中国临床药理学与治疗学 ›› 2026, Vol. 31 ›› Issue (4): 509-516.doi: 10.12092/j.issn.1009-2501.2026.04.010
李金菊1(
), 杨浩2, 阮诺冰1, 许奇1, 毕正1, 李瑜璠1, 王帆竞1, 林逸轩3, 方朝晖3,4,*(
)
收稿日期:2024-10-18
修回日期:2024-11-15
出版日期:2026-04-26
发布日期:2026-04-30
通讯作者:
方朝晖
E-mail:2677161385@qq.com;fangzhaohui9097@163.com
作者简介:李金菊,女,博士研究生,从事中医药防治内分泌代谢病研究。E-mail:基金资助:
Jinju LI1(
), Hao YANG2, Nuobing RUAN1, Qi XU1, Zheng BI1, Yufan LI1, Fanjing WANG1, Yixuan LIN3, Zhaohui FANG3,4,*(
)
Received:2024-10-18
Revised:2024-11-15
Online:2026-04-26
Published:2026-04-30
Contact:
Zhaohui FANG
E-mail:2677161385@qq.com;fangzhaohui9097@163.com
摘要:
糖尿病微血管病变是糖尿病最早出现且最常见的并发症,其特征是微血管内皮功能受损、基底膜增厚和微血栓形成,累及肾脏、视网膜和神经,也是导致患者生活质量下降和预期寿命缩短的关键因素。近年来的临床及实验研究发现,细胞衰老是该类疾病的主要危险因素。细胞衰老是一种不可逆的细胞周期停滞状态,参与多种生理病理过程影响糖尿病微血管病变的发生发展。本文就细胞衰老在糖尿病微血管病变进程中的作用机制及目前靶向细胞衰老治疗糖尿病微血管病变的药物进行综述,为防治糖尿病微血管病变提供新的研究思路。
中图分类号:
李金菊, 杨浩, 阮诺冰, 许奇, 毕正, 李瑜璠, 王帆竞, 林逸轩, 方朝晖. 糖尿病微血管病变中的细胞衰老及治疗药物研究进展[J]. 中国临床药理学与治疗学, 2026, 31(4): 509-516.
Jinju LI, Hao YANG, Nuobing RUAN, Qi XU, Zheng BI, Yufan LI, Fanjing WANG, Yixuan LIN, Zhaohui FANG. Research progress on cellular senescence and therapeutic drugs in diabetic microvascular complications[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(4): 509-516.
| 1 |
Sun H, Saeedi P, Karuranga S, et al. Erratum to "IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045" [Diabetes Res. Clin. Pract. 183 (2022) 109119][J]. Diabetes Res Clin Pract, 2023, 204, 110945.
doi: 10.1016/j.diabres.2023.110945 |
| 2 |
Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition[J]. Diabetes Res Clin Pract, 2019, 157, 107843.
doi: 10.1016/j.diabres.2019.107843 |
| 3 |
Sabanayagam C, Chee ML, Banu R, et al. Association of diabetic retinopathy and diabetic kidney disease with all-cause and cardiovascular mortality in a multiethnic Asian population[J]. JAMA Netw Open, 2019, 2 (3): e191540.
doi: 10.1001/jamanetworkopen.2019.1540 |
| 4 |
An J, Nichols GA, Qian L, et al. Prevalence and incidence of microvascular and macrovascular complications over 15 years among patients with incident type 2 diabetes[J]. BMJ Open Diabetes Res Care, 2021, 9 (1): e001847.
doi: 10.1136/bmjdrc-2020-001847 |
| 5 |
An Y, Xu BT, Wan SR, et al. The role of oxidative stress in diabetes mellitus-induced vascular endothelial dysfunction[J]. Cardiovasc Diabetol, 2023, 22 (1): 237.
doi: 10.1186/s12933-023-01965-7 |
| 6 |
Wołoszyn-Durkiewicz A, Myśliwiec M. The prognostic value of inflammatory and vascular endothelial dysfunction biomarkers in microvascular and macrovascular complications in type 1 diabetes[J]. Pediatr Endocrinol Diabetes Metab, 2019, 25 (1): 28- 35.
