L-ergothioneine; a potential adjuvant in the management of diabetic nephropathy

Abstract

Diabetic Nephropathy (DN), a leading cause of end-stage renal damage (ESRD), is associated with increased oxidative stress and renal inflammation caused by chronic hyperglycemia. Giant strides over the past decades have broadened our understanding of the pathogenesis of DN. Nevertheless, there is no effective overall treatment for this complication, and patients still present with symptoms despite the conventional treatment regimen. Therefore, the search for effective therapeutic strategies to manage DN has been an active area of research. Recently, combination therapies have shown better efficacy than prolonged monotherapy, allowing patients to achieve glycemic control and mitigate pathogenic risk factors of DN. These combination regimens usually comprise of an adjuvant (including synthetic drugs or nutraceuticals), which may improve the efficacy of conventional therapies to prevent microalbuminuria, reduce the progression of nephropathy and adverse effects. Several nutraceuticals (including L-ergothioneine) have been identified as valuable adjuvant, owing to their numerous bioactivities, accessibility, and safety. L-Ergothioneine (L-egt), a natural compound obtained from dietary sources (including mushroom, beans), has been approved to be used as a supplement. L-egt has received much attention owing to the identification of its specific transporter (OCTN) in the body, its antioxidant, anti-inflammatory, and cytoprotective effects in tissues exposed to injury. Also, supplementation of L-egt with other pharmacological agents has been associated with improved treatment outcomes in different disease models. Therefore, this article highlights the potential benefits of L-ergothioneine in managing renal complications associated with diabetes.

Keywords

• L-ergothioneine
• Diabetes
• nutraceuticals
• Kidney
• Oxidative stress