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Mechanisms of Herbal Nephroprotection in diabetes mellitus

Diabetic nephropathy (DN) is a leading cause of kidney morbidity. Despite the multilayered complexity of the mechanisms involved in the pathogenesis of DN, the conventional treatment is limited to just a few drug classes fraught with the risk of adverse events, including the progression of renal dys...

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Autores principales: Dragoș, Dorin, Manea, Maria Mirabela, Timofte, Delia, Ionescu, Dorin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362309/
https://www.ncbi.nlm.nih.gov/pubmed/32695828
http://dx.doi.org/10.1155/2020/5710513
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author Dragoș, Dorin
Manea, Maria Mirabela
Timofte, Delia
Ionescu, Dorin
author_facet Dragoș, Dorin
Manea, Maria Mirabela
Timofte, Delia
Ionescu, Dorin
author_sort Dragoș, Dorin
collection PubMed
description Diabetic nephropathy (DN) is a leading cause of kidney morbidity. Despite the multilayered complexity of the mechanisms involved in the pathogenesis of DN, the conventional treatment is limited to just a few drug classes fraught with the risk of adverse events, including the progression of renal dysfunction. Phytoceuticals offer a promising alternative as they act on the many-sidedness of DN pathophysiology, multitargeting its intricacies. This paper offers a review of the mechanisms underlying the protective action of these phytoagents, including boosting the antioxidant capabilities, suppression of inflammation, averting the proliferative and sclerosing/fibrosing events. The pathogenesis of DN is viewed as a continuum going from the original offense, high glucose, through the noxious products it generates (advanced glycation end-products, products of oxidative and nitrosative stress) and the signaling chains consequently brought into action, to the harmful mediators of inflammation, sclerosis, and proliferation that eventually lead to DN, despite the countervailing attempts of the protective mechanisms. Special attention was given to the various pathways involved, pointing out the ability of the phytoagents to hinder the deleterious ones (especially those leading to, driven by, or associated with TGF-β activation, SREBP, Smad, MAPK, PKC, NF-κB, NLRP3 inflammasome, and caspase), to promote the protective ones (PPAR-α, PPAR-γ, EP4/Gs/AC/cAMP, Nrf2, AMPK, and SIRT1), and to favorably modulate those with potentially dual effect (PI3K/Akt). Many phytomedicines have emerged as potentially useful out of in vitro and in vivo studies, but the scarcity of human trials seriously undermines their usage in the current clinical practice—an issue that stringently needs to be addressed.
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spelling pubmed-73623092020-07-20 Mechanisms of Herbal Nephroprotection in diabetes mellitus Dragoș, Dorin Manea, Maria Mirabela Timofte, Delia Ionescu, Dorin J Diabetes Res Review Article Diabetic nephropathy (DN) is a leading cause of kidney morbidity. Despite the multilayered complexity of the mechanisms involved in the pathogenesis of DN, the conventional treatment is limited to just a few drug classes fraught with the risk of adverse events, including the progression of renal dysfunction. Phytoceuticals offer a promising alternative as they act on the many-sidedness of DN pathophysiology, multitargeting its intricacies. This paper offers a review of the mechanisms underlying the protective action of these phytoagents, including boosting the antioxidant capabilities, suppression of inflammation, averting the proliferative and sclerosing/fibrosing events. The pathogenesis of DN is viewed as a continuum going from the original offense, high glucose, through the noxious products it generates (advanced glycation end-products, products of oxidative and nitrosative stress) and the signaling chains consequently brought into action, to the harmful mediators of inflammation, sclerosis, and proliferation that eventually lead to DN, despite the countervailing attempts of the protective mechanisms. Special attention was given to the various pathways involved, pointing out the ability of the phytoagents to hinder the deleterious ones (especially those leading to, driven by, or associated with TGF-β activation, SREBP, Smad, MAPK, PKC, NF-κB, NLRP3 inflammasome, and caspase), to promote the protective ones (PPAR-α, PPAR-γ, EP4/Gs/AC/cAMP, Nrf2, AMPK, and SIRT1), and to favorably modulate those with potentially dual effect (PI3K/Akt). Many phytomedicines have emerged as potentially useful out of in vitro and in vivo studies, but the scarcity of human trials seriously undermines their usage in the current clinical practice—an issue that stringently needs to be addressed. Hindawi 2020-06-30 /pmc/articles/PMC7362309/ /pubmed/32695828 http://dx.doi.org/10.1155/2020/5710513 Text en Copyright © 2020 Dorin Dragoș et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Dragoș, Dorin
Manea, Maria Mirabela
Timofte, Delia
Ionescu, Dorin
Mechanisms of Herbal Nephroprotection in diabetes mellitus
title Mechanisms of Herbal Nephroprotection in diabetes mellitus
title_full Mechanisms of Herbal Nephroprotection in diabetes mellitus
title_fullStr Mechanisms of Herbal Nephroprotection in diabetes mellitus
title_full_unstemmed Mechanisms of Herbal Nephroprotection in diabetes mellitus
title_short Mechanisms of Herbal Nephroprotection in diabetes mellitus
title_sort mechanisms of herbal nephroprotection in diabetes mellitus
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362309/
https://www.ncbi.nlm.nih.gov/pubmed/32695828
http://dx.doi.org/10.1155/2020/5710513
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