title: Role of nutrient-sensing signals in the pathogenesis of diabetic nephropathy.
abstract: Diabetic nephropathy is the leading cause of end-stage renal disease worldwide. The multipronged drug approach still fails to fully prevent the onset and progression of diabetic nephropathy. Therefore, a new therapeutic target to improve the prognosis of diabetic nephropathy is urgently required. Nutrient-sensing signals and their related intracellular machinery have evolved to combat prolonged periods of starvation in mammals; and these systems are conserved in the kidney. Recent studies have suggested that the activity of three nutrient-sensing signals, mTORC1, AMPK, and Sirt1, is altered in the diabetic kidney. Furthermore, autophagy activity, which is regulated by the above-mentioned nutrient-sensing signals, is also altered in both podocytes and proximal tubular cells under diabetic conditions. Under diabetic conditions, an altered nutritional state owing to nutrient excess may disturb cellular homeostasis regulated by nutrient-responsible systems, leading to exacerbation of organelle dysfunction and diabetic nephropathy. In this review, we discuss new findings showing relationships between nutrient-sensing signals, autophagy, and diabetic nephropathy and suggest the therapeutic potential of nutrient-sensing signals in diabetic nephropathy.
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Tsukinowa-Cho, Seta, Otsu, Shiga 520-2192, Japan.
authors.forename: Shinji
authors.identifier: 0000-0001-6937-9715
authors.initials: S
authors.lastname: Kume
authors.affiliation: Division of Diabetology & Endocrinology, Kanazawa Medical University, Kahoku-Gun, Ishikawa 920-0265, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Koya
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Tsukinowa-Cho, Seta, Otsu, Shiga 520-2192, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Uzu
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Tsukinowa-Cho, Seta, Otsu, Shiga 520-2192, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maegawa
mesh_terms: D000091162:AMP-Activated Protein Kinase Kinases; D000818:Animals; D001343:Autophagy / Q000235:genetics; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D005502:Food; D006801:Humans; D000076222:Mechanistic Target of Rapamycin Complex 1; D053858:Metabolic Networks and Pathways / Q000235:genetics; D046912:Multiprotein Complexes / Q000378:metabolism*; D050199:Podocytes / Q000378:metabolism / Q000473:pathology; D011494:Protein Kinases / Q000378:metabolism*; D056564:Sirtuin 1 / Q000378:metabolism*; D058570:TOR Serine-Threonine Kinases / Q000378:metabolism*
chemical_list: D046912:Multiprotein Complexes; D011494:Protein Kinases; D000076222:Mechanistic Target of Rapamycin Complex 1; D058570:TOR Serine-Threonine Kinases; D000091162:AMP-Activated Protein Kinase Kinases; C447939:SIRT1 protein, human; D056564:Sirtuin 1