Diabetic kidney disease remains a significant complication of diabetes mellitus, contributing to considerable morbidity and mortality globally. Despite advancements in treatment, the management of DKD remains challenging, necessitating the exploration of novel therapeutic approaches. Recently, there has been a surge of interest in targeting macrophages, key immune cells implicated in the pathogenesis of DKD, as a promising avenue for intervention. This review provides an overview of the role of macrophages in DKD and discusses emerging therapeutic strategies aimed at modulating their function to mitigate renal damage and improve patient outcomes. Macrophages play a pivotal role in DKD pathogenesis by promoting inflammation, fibrosis, and tissue injury within the kidney. Therapeutic approaches targeting macrophages encompass modulation of macrophage recruitment, polarization, and function. Inhibition of chemotactic signals and promotion of anti-inflammatory M2 polarization have shown promise in preclinical models of DKD. Additionally, advancements in drug delivery technologies, such as nanoparticle-based systems, enable targeted delivery of therapeutic agents to macrophages within the kidney, enhancing therapeutic efficacy while minimizing off-target effects. Cell-based therapies, particularly mesenchymal stem cell transplantation, offer a potential avenue for modulating macrophage activity and promoting tissue repair in DKD. However, several challenges, including precise targeting of macrophages, optimization of drug delivery, and identification of biomarkers for treatment monitoring, need to be addressed. Despite these challenges, targeting macrophages holds significant promise as a therapeutic strategy for DKD, offering the potential to attenuate inflammation, fibrosis, and renal injury. Continued research efforts are essential for translating these findings into clinical practice and improving outcomes for patients with DKD.
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Journal of Nephrology & Therapeutics received 784 citations as per Google Scholar report
