Chinese Herbal Medicine in Ameliorating Diabetic Kidney Disease via Activating Autophagy

Figure 2

The process and regulatory mechanisms of autophagy during healthy conditions and DKD. The process of autophagy involves five steps: formation of phagophore, phagophore elongation, appearance of autophagosome, formation of autolysosome, and degradation. Under normal conditions, activity of autophagy is kept at a higher level in order to maintain cellular homeostasis via the clearance, degradation, and recycling of cytoplasmic long-lived proteins and damaged organelles. Under diabetic conditions, high glucose leads to a marked suppression of autophagy activity mainly through nutrient-sensing pathways including mTOR, AMPK, and Sirt1, resulting in aberrant protein degradation and may contribute to the pathogenesis of DKD.