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Suppressing renal NADPH oxidase to treat diabetic nephropathy

Akihiro Tojo1, Kensuke Asaba, Maristela L Onozato

  • 1University of Tokyo, Division of Nephrology and Endocrinology, Division of Nephrology and Endocrinology, Japan. tojyo-2im@h.u-tokyo.ac.jp

Expert Opinion on Therapeutic Targets
|August 2, 2007
PubMed

Insights

Diabetic nephropathy involves oxidative stress from renal NADPH oxidase. Inhibiting this enzyme with drugs or picrorhiza may treat kidney damage and reduce proteinuria.

Area of Science:

  • Nephrology
  • Biochemistry
  • Pharmacology

Background:

  • Renal nicotinamide adenine dinucleotide phosphate reduced form (NADPH) oxidase is a key contributor to oxidative stress in diabetic nephropathy.
  • Its expression is elevated in the glomerulus and tubules, exacerbating kidney damage.

Purpose of the Study:

  • To explore the role of renal NADPH oxidase in diabetic nephropathy.
  • To identify therapeutic strategies targeting NADPH oxidase for treating diabetic nephropathy.

Main Methods:

  • Investigated the mechanisms of NADPH oxidase activation by high glucose, protein kinase C, and angiotensin II.
  • Examined the effects of renin-angiotensin-aldosterone system inhibitors, statins, and the herb picrorhiza on NADPH oxidase activity and downstream effects.
  • Assessed the impact on reactive oxygen species (ROS) production, proteinuria, and tubulointerstitial damage.

Main Results:

  • NADPH oxidase-derived ROS damage podocytes, glomerular basement membranes, and slit diaphragms, leading to proteinuria.
  • Mesangial and glomerular endothelial NADPH oxidase activation increases TGF-beta, promoting collagen and fibronectin accumulation.
  • Tubular NADPH oxidase contributes to sodium retention and tubulointerstitial damage.
  • Inhibition of the renin-angiotensin-aldosterone system, statins, and picrorhiza show potential in reducing renal oxidative stress and damage.

Conclusions:

  • Renal NADPH oxidase plays a critical role in the pathogenesis of diabetic nephropathy.
  • Targeting NADPH oxidase, through pharmacological agents or natural compounds like picrorhiza, represents a promising therapeutic strategy for diabetic nephropathy.
  • Inhibiting NADPH oxidase can reduce ROS, proteinuria, and glomerulosclerosis, offering a novel treatment approach.

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