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转化生长因子β1介导的非经典信号通路在肾纤维化中的研究进展

Advances in transforming growth factor-β1 mediated non-canonical signaling pathways in renal fibrosis

  • 摘要: 肾纤维化是慢性肾脏病(chronic kidney disease, CKD)进展至终末期肾病的关键病理过程,主要表现为慢性炎症反应、细胞外基质(extracellular matrix, ECM)过度沉积,肾小管间质损伤和功能丧失。近年来对肾纤维化分子机制的研究证实,除经典的Smad信号通路外,转化生长因子β1(transforming growth factor-β1,TGF-β1)还可通过丝裂原活化蛋白激酶(mitogen-activated protein kinase, MAPK)、磷脂酰肌醇3-激酶/蛋白激酶B(phosphatidylinositol 3-kinase/protein kinase B, PI3K/Akt)等非经典信号通路调控肾纤维化进程。这些非经典通路与Smad经典通路交互作用,协同调控ECM代谢、炎症反应及上皮-间质转化(epithelial-mesenchymal transition, EMT)等机制,共同驱动肾纤维化的发生和发展。值得注意的是,多种中药活性成分可通过调节上述通路发挥抗纤维化作用,展现出多靶点干预的治疗潜力。本文旨在系统综述TGF-β1介导的MAPK、PI3K/Akt非经典信号通路在肾纤维化中的研究进展,并探讨以其为靶点的干预策略。

     

    Abstract: Renal fibrosis represents the pivotal pathological process driving the progression of chronic kidney disease (CKD) towards end-stage renal disease. Its core manifestations include chronic inflammation, excessive deposition of extracellular matrix (ECM), and tubulointerstitial injury resulting in functional deterioration. Emerging research on the molecular mechanisms underlying renal fibrosis has established that, beyond the canonical Smad-dependent pathway, transforming growth factor-β1 (TGF-β1) also modulates fibrogenesis through non-canonical signaling pathways, notably the mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) cascades. These non-canonical pathways engage in crosstalk with the canonical Smad pathway, synergistically regulating key processes such as ECM metabolism, inflammatory responses, and epithelial-mesenchymal transition (EMT), thereby collectively orchestrating the initiation and progression of renal fibrosis. Notably, various active components derived from traditional Chinese medicine have demonstrated anti-fibrotic efficacy by modulating these pathways, highlighting their promising multi-target therapeutic potential. This review aims to systematically summarize recent advances in understanding the roles of TGF-β1-mediated MAPK and PI3K/Akt non-canonical signaling pathways in renal fibrosis and to discuss potential therapeutic strategies targeting these pathways.

     

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