doi: 10.5114/pedm.2019.84710 |
| 7 |
Zochodne DW. The challenges of diabetic polyneuropathy: a brief update[J]. Curr Opin Neurol, 2019, 32 (5): 666- 675.
doi: 10.1097/WCO.0000000000000723 |
| 8 |
López-Otín C, Blasco MA, Partridge L, et al. Hallmarks of aging: An expanding universe[J]. Cell, 2023, 186 (2): 243- 278.
doi: 10.1016/j.cell.2022.11.001 |
| 9 |
Gorgoulis V, Adams PD, Alimonti A, et al. Cellular senescence: Defining a path forward[J]. Cell, 2019, 179 (4): 813- 827.
doi: 10.1016/j.cell.2019.10.005 |
| 10 |
Jha SK, De Rubis G, Devkota SR, et al. Cellular senescence in lung cancer: Molecular mechanisms and therapeutic interventions[J]. Ageing Res Rev, 2024, 97, 102315.
doi: 10.1016/j.arr.2024.102315 |
| 11 |
Saito Y, Yamamoto S, Chikenji TS. Role of cellular senescence in inflammation and regeneration[J]. Inflamm Regen, 2024, 44 (1): 28.
doi: 10.1186/s41232-024-00342-5 |
| 12 |
Zhang W, Sun HS, Wang X, et al. Cellular senescence, DNA damage, and neuroinflammation in the aging brain[J]. Trends Neurosci, 2024, 47 (6): 461- 474.
doi: 10.1016/j.tins.2024.04.003 |
| 13 | Hayflickl Moorheadps. The serialcultivation of human diploid cellstrains[J]. Exp Cell Res, 1961, 25, 585- 621. |
| 14 |
Wang B, Han J, Elisseeff JH, et al. The senescence-associated secretory phenotype and its physiological and pathological implications[J]. Nat Rev Mol Cell Biol, 2024, 25 (12): 958- 978.
doi: 10.1038/s41580-024-00727-x |
| 15 |
Fu H, Liu S, Bastacky SI, et al. Diabetic kidney diseases revisited: A new perspective for a new era[J]. Mol Metab, 2019, 30, 250- 263.
doi: 10.1016/j.molmet.2019.10.005 |
| 16 |
Verzola D, Gandolfo MT, Gaetani G, et al. Accelerated senescence in the kidneys of patients with type 2 diabetic nephropathy[J]. Am J Physiol Renal Physiol, 2008, 295 (5): F1563- F1573.
doi: 10.1152/ajprenal.90302.2008 |
| 17 |
Guo H, Rogg M, Keller J, et al. ADP-ribosylation factor-interacting protein 2 acts as a novel regulator of mitophagy and autophagy in podocytes in diabetic nephropathy[J]. Antioxidants (Basel), 2024, 13 (1): 81.
doi: 10.3390/antiox13010081 |
| 18 |
Fu B, Yang J, Chen J, et al. Preventive effect of Shenkang injection against high glucose-induced senescence of renal tubular cells[J]. Front Med, 2019, 13 (2): 267- 276.
doi: 10.1007/s11684-017-0586-8 |
| 19 |
Cao D, Zhao M, Wan C, et al. Role of tea polyphenols in delaying hyperglycemia-induced senescence in human glomerular mesangial cells via miR-126/Akt-p53-p21 pathways[J]. Int Urol Nephrol, 2019, 51 (6): 1071- 1078.
doi: 10.1007/s11255-019-02165-7 |
| 20 |
Cao DW, Jiang CM, Wan C, et al. Upregulation of miR-126 delays the senescence of human glomerular mesangial cells induced by high glucose via telomere-p53-p21-Rb signaling pathway[J]. Curr Med Sci, 2018, 38 (5): 758- 764.
doi: 10.1007/s11596-018-1942-x |
| 21 |
Yamagishi S, Nakamura N, Suematsu M, et al. Advanced glycation end products: A molecular target for vascular complications in diabetes[J]. Mol Med, 2015, 21 (S1): S32- S40.
