Astragaloside IV Improves Diabetic Kidney Disease by Regulating NLRP3 Inflammasome

Diabetic kidney disease (DKD) is a chronic complication that seriously affects the prognosis of diabetic patients and is a primary reason for end-stage renal disease worldwide. The existing treatment strategies have shown unsatisfactory results in the clinical practice of DKD, and there is an immediate need to discover novel and efficacious medicines. Natural products are considered to have the potential for drug design and development due to their diverse pharmacological effects. Astragaloside IV (AS-IV) has a variety of biological activities as a natural product, and existing studies have demonstrated that it can effectively delay the progression of DKD through multiple pathways. Aseptic inflammation is a key characteristic of DKD and is crucial in its pathogenesis. Nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome is an essential regulator of inflammatory amplification. In this review, we focus on the mechanisms by which AS-IV improves DKD by regulating NLRP3 inflammasome activation, including anti-inflammatory, antioxidative stress, reducing endoplasmic reticulum stress (ERS), regulating lipid metabolism disorders, and reducing pyroptosis. These discoveries have provided new ideas for the treatment of DKD.