Diabetic nephropathy (DN) is one of the most serious chronic kidney diseases and the major cause of end-stage renal failure worldwide. The underlying mechanisms of DN are complex and required to be further investigated. Both innate immunity and renin-angiotensin system (RAS) play critical roles in the pathogenesis of DN. Except for traditional functions, abnormally regulated RAS has been proved to be involved in the inflammatory process of DN. Toll-like receptor 4 (TLR4) is the most deeply studied pattern recognition receptor in the innate immune system, and its activation has been reported to mediate the development of DN. In this review, we aim at discussing how dysregulated RAS affects TLR4 activation in the kidney that contributes to the exploration of the pathogenesis of DN. Understanding the interplay of RAS and TLR4 in inducing the progression of DN may provide new insights to develop effective treatments.

中文翻译：

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肾素-血管紧张素系统与Toll样受体4在糖尿病肾病炎症中的相互作用。

糖尿病肾病（DN）是世界上最严重的慢性肾脏疾病之一，也是终末期肾衰竭的主要原因。DN的潜在机制很复杂，需要进一步研究。先天免疫和肾素-血管紧张素系统（RAS）在DN的发病机理中都起着关键作用。除传统功能外，异常调节的RAS已被证明与DN的炎症过程有关。Toll样受体4（TLR4）是先天免疫系统中最深入研究的模式识别受体，据报道其激活介导DN的发展。在这篇综述中，我们旨在讨论失调的RAS如何影响肾脏中TLR4的活化，从而有助于探索DN的发病机理。