Immune-mediated renal injury in diabetic kidney disease: from mechanisms to therapy
Diabetic kidney disease (DKD) is now recognized as a multifactorial disorder, driven by the interplay of metabolic dysfunction, chronic inflammation, and immune-mediated renal injury. This review comprehensively synthesizes recent advancements in understanding immune dysregulation as a central drive...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1587806/full |
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| author | Lingli Ma Dianyuan Liu Yue Yu Zimeng Li Qing Wang |
| author_facet | Lingli Ma Dianyuan Liu Yue Yu Zimeng Li Qing Wang |
| author_sort | Lingli Ma |
| collection | DOAJ |
| description | Diabetic kidney disease (DKD) is now recognized as a multifactorial disorder, driven by the interplay of metabolic dysfunction, chronic inflammation, and immune-mediated renal injury. This review comprehensively synthesizes recent advancements in understanding immune dysregulation as a central driver of DKD pathogenesis, integrating molecular mechanisms with emerging therapeutic strategies. Innate immune activation, which includes macrophage polarization and adaptive immune perturbations, exacerbates glomerulosclerosis and interstitial fibrosis through cytokine storms and mitochondrial oxidative stress. Despite clinical guidelines emphasizing glycemic control and renin-angiotensin-aldosterone system (RAAS) inhibition, their limited efficacy in halting immune-mediated tubular atrophy highlights the unmet need for targeted immunotherapies. By connecting mechanistic discoveries to clinical translation, this work establishes a roadmap for the development of immune-centric therapies. Its critical synthesis of multi-omics data, clinical trial evidence, and preclinical models bridges the gap between laboratory discoveries and bedside applications, laying the groundwork for redefining DKD as a treatable immune-metabolic disorder. |
| format | Article |
| id | doaj-art-b52270e1fb91455691b195e36b6035cc |
| institution | OA Journals |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-b52270e1fb91455691b195e36b6035cc2025-08-20T02:32:04ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-06-011610.3389/fimmu.2025.15878061587806Immune-mediated renal injury in diabetic kidney disease: from mechanisms to therapyLingli MaDianyuan LiuYue YuZimeng LiQing WangDiabetic kidney disease (DKD) is now recognized as a multifactorial disorder, driven by the interplay of metabolic dysfunction, chronic inflammation, and immune-mediated renal injury. This review comprehensively synthesizes recent advancements in understanding immune dysregulation as a central driver of DKD pathogenesis, integrating molecular mechanisms with emerging therapeutic strategies. Innate immune activation, which includes macrophage polarization and adaptive immune perturbations, exacerbates glomerulosclerosis and interstitial fibrosis through cytokine storms and mitochondrial oxidative stress. Despite clinical guidelines emphasizing glycemic control and renin-angiotensin-aldosterone system (RAAS) inhibition, their limited efficacy in halting immune-mediated tubular atrophy highlights the unmet need for targeted immunotherapies. By connecting mechanistic discoveries to clinical translation, this work establishes a roadmap for the development of immune-centric therapies. Its critical synthesis of multi-omics data, clinical trial evidence, and preclinical models bridges the gap between laboratory discoveries and bedside applications, laying the groundwork for redefining DKD as a treatable immune-metabolic disorder.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1587806/fullimmune celldiabetic kidney diseasemechanismstreatment methodsimmunotherapy |
| spellingShingle | Lingli Ma Dianyuan Liu Yue Yu Zimeng Li Qing Wang Immune-mediated renal injury in diabetic kidney disease: from mechanisms to therapy Frontiers in Immunology immune cell diabetic kidney disease mechanisms treatment methods immunotherapy |
| title | Immune-mediated renal injury in diabetic kidney disease: from mechanisms to therapy |
| title_full | Immune-mediated renal injury in diabetic kidney disease: from mechanisms to therapy |
| title_fullStr | Immune-mediated renal injury in diabetic kidney disease: from mechanisms to therapy |
| title_full_unstemmed | Immune-mediated renal injury in diabetic kidney disease: from mechanisms to therapy |
| title_short | Immune-mediated renal injury in diabetic kidney disease: from mechanisms to therapy |
| title_sort | immune mediated renal injury in diabetic kidney disease from mechanisms to therapy |
| topic | immune cell diabetic kidney disease mechanisms treatment methods immunotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1587806/full |
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