Published online Aug 15, 2023. doi: 10.4239/wjd.v14.i8.1234
Peer-review started: April 20, 2023
First decision: June 1, 2023
Revised: June 12, 2023
Accepted: July 7, 2023
Article in press: July 7, 2023
Published online: August 15, 2023
Processing time: 113 Days and 3.5 Hours
The study focuses on the effects of high glucose (HG) levels in diabetes and its implications on kidney function. It builds upon existing literature indicating that protein misfolding and endoplasmic reticulum (ER) stress are prevalent in kidney diseases, including diabetic nephropathy (DN) and chronic kidney disease. In addition, the flavonol glycoside Icariin (ICA), a traditional Chinese medicine (TCM), has shown potential in attenuating ER stress, which may potentially prevent or halt the progression of kidney diseases.
The research aimed to explore the potential of ICA as a treatment for HG-induced cellular damage, focusing on its interaction with specific microRNAs and proteins that contribute to renal cell damage. Given the increasing interest in the use of TCM as a safer and efficient alternative therapy, understanding the cellular mechanisms of ICA could provide valuable insights for potential therapeutic interventions in DN.
The primary goal was to investigate the effects of ICA on HG-treated kidney cells, with a particular emphasis on the role of miR-503 and sirtuin 4 (SIRT4) in the pathogenesis of HG-induced kidney injury. The study's findings could further the understanding of the mechanisms of ICA, paving the way for future research into its effectiveness and reliability as a treatment for DN.
The research used in vitro experiments to study the effects of ICA on HG-induced cell injury and ER stress in renal cells. The methods adopted included overexpression and inhibition of miR-503 and measuring levels of ER stress markers. The study also conducted a dual luciferase assay to determine whether SIRT4 is a direct target of miR-503.
The study identified that ICA ameliorates HG-induced cell injury by reducing the expression of miR-503. This research also discovered that miR-503 directly targets SIRT4, a novel finding in the field. However, some problems remain, such as establishing the causative role of miR-503 in DN and validating the results in other cell types associated with diabetes.
This study proposes a new theory suggesting the role of the ICA/miR-503/SIRT4 axis in the pathogenesis of HG-induced renal cell injury. Additionally, it presents a new method of using ICA treatment to regulate the miR-503/SIRT4 axis, thereby protecting cells from HG-induced cell damage and ER stress.
Future research should focus on validating these findings in animal models and different diabetic-associated cell types like podocytes or β-cells. Further studies should also explore the therapeutic efficacy of Icariin or miR-503 in clinical settings for conditions like DN, ultimately advancing our understanding of the ICA/miR-503/SIRT4 axis's role in managing diabetes.