Diabetic nephropathy: New insights into established therapeutic paradigms and novel molecular targets. (June 2017)

• Record Type: Journal Article
• Authors: Sharma, Dilip; Bhattacharya, Pallab; Kalia, Kiran; Tiwari, Vinod
• Is Part Of: Diabetes research and clinical practice. Volume 128(2017)
• Page Start: 91
• Page End: 108
• Publication Date: 2017-06
• Subjects: Diabetic nephropathy -- Endothelin -- Epigenetics -- Inflammation -- Micro-RNA -- Wnt signaling; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2017.04.010
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Diabetic nephropathy is a major microvascular complication that accounts for 30–47% cases of end-stage renal disorders. Xanthine oxidase inhibitors should be further explored for the prevention and treatment of diabetic nephropathy. Ruboxistaurin (RBX) and JTT-010, selective PKC inhibitors, holds a potential for the reversal of diabetic nephropathy. Fatty acid-binding protein 4 inhibitors might be the potential molecules against ER stress in diabetic nephropathy. More research studies are required to further explore the key epigenetical mechanism and make them clinically translatable in patients suffering from diabetic nephropathy. Abstract: Diabetic nephropathy is one of the most prevalent microvascular complication in patients suffering from diabetes and is reported to be the major cause of renal failure when compared to any other kidney disease. Currently, available therapies provide only symptomatic relief and unable to treat the underlying pathophysiology of diabetic nephropathy. This review will explore new insights into the established therapeutic paradigms targeting oxidative stress, inflammation and endoplasmic reticulum stress with the focus on recent clinical developments. Apart from this, the involvement of novel cellular and molecular mechanisms including the role of endothelin-receptor antagonists, Wnt signaling pathway, epigenetics and micro RNA is also discussed so that key molecular switches involved in the pathogenesis of diabetic nephropathy can be identified. Elucidating new molecular pathways will help in the development of novel therapeutics for the prevention and treatment of diabetic nephropathy.