Innate immunity in diabetic nephropathy: Pathogenic mechanisms and therapeutic targets

  • Le-Xin Chen 1 ,
  • Shu-Ru Lu 1 ,
  • Zhi-Hao Wu 1 ,
  • En-Xin Zhang 2 ,
  • Qing-Qun Cai , 3 ,
  • Xiao-Jun Zhang , 1
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  • 1. School of Pharmaceutical Science, Guangzhou University of Chinese Medicine, Guangzhou, PR China
  • 2. Shenzhen Bao’an Authentic TCM Therapy Hospital, Shenzhen, PR China
  • 3. The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, PR China
yaoxuebu2021@163.com
zhangxj@gzucm.edu.cn

Received date: 29 Aug 2023

Revised date: 11 Feb 2024

Accepted date: 18 Feb 2024

Copyright

2024 2024 The Authors. MedComm – Future Medicine published by John Wiley & Sons Australia, Ltd on behalf of Sichuan International Medical Exchange & Promotion Association (SCIMEA).

Abstract

Diabetic nephropathy (DN) represents a prevalent chronic microvascular complication of diabetes mellitus (DM) and is a major cause of end-stage renal disease. The anfractuous surrounding of DN pathogenesis and the intricate nature of this metabolic disorder often pose challenges in both the diagnosis and treatment of DN compared to other kidney diseases. Hyperglycaemia in DM predispose vulnerable renal cells into microenvironmental disequilibrium and thereby results in innate immunocytes infiltration including neutrophils, macrophages, myeloid-derived suppressor cells, dendritic cells, and so forth. These immune cells play dual roles in kidney injury and closely correlated with the degree of proteinuria in DN patients. Additionally, innate immune signaling cascades, initiated by altered metabolic and hemodynamic in diabetic context, are crucial in instigating and perpetuating renal inflammation, which detrimentally contribute to DN pathogenesis. As such, antiinflammatory therapies, particularly those targeting innate immunity, hold renoprotective promise in DN. In this article, we reviewed the origin and feature of the above four prominent kidney innate immune cells, analyze their pathogenic role in DN, and discuss potential targeted-therapeutic strategies, aiming to enhance the current understanding of renal innate immunity and hence help to discover promising therapeutic approaches for DN.

Cite this article

Le-Xin Chen , Shu-Ru Lu , Zhi-Hao Wu , En-Xin Zhang , Qing-Qun Cai , Xiao-Jun Zhang . Innate immunity in diabetic nephropathy: Pathogenic mechanisms and therapeutic targets[J]. MEDCOMM - Future Medicine, 2024 , 3(1) : 76 . DOI: 10.1002/mef2.76

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