doi: 10.2119/molmed.2015.00067 |
| 22 |
Kan WC, Hwang JY, Chuang LY, et al. Effect of osthole on advanced glycation end products-induced renal tubular hypertrophy and role of klotho in its mechanism of action[J]. Phytomedicine, 2019, 53, 205- 212.
doi: 10.1016/j.phymed.2018.09.030 |
| 23 |
Zhang X, Chen X, Wu D, et al. Downregulation of connexin 43 expression by high glucose induces senescence in glomerular mesangial cells[J]. J Am Soc Nephrol, 2006, 17 (6): 1532- 1542.
doi: 10.3410/f.13983.471489 |
| 24 |
Liu J, Yang JR, Chen XM, et al. Impact of ER stress-regulated ATF4/p16 signaling on the premature senescence of renal tubular epithelial cells in diabetic nephropathy[J]. Am J Physiol Cell Physiol, 2015, 308 (8): C621- C630.
doi: 10.1152/ajpcell.00096.2014 |
| 25 |
Chen K, Dai H, Yuan J, et al. Optineurin-mediated mitophagy protects renal tubular epithelial cells against accelerated senescence in diabetic nephropathy[J]. Cell Death Dis, 2018, 9 (2): 105.
doi: 10.1038/s41419-017-0127-z |
| 26 |
Korolchuk VI, Miwa S, Carroll B, et al. Mitochondria in cell senescence: Is mitophagy the weakest link?[J]. E Bio Medicine, 2017, 21, 7- 13.
doi: 10.1016/j.ebiom.2017.03.020 |
| 27 |
Troyano-Suárez N, del Nogal-Avila M, Mora I, et al. Glucose oxidase induces cellular senescence in immortal renal cells through ILK by downregulating Klotho gene expression[J]. Oxid Med Cell Longev, 2015, 2015, 416738.
doi: 10.1155/2016/8392708 |
| 28 |
Yeh TH, Tu KC, Wang HY, et al. From acute to chronic: Unraveling the pathophysiological mechanisms of the progression from acute kidney injury to acute kidney disease to chronic kidney disease[J]. Int J Mol Sci, 2024, 25 (3): 1755.
doi: 10.3390/ijms25031755 |
| 29 |
Zhang S, Cai G, Fu B, et al. SIRT1 is required for the effects of rapamycin on high glucose-inducing mesangial cells senescence[J]. Mech Ageing Dev, 2012, 133 (6): 387- 400.
doi: 10.1016/j.mad.2012.04.005 |
| 30 |
Gong W, Luo C, Peng F, et al. Brahma-related gene-1 promotes tubular senescence and renal fibrosis through Wnt/β-catenin/autophagy axis[J]. Clin Sci (Lond), 2021, 135 (15): 1873- 1895.
doi: 10.1042/CS20210447 |
| 31 |
Crespo-Garcia S, Tsuruda PR, Dejda A, et al. Pathological angiogenesis in retinopathy engages cellular senescence and is amenable to therapeutic elimination via BCL-xL inhibition[J]. Cell Metab, 2021, 33 (4): 818- 832.
doi: 10.1016/j.cmet.2021.01.011 |
| 32 |
Zhang S, Chen S, Sun D, et al. TIN2-mediated reduction of mitophagy induces RPE senescence under high glucose[J]. Cell Signal, 2024, 119, 111188.
doi: 10.1016/j.cellsig.2024.111188 |
| 33 |
Peng H, Han W, Ma B, et al. Autophagy and senescence of rat retinal precursor cells under high glucose[J]. Front Endocrinol (Lausanne), 2023, 13, 1047642.
doi: 10.3389/fendo.2022.1047642 |
| 34 |
Liu J, Chen S, Biswas S, et al. Glucose-induced oxidative stress and accelerated aging in endothelial cells are mediated by the depletion of mitochondrial SIRTs[J]. Physiol Rep, 2020, 8 (3): e14331.
