Role of SIRT-1 as a target for treatment and prevention of Diabetic Nephropathy: A Review.

Type-2 diabetes mellitus is a prime factor for the development of Diabetic Nephropathy (DN) that affects the vital organ, namely the kidneys, and further alters the functions of the nephron system. DN is becoming a challenge for scientists worldwide because of its high pervasiveness and complex medication. Various risk factors are involved in the initiation of pathogenic DN, which are associated with different pathways against drug activity. Due to this, DN becomes an unpredictable query for the researchers. SIRT1, a silent information regulator factor 2 related enzyme 1 (SIRT1), is nicotinamide adenine dinucleotide (NAD+) dependent deacetylase that functions as an intracellular regulator of transcriptional activity. An activated version of SIRT-1 improves the diseased metabolic conditions associated with other molecular pathways. SIRT1 attenuates diabetic nephropathy in in vitro and in vivo experimental models of diabetes containing podocytes, mesangial cells, and renal proximal tubular cells. SIRT1 shows nephroprotective effects in DN through deacetylation of transcription factors, i.e., in the disease, like p53, PTP1B, FOXO, RelA, NF- kβ, STAT-3, and PGC-1α/ PPARγ. It has been shown that some natural products like resveratrol and synthetic compounds activate the SIRT1, further involving the cascade pathways to prevent DN. This review will help regarding the effectiveness of SIRT1 as a target in the prevention and treatment of DN.