Intermodulation of endoplasmic reticulum stress and ferroptosis in diabetic nephropathy: molecular mechanisms and...

Diabetic nephropathy is a prevalent complication of diabetes mellitus, characterized by progressive renal failure, a leading cause of end-stage renal disease. The pathogenesis of diabetic nephropathy is intricate, with recent research highlighting the significant roles of endoplasmic reticulum stress and ferroptosis in its development. Endoplasmic reticulum stress is initiated by the accumulation of misfolded proteins in the endoplasmic reticulum, activating the unfolded protein response. Ferroptosis, an iron-dependent form of programmed cell death, involves iron ion buildup and heightened lipid peroxidation. In diabetic nephropathy, persistent endoplasmic reticulum stress and ferroptosis intensify renal inflammation, fibrosis, and apoptosis, which are crucial processes in the development of the condition. This review seeks to clarify the molecular mechanisms and interactions between endoplasmic reticulum stress and ferroptosis in diabetic nephropathy, as well as anticipate innovative therapeutic strategies that target endoplasmic reticulum stress and ferroptosis to slow down disease advancement and provide hope for individuals affected by diabetic nephropathy.