Diabetes mellitus (DM) is an outcome of an absolute or relative deficiency of insulin which may be due to autoimmune destruction. It is mainly characterised by hyperglycemia, causes auto-oxidation of glucose, glycation of proteins and activation of polyol mechanism. This leads to oxidative stress, defined as an increase in the intracellular level of reactive oxygen species (ROS). Overproduction of ROS contributes to several microvascular and macrovascular complications of DM including diabetic nephropathy (DN). DN is a primary cause of chronic kidney disease and end-stage renal failure in various parts of the world. Minimizing the risk factors associated with DN is insufficient in lowering the vulnerability of this disorder. Henceforth, an increased knowledge on the role of oxidative stress would lead the way to the exploration of a number of molecules having antioxidant property as therapeutic option. These agents could reduce the severity of DN by decreasing the level of ROS and modulating an array of signalling cascade, thereby ameliorating oxidative stress via its antioxidative and immunomodulatory properties. This review provides valuable information concerning the recent advancements in understanding the role of well-known therapeutic agents in alleviating oxidative stress induced renovascular complications in DM. This review also encompasses the role of different natural products on their effect on the T-cell driven immune response in autoimmune diabetic nephropathy.
Namrata Agarwal, Pritam Sadhukhan, Sukanya Saha and Parames C Sil
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