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Inflammatory mechanisms in diabetic nephropathy: emerging insights and targeted therapeutics

Title: Inflammatory mechanisms in diabetic nephropathy: emerging insights and targeted therapeutics
Authors: Lin, Shengnan; Shu, Zheng; Zhou, Mi; Jia, Zhen; Wei, Tianshu; Zhou, Xiaojun
Source: Frontiers in Medicine ; volume 12 ; ISSN 2296-858X
Publisher Information: Frontiers Media SA
Publication Year: 2026
Collection: Frontiers (Publisher - via CrossRef)
Description: Background Diabetic kidney disease (DKD) remains a leading cause of end-stage renal disease (ESRD) worldwide. Understanding of DKD pathogenesis has undergone a pivotal shift, moving beyond traditional metabolic and hemodynamic paradigms to underscore the critical role of chronic inflammation. Objective This review aims to systematically delineate recent advances in the inflammatory mechanisms of DKD and to discuss their translational implications. It will focus on emerging diagnostic biomarkers and novel inflammation-targeted therapeutic strategies. Main content This review portrays the complex interplay of emerging inflammatory mechanisms in DKD, encompassing inflammatory pathway activation, cellular senescence, impaired podocyte autophagy, the gut microbiota-kidney axis, and regulation by non-coding RNAs (ncRNAs). Meanwhile, a novel diagnostic paradigm powered by omics technologies and artificial intelligence (AI) is described, highlighting the associated biomarkers. Lastly, the therapeutic landscape, focusing on agents with proven renal benefits, including sodium-glucose cotransporter 2 (SGLT2) inhibitors, non-steroidal mineralocorticoid receptor antagonists (ns-MRAs), and glucagon-like peptide-1 receptor agonists (GLP-1RAs) is reviewed, with evaluating the promise of natural products as multi-target interventions. Conclusion Inflammation in DKD is driven by an intricate network of local and systemic factors. A multifaceted approach which prioritizes the integration of multi-omics data for inflammatory subtyping, deciphering inter-organ communication, and developing combined therapies that leverage conventional drugs, targeted agents, and natural compounds should be adopted to advance the management of DKD.
Document Type: article in journal/newspaper
Language: unknown
DOI: 10.3389/fmed.2025.1722159
DOI: 10.3389/fmed.2025.1722159/full
Availability: https://doi.org/10.3389/fmed.2025.1722159; https://www.frontiersin.org/articles/10.3389/fmed.2025.1722159/full
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.8C28D45C
Database: BASE