Diabetes mellitus (DM) is a group of
metabolic diseases caused by absolute or relative deficiency of insulin secretion and characterized by chronic
hyperglycemia. Its complications affect almost every tissue of the body, usually leading to
blindness,
renal failure,
amputation, etc. and in the final stage, it mostly develops into
cardiac failure, which is the main reason why
diabetes mellitus manifests itself as a high clinical lethality. The pathogenesis of
diabetes mellitus and its complications involves various
pathological processes including excessive production of mitochondrial
reactive oxygen species (ROS) and metabolic imbalance.
Hypoxia-inducible Factor (HIF) signaling pathway plays an important role in both of the above processes.
Roxadustat is an activator of
Hypoxia-inducible Factor-1α, which increases the transcriptional activity of
Hypoxia-inducible Factor-1α by inhibiting
hypoxia-inducible factor
prolyl hydroxylase (HIF-PHD).
Roxadustat showed regulatory effects on maintaining metabolic stability in the hypoxic state of the body by activating many downstream signaling pathways such as
vascular endothelial growth factor (
VEGF),
glucose transporter protein-1 (GLUT1),
lactate dehydrogenase (LDHA), etc. This review summarizes the current research findings of
roxadustat on the diseases of
cardiomyopathy, nephropathy,
retinal damage and impaired wound healing, which also occur at different stages of diabetes and greatly contribute to the damage caused by diabetes to the organism. We attempts to uncover a more comprehensive picture of the
therapeutic effects of
roxadustat, and inform its expanding research about
diabetic complications treatment.