doi: 10.14814/phy2.14331 |
| 35 |
Mortuza R, Chen S, Feng B, et al. High glucose induced alteration of SIRTs in endothelial cells causes rapid aging in a p300 and FOXO regulated pathway[J]. PLoS One, 2013, 8 (1): e54514.
doi: 10.1371/journal.pone.0054514 |
| 36 |
Cheng Y, Zhang M, Xu R, et al. p53 accelerates endothelial cell senescence in diabetic retinopathy by enhancing FoxO3a ubiquitylation and degradation via UBE2L6[J]. Exp Gerontol, 2024, 188, 112391.
doi: 10.1016/j.exger.2024.112391 |
| 37 |
Sun D, Li S, Chen S, et al. TRIM25 inhibition attenuates inflammation, senescence, and oxidative stress in microvascular endothelial cells induced by hyperglycemia[J]. Graefes Arch Clin Exp Ophthalmol, 2024, 262 (1): 81- 91.
doi: 10.1007/s00417-023-06160-8 |
| 38 |
Chen Q, Tang L, Xin G, et al. Oxidative stress mediated by lipid metabolism contributes to high glucose-induced senescence in retinal pigment epithelium[J]. Free Radic Biol Med, 2019, 130, 48- 58.
doi: 10.1016/j.freeradbiomed.2018.10.419 |
| 39 |
Sardella-Silva G, Mietto BS, Ribeiro-Resende VT. Four seasons for Schwann cell biology, revisiting key periods: development, homeostasis, repair, and aging[J]. Biomolecules, 2021, 11 (12): 1887.
doi: 10.3390/biom11121887 |
| 40 |
Kohlmeyer JL, Kaemmer CA, Umesalma S, et al. RABL6A regulates Schwann cell senescence in an RB1-dependent manner[J]. Int J Mol Sci, 2021, 22 (10): 5367.
doi: 10.3390/ijms22105367 |
| 41 | Lin HS, Yang CH, Yin TC, et al. Addition of adipose tissue-derived mesenchymal stem cells improves empagliflozin therapy for alleviating hyperglycemia--induced neuropathy [J]. Am J Transl Res, 2023, 15(10): 6264-6285. |
| 42 |
Hickson LJ, Langhi Prata LGP, Bobart SA, et al. Senolytics decrease senescent cells in humans: Preliminary report from a clinical trial of Dasatinib plus Quercetin in individuals with diabetic kidney disease[J]. EBioMedicine, 2019, 47, 446- 456.
doi: 10.1016/j.ebiom.2019.08.069 |
| 43 |
Jiang X, Ruan XL, Xue YX, et al. Metformin reduces the senescence of renal tubular epithelial cells in diabetic nephropathy via the MBNL1/miR-130a-3p/STAT3 pathway[J]. Oxid Med Cell Longev, 2020, 2020, 8708236.
doi: 10.1155/2020/8708236 |
| 44 |
Eleftheriadis T, Pissas G, Filippidis G, et al. Dapagliflozin prevents high-glucose-induced cellular senescence in renal tubular epithelial cells[J]. Int J Mol Sci, 2022, 23 (24): 16107.
doi: 10.3390/ijms232416107 |
| 45 | Kim MN, Moon JH, Cho YM. Sodium-glucose cotransporter-2 inhibition reduces cellular senescence in the diabetic kidney by promoting ketone body-induced NRF2 activation[J]. Diabetes Obes Metab, 2021, 23 (11): 2561- 2571. |
| 46 |
Wang Z, Han N, Zhao K, et al. Protective effects of pyrroloquinoline quinine against oxidative stress-induced cellular senescence and inflammation in human renal tubular epithelial cells via Keap1/Nrf2 signaling pathway[J]. Int Immunopharmacol, 2019, 72, 445- 453.
doi: 10.1016/j.intimp.2019.04.040 |
| 47 |
Fang X, Huang W, Sun Q, et al. Melatonin attenuates cellular senescence and apoptosis in diabetic nephropathy by regulating STAT3 phosphorylation[J]. Life Sci, 2023, 332, 122108.
