MicroRNA: a novel biomarker and therapeutic target to combat autophagy in diabetic nephropathy

Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease worldwide and is associated with increased morbidity and mortality in patients with both type 1 and type 2 diabetes. Early treatment of DKD can prevent or slow its progression. Some studies suggest that traditional risk factors such as albuminuria do not effectively predict DKD progression, and other predictors have yet to be characterized and validated. Therefore, there is an urgent need to identify sensitive and easily detectable biomarkers to monitor the decline in renal function. MicroRNAs (miRNAs) have recently emerged as important regulators that are ubiquitous in human tissues and bodily fluids, numerous diseases, including early DKD. Recent developments have revealed that miRNAs-mediated post-transcriptional regulation of gene expression represents an integral part of the autophagy regulatory network. In this review, we explored the utility of miRNAs as biomarkers for the early detection and progression of DKD. We also examined some of the molecular mechanisms by which miRNAs manipulate the autophagic machinery to maintain cellular homeostasis during DKD. A better understanding of the interaction between miRNAs and autophagy may ultimately benefit future DKD diagnosis and therapy.