer and monomer combination of Chinese medicinals.At the same time,attention has been paid to the safety of Chinese medicinals,and in the future,it is also necessary to pay attention to innovating and optimizing the formula structure while ensu-ring the safety of Chinese medicinals,combining with traditional syndrome differentiation theory to improve clinical efficacy.
国家科技期刊平台
NSTL
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