Targeted drug delivery strategy: a bridge to the therapy of diabetic kidney disease

Abstract

Diabetic kidney disease (DKD) is the main complication in diabetes mellitus (DM) and the main cause of end-stage kidney disease worldwide. However, sodium glucose cotransporter 2 (SGLT2) inhibition, glucagon-like peptide-1 (GLP-1) receptor agonist, mineralocorticoid receptor antagonists and endothelin receptor A inhibition have yielded promising effects in DKD, a great part of patients inevitably continue to progress to uremia. Newly effective therapeutic options are urgently needed to postpone DKD progression. Recently, accumulating evidence suggests that targeted drug delivery strategies, such as macromolecular carriers, nanoparticles, liposomes and so on, can enhance the drug efficacy and reduce the undesired side effects, which will be a milestone treatment in the management of DKD. The aim of this article is to summarize the current knowledge of targeted drug delivery strategies and select the optimal renal targeting strategy to provide new therapies for DKD.

The Usefulness of Resistant Maltodextrin and Chitosan Oligosaccharide in Management of Gut Leakage and Microbiota in Chronic Kidney Disease

“…Recent studies revealed the beneficial effects of chitosan nanoparticles and COS in ulcerative colitis, autoimmune encephalitis, autoimmune arthritis, lupus nephritis, and autoimmune hepatitis [32][33][34]; however, there have been a limited number of studies about COS in renal diseases. Chitosan nanoparticle-encapsulated drugs combined with metformin reduced creatinine, proteinuria, and downregulated TNF-α, IL-6, and IL-1β in type 2 DM rats [35,36]. Zhang H., et al, revealed that COS ameliorated proteinuria and the expression of kidney injury markers and may reverse pathologic change in diabetic rats' kidneys [37].…”

Understanding Proteinuria in Patients with Diabetic Kidney Disease and Progress of Drug Therapy from a New Perspective

“…Although these drugs have shown encouraging efficacy in treating DKD proteinuria, some patients continue to experience uremia. Increasing evidence has shown that targeted drug delivery strategies, such as macromolecular carriers, nanoparticles, and liposomes, can improve drug efficacy and reduce adverse side effects, which may become a new milestone in treating DKD [130]. HDAC4 is involved in podocyte injury in DKD, and HDAC4 siRNA shows good therapeutic prospects for DKD.…”

A multi-omics approach to investigate characteristics of gut microbiota and metabolites in hypertension and diabetic nephropathy SPF rat models

“…Diabetic nephropathy (DN) is a prevalent microvascular complication of diabetes and the leading cause of end-stage renal disease (ESRD) in developed countries and developed regions of China (Ma, 2018 ; Johansen et al, 2021 ). Approximately 40% of DM patients will eventually develop DN (Chen et al, 2023 ).…”