doi: 10.1016/j.lfs.2023.122108 |
| 48 |
Coughlan MT, Ziemann M, Laskowski A, et al. Valproic acid attenuates cellular senescence in diabetic kidney disease through the inhibition of complement C5a receptors[J]. Sci Rep, 2022, 12 (1): 20278.
doi: 10.1038/s41598-022-24851-w |
| 49 |
Zheng S, Geng R, Guo J, et al. Oleuropein supplementation ameliorates long-course diabetic nephropathy and diabetic cardiomyopathy induced by advanced stage of type 2 diabetes in db/db mice[J]. Nutrients, 2024, 16 (6): 848.
doi: 10.3390/nu16060848 |
| 50 |
Fang Y, Chen B, Gong AY, et al. The ketone body β-hydroxybutyrate mitigates the senescence response of glomerular podocytes to diabetic insults[J]. Kidney Int, 2021, 100 (5): 1037- 1053.
doi: 10.1016/j.kint.2021.06.031 |
| 51 |
Abharzanjani F, Hemmati M. Protective effects of quercetin and resveratrol on aging markers in kidney under high glucose condition: in vivo and in vitro analysis[J]. Mol Biol Rep, 2021, 48 (7): 5435- 5442.
doi: 10.1007/s11033-021-06550-3 |
| 52 |
Cheng YW, Huang YC, Chang KF, et al. Protective effect of curcumin on the tight junction integrity and cellular senescence in human retinal pigment epithelium of early diabetic retinopathy[J]. J Physiol Investig, 2024, 67 (3): 107- 117.
doi: 10.4103/ejpi.EJPI-D-23-00035 |
| 53 |
Huang YC, Chen BC, Chang KF, et al. The alleviation effects of n-butylidenephthalide on apoptosis, senescence, and tight junction impairment of retinal pigment epithelium by activating Nrf-2/HO-1 signaling pathway in early diabetic retinopathy[J]. Life Sci, 2023, 327, 121815.
doi: 10.1016/j.lfs.2023.121815 |
| 54 |
Hou L, Du J, Dong Y, et al. Liraglutide prevents cellular senescence in human retinal endothelial cells (HRECs) mediated by SIRT1: an implication in diabetes retinopathy[J]. Hum Cell, 2024, 37 (3): 666- 674.
doi: 10.1007/s13577-024-01038-1 |
| 55 |
Nian S, Mi Y, Ren K, et al. The inhibitory effects of Dulaglutide on cellular senescence against high glucose in human retinal endothelial cells[J]. Hum Cell, 2022, 35 (4): 995- 1004.
doi: 10.1007/s13577-022-00703-7 |
| 56 | Zhou X, Wang L, Zhang Z, et al. Fluorometholone inhibits high glucose-induced cellular senescence in human retinal endothelial cells [J]. Hum Exp Toxicol, 2022, 41: 9603271221076107. |
| 57 |
Gericke A, Suminska-Jasińska K, Bręborowicz A. Sulodexide reduces glucose induced senescence in human retinal endothelial cells[J]. Sci Rep, 2021, 11 (1): 11532.
doi: 10.1038/s41598-021-90987-w |
| 58 |
Crespo-Garcia S, Fournier F, Diaz-Marin R, et al. Therapeutic targeting of cellular senescence in diabetic macular edema: preclinical and phase 1 trial results[J]. Nat Med, 2024, 30 (2): 443- 454.
doi: 10.1038/s41591-024-02802-4 |
| 59 |
Song J, Lee B, Kang S, et al. Agmatine ameliorates high glucose-induced neuronal cell senescence by regulating the p21 and p53 signaling[J]. Exp Neurobiol, 2016, 25 (1): 24- 32.
doi: 10.5607/en.2016.25.1.24 |
| 60 |
Zhu WW, Xiao F, Tang YY, et al. Spermidine prevents high glucose-induced senescence in HT-22 cells by upregulation of CB1 receptor[J]. Clin Exp Pharmacol Physiol, 2018, 45 (8): 832- 840.
doi: 10.1111/1440-1681.12955 |
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