4.5 Review

Therapeutic potential of Nrf-2 pathway in the treatment of diabetic neuropathy and nephropathy

Journal

MOLECULAR BIOLOGY REPORTS
Volume 48, Issue 3, Pages 2761-2774

Publisher

SPRINGER
DOI: 10.1007/s11033-021-06257-5

Keywords

Type-2 diabetes; Diabetic neuropathy; Diabetic nephropathy; Nrf-2 activation; Nrf-2 activators; Nrf-2-Keap-1 association

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Type 2 diabetes is a widely spread metabolic disorder with the number of affected individuals expected to increase. Targeted therapies are needed to maintain glucose levels and improve insulin sensitivity. The regulation of Nrf-2 activity may offer therapeutic benefits and emerge as a novel therapy in the treatment of diabetes and its associated complications.
Type 2 diabetes (T2D) is one of the most widely spread metabolic disordersand is also referred as a 'lifestyle' disorder. According toa study conducted by IDB, the number of individuals affected with diabetes is expected to increase from 463 to 700 million by the end of year 2045. Thus, there is a great need to developed targeted therapies that can maintain homeostasis of glucose levels and improving insulin sensitivity which can overcome hurdles associated with conventional medicine. Detailed analysis was conducted by analyzing various research and review papers which were searched using MEDLINE and EMBASE using various keywords. This search retrieved the most appropriate content on these molecules targeting Nrf-2 functions and Nrf-2 pathway associated with diabetic neuropathy and nephropathy. In this review article, we have highlighted the role of Nrf-2 in diabetic associated complications of neuropathy and nephropathy. Since hyperglycemia is associated with oxidative stress and inflammation, regulating Nrf-2 activity through various synthetic and natural activators whichmay provide therapeutic benefits for the treatment and mitigation of diabetic neuropathy and nephropathy as well. Based on the available literature on Nrf-2 activity and despite some controversies in the association of Nrf-2 activity and its therapeutic usage, it can be concluded that regulation of this pathway is a trigger in the development of diabetes-associated complications. Thus, targeting this pathway with various activators may emerge as a novel therapy in the treatment of diabetes and diabetes-associated complications.

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