Diabetic kidney disease (DKD) is the most common and severe microvascular complication in clinical practice and one of the main causes for diabetic patients to develop chronic kidney disease and end-stage renal disease. The pathogenesis of this disease involves the combined effects of multiple factors, such as genetic factors, dysregulation of glucose and lipid metabolism, changes in renal hemodynamics, inflammatory responses and oxidative stress, among others. Among these, oxidative stress is the core process in the occurrence and development of DKD. The nuclear transcription factor E2-related factor (Nrf2) is an important regulatory factor for antioxidant stress transcription. Activating Nrf2 can stimulate the expression of downstream heme oxygenase-1 (HO-1), thereby widely participating in various biological processes such as regulating oxidative stress, reducing inflammatory responses and inhibiting cell apoptosis in the body. Recent studies have shown that the Nrf2/HO-1 signaling pathway is involved in the occurrence, development and drug intervention process of DKD. Traditional Chinese medicine (TCM) has the characteristics of multi-target, multi-pathway and multi-level, and the advantages of synergism and attenuation, showing unique advantages in making up for the shortcomings of modern medicine. However, there is still a lack of systematic summary of the mechanism of this pathway in the prevention and treatment of DKD and the research progress of traditional Chinese medicine. In this paper, the biological function and activation process of Nrf2/HO-1 pathway, the relationship between Nrf2/HO-1 pathway and DKD, the related research of traditional Chinese medicine to improve DKD by targeting the pathway in recent years, the treatment strategy of integrated traditional Chinese and western medicine, and the future research direction were systematically reviewed, in order to provide theoretical reference for the clinical treatment and drug development of DKD.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |