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Recent Advances in Understanding Nrf2 Agonism and Its Potential Clinical Application to Metabolic and Inflammatory
1Department of Endocrinology in Internal Medicine, Kyungpook National University Hospital, Daegu 41944, Korea.
Abstract:
Oxidative stress is a major component of cell damage and cell fat, and as such, it occupies a central position in the pathogenesis of metabolic disease. Nuclear factor-erythroid-derived 2-related factor 2 (Nrf2), a key transcription factor that coordinates expression of genes encoding antioxidant and detoxifying enzymes, is regulated primarily by Kelch-like ECH-associated protein 1 (Keap1). However, involvement of the Keap1-Nrf2 pathway in tissue and organism homeostasis goes far beyond protection from cellular stress. In this review, we focus on evidence for Nrf2 pathway dysfunction during development of several metabolic/inflammatory disorders, including diabetes and diabetic complications, obesity, inflammatory bowel disease, and autoimmune diseases. We also review the beneficial role of current molecular Nrf2 agonists and summarize their use in ongoing clinical trials. We conclude that Nrf2 is a promising target for regulation of numerous diseases associated with oxidative stress and inflammation. However, more studies are needed to explore the role of Nrf2 in the pathogenesis of metabolic/inflammatory diseases and to review safety implications before therapeutic use in clinical practice.
Insights
The Keap1-Nrf2 pathway is crucial for metabolic health. Its dysfunction contributes to diseases like diabetes and obesity, highlighting Nrf2 as a potential therapeutic target for oxidative stress and inflammation.
Area of Science:
- Biochemistry
- Molecular Biology
- Pathophysiology
Background:
- Oxidative stress is integral to metabolic disease pathogenesis.
- The Kelch-like ECH-associated protein 1 (Keap1)-Nuclear factor-erythroid-derived 2-related factor 2 (Nrf2) pathway regulates antioxidant and detoxifying enzymes.
- The Keap1-Nrf2 pathway's role extends beyond cellular stress to organism homeostasis.
Purpose of the Study:
- To review evidence of Keap1-Nrf2 pathway dysfunction in metabolic/inflammatory disorders.
- To examine the therapeutic potential of Nrf2 agonists in clinical trials.
- To highlight Nrf2 as a target for diseases linked to oxidative stress and inflammation.
Main Methods:
- Literature review focusing on Nrf2 pathway dysfunction.
- Analysis of Nrf2 agonist efficacy in metabolic and inflammatory diseases.
- Summary of ongoing clinical trials involving Nrf2 modulators.
Main Results:
- Nrf2 pathway dysfunction is implicated in diabetes, obesity, inflammatory bowel disease, and autoimmune diseases.
- Molecular Nrf2 agonists demonstrate beneficial effects in preclinical and clinical studies.
- Nrf2 activation shows promise for managing oxidative stress and inflammation-related conditions.
Conclusions:
- The Keap1-Nrf2 pathway is a significant factor in metabolic and inflammatory diseases.
- Nrf2 agonists represent a promising therapeutic strategy for various oxidative stress-related conditions.
- Further research is essential to fully understand Nrf2's role and ensure therapeutic safety.
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