Globally, diabetes mellitus (DM) affects more than 450 million people, a number poised to rise above 700 million by 2045. Microvascular changes often occur in DM patients, leading to diabetic kidney disease (DKD), a consequence of hyperglycemia. Previously, DKD’s diagnosis relied on the presence of microalbuminuria. Without early intervention, approximately 50% of patients with DKD progress to macroalbuminuria - a status associated with a tenfold increased risk of progressing to end-stage renal disease (ESRD). Therefore, halting the development of DKD is of tremendous importance to DM patients.

Gut microbiota dysregulation and associated metabolites have been implicated in DM and its complications. The notion of a 'gut-kidney' axis has garnered significant attention in kidney disease pathogenesis, notably in the realm of gut-originated uremic toxins such as urea nitrogen (Scr), indoxyl sulfate (IS), phenyl sulfate (PS), and trimethylamine-N-oxide (TMAO). These uremic toxins—products of proteolytic fermentation in a typical gut microbial disorder environment in DM patients—inhibit endothelial cell repair, cause direct vascular injury, and increase the risk of vascular complications.
The early screening, diagnosis, and treatment of DKD are critical for delaying the onset of ESRD. Consequently, the quest for superior biomarkers for early DKD diagnosis is increasingly essential. We urgently need to further investigate DKD's pathogenesis and find effective, safe therapeutic approaches, which hold significant clinical implications for preventing and treating DKD.

Gut microbiota and gut-derived uremic toxins play important roles in the development and progression of DKD. Key objectives for DKD prevention include regulating gut microbiota, effectively reducing or inhibiting the production of uremic toxins, and halting its transport and action pathways.
The systematic integration of multi-omics data to examine the clinical pathogenesis of diseases aids in identifying disease targets and discovering biomarkers. Utilizing multi-omics methods to clarify biomarkers, exploring the mechanisms of biomarker synthesis and transport, and identifying key signaling pathways are especially beneficial for applying preventative and therapeutic measures for DKD.

This research topic will primarily delve into the genetic and molecular mechanisms underpinning susceptibility to diabetic nephropathy through the lens of multi-omics techniques - including microbiome and metabolomics. In conjunction, we will use bioinformatics, biochemistry, cell biology, experimental animal models, and clinical research methods to illuminate the pathogenesis, action principles, and drug intervention methods, laying the foundation for diagnosing and treating DKD.
We cordially invite authors to submit manuscripts, including original research papers, reviews, and perspectives, to be part of this research topic. The aim should be to:
• Enhance understanding of mechanisms and novel molecular and cellular pathways mediating the therapeutic actions of herbal medicine
• Investigate the pharmacological roles of herbal medicine in treating complications of DKD, such as anemia and iron deficiency
• Identify active metabolites in herbal medicine for treating DKD
• Evaluate potential toxic effects of herbal medicine in treating DKD
• Investigate multi-omics technologies and their application in immunotherapy for DKD
• Uncover new biomarkers, pathways, and targets for DKD derived from multi-omics data
• Examine the integration of multi-omics data with clinical data to enhance patient outcomes
• Explore 'Big Data' applications in the prevention and treatment of DKD.

All the manuscripts submitted to this project will be peer-reviewed and need to fully comply with the Four Pillars of Best Practice in Ethnopharmacology Four Pillars of Best Practice in Ethnopharmacology (you can freely download the full version here). Importantly, please ascertain that the ethnopharmacological context is clearly described (pillar 3d) and that the material investigated is characterized in detail (pillars 2 a and b).

Submit your idea

Impact

Frontiers in Pharmacology

Submit your idea

Impact