Interleukin-17 A and diabetic kidney disease: emerging evidence on its pathogenic role and targeted modulation

Area of Science:

• Nephrology
• Immunology
• Endocrinology

Background:

• Diabetic kidney disease (DKD) is a major complication of diabetes, leading to chronic kidney disease (CKD) and end-stage renal disease (ESRD).
• Interleukin-17A (IL-17A), a pro-inflammatory cytokine, is implicated in DKD pathogenesis.
• IL-17A's role in DKD is complex, potentially involving both detrimental and protective mechanisms.

Purpose of the Study:

• To review the mechanistic basis of IL-17A's role in DKD.
• To examine IL-17A-mediated therapeutic strategies for DKD.
• To identify research gaps and future directions for IL-17A in DKD.

Main Methods:

• Literature review of established and emerging research on IL-17A and DKD.
• Analysis of IL-17A's pathogenic mechanisms (inflammation, fibrosis, autophagy, microbiota).
• Comparative analysis with other cytokines (IL-6, IL-1β, TNF-α, IL-22).

Main Results:

• IL-17A contributes to DKD through inflammation, fibrosis, disrupted immune homeostasis, impaired mitochondrial autophagy, and altered gut microbiota.
• IL-17A exhibits context-dependent dual roles, potentially being both pathogenic and protective.
• Further research is needed to clarify IL-17A's precise role and therapeutic potential compared to other cytokines.

Conclusions:

• IL-17A is a significant factor in DKD, mediating key pathological processes.
• Targeting IL-17A presents a potential therapeutic avenue for DKD, but its dual nature requires careful consideration.
• Future research should focus on elucidating IL-17A's complex functions and its place within the cytokine network for effective DKD treatment.