| 慢性肾脏病胰岛素抵抗的发病机制、治疗策略及中药的干预作用 |
| |
| 引用本文： | 吴薇,杨晶晶,万毅刚,涂玥,石格,韩文贝,刘不悔,姚建.慢性肾脏病胰岛素抵抗的发病机制、治疗策略及中药的干预作用[J].中国中药杂志,2017,42(1):49-55. |
| |
| 作者姓名： | 吴薇 杨晶晶 万毅刚 涂玥 石格 韩文贝 刘不悔 姚建 |
| |
| 作者单位： | 南京中医药大学 中西医结合鼓楼临床医学院 中医科, 江苏 南京 210008,南京中医药大学 中西医结合鼓楼临床医学院 中医科, 江苏 南京 210008,南京大学 医学院 附属鼓楼医院 中医科, 江苏 南京 210008,南京中医药大学 第二临床医学院 中医养生学教研室, 江苏 南京 210023,南京中医药大学 中西医结合鼓楼临床医学院 中医科, 江苏 南京 210008,南京中医药大学 中西医结合鼓楼临床医学院 中医科, 江苏 南京 210008,南京中医药大学 中西医结合鼓楼临床医学院 中医科, 江苏 南京 210008,Division of Molecular Signaling, Department of Advanced Biomedical Research, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi 409-3898, Japan |
| |
| 基金项目： | 国家自然科学基金项目（81603238，81403053） |
| |
| 摘 要： | 肾脏是胰岛素的靶器官,具备丰富的胰岛素受体,其中,肾脏固有细胞,如肾小球足细胞、内皮细胞、系膜细胞以及肾小管、集合管上皮细胞都是胰岛素高度敏感的效应细胞,其结构和功能的异常与胰岛素及其受体活性密切相关。慢性肾脏病(chronic kidney disease,CKD)患者存在全身或肾组织胰岛素抵抗(insulin resistance,IR)。IR既是CKD致病因素,又是其进展的机制之一。CKD患者IR的致病因素包括全身性因素和存在于肌肉、脂肪细胞的局部因素;其发病机制涉及肾小球、近端肾小管、集合管以及相应的肾脏固有细胞,如足细胞、系膜细胞和肾小管、集合管上皮细胞。IR相关信号调控途径包括胰岛素受体底物(insulin receptor substrate,IRS)/磷脂酰肌醇3激酶(phosphatidylinositol-3-kinase,PI3K)/丝氨酸-苏氨酸激酶(serine-threonine kinase,Akt)通路、单磷酸腺苷活化蛋白激酶(adenosine monophosphate activated protein kinase,AMPK)通路、葡萄糖转运蛋白4(glucose transporter4,GLUT4)通路、核因子(nuclear factor,NF)-κB通路以及丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)通路等,其中,IRS1/PI3K/Akt2通路是肾小球足细胞IR的主要信号调控途径,干预其活性就可以改善足细胞损伤。临床上,一些经典的口服降糖药和利尿剂,如二甲双胍、罗格列酮、格列本脲、噻唑烷二酮、安体舒通等,还有一些单味中药的提取物,如黄芪多糖、槲皮素、葛根素、大黄素、小檗碱、姜黄素以及栀子苷等可以干预胰岛素及其受体活性以及IR相关信号调控途径,改善IR,缓解CKD进展。总之,基于CKD肾脏固有细胞IR信号调控途径的相关药理学研究是今后的发展方向之一。
|
| 关 键 词： | 慢性肾脏病 中药 胰岛素抵抗 发病机制 IRS1/PI3K/Akt2信号通路 |
| 收稿时间： | 2016/12/22 0:00:00 |
Pathogenesis and treatment of insulin resistance in chronic kidney disease and interventional effects of Chinese herbal medicine |
| |
| WU Wei,YANG Jing-jing,WAN Yi-gang,TU Yue,SHI Ge,HAN Wen-bei,LIU Bu-hui and YAO Jian.Pathogenesis and treatment of insulin resistance in chronic kidney disease and interventional effects of Chinese herbal medicine[J].China Journal of Chinese Materia Medica,2017,42(1):49-55. |
| |
| Authors: | WU Wei YANG Jing-jing WAN Yi-gang TU Yue SHI Ge HAN Wen-bei LIU Bu-hui and YAO Jian |
| |
| Institution: | Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China,Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China,Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China,Department of Regimens in Chinese Medicine, Second Clinic Medical School, Nanjing University of Chinese Medicine, Nanjng 210023, China,Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China,Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China,Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China and Division of Molecular Signaling, Department of Advanced Biomedical Research, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi 409-3898, Japan |
| |
| Abstract: | |
| |
| Keywords: | chronic kidney disease Chinese herbal medicine insulin resistance pathogenesis IRS1/PI3K/Akt2 signaling pathway |
| 本文献已被 CNKI 等数据库收录！ |
|
