REVIEW article
Front. Immunol.
Sec. Inflammation
Unveiling the Immune Microenvironment in Diabetic Nephropathy: From Mechanisms to Therapeutics
Tao Jiang 1,2
Ran Chen 1,2
Jianying Chang 2
jiajia Duan 1,2
Yanqiu Wang 1,2
Yuhan Sun 1,2
Xiaowan Chen 1,2
Yujin Ma 1,2
Liwen Zhang 2,1
Hongwei Jiang 2
Hetao Chen 1,2
1. Medical College, Henan University of Science and Technology, Luoyang, China
2. The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
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Abstract
Diabetic nephropathy (DN) is one of the most common microvascular complications of diabetes and is the primary cause of end-stage renal disease, imposing a significant burden on patients' health, the medical and economic systems. The traditional view holds that the pathogenesis of DN is mainly related to metabolic disorders caused by hyperglycemia, genetic susceptibility, and abnormal hemorheology. However, with the deep integration of immunology and nephrology research, more and more evidence indicates that immune factors play a core role in its pathogenesis. The renal immune microenvironment is a network composed of immune cells, cytokines, and matrix components, which promotes the progression of the disease through continuous inflammation, immune cell infiltration, and imbalanced homeostasis. This study systematically reviews the core mechanisms of the immune microenvironment in the occurrence and development of DN, focusing on the interaction between immune cells and innate renal cells, as well as the regulatory roles of the intestinal microbiota and immune axes. We also summarize possible diagnostic markers and treatment strategies related to immunity, aiming to provide new ideas for precision medicine of DN.
Summary
Keywords
diabetic nephropathy, Fibrosis, gut-kidney axis, immune microenvironment, Macrophage polarization
Received
20 November 2025
Accepted
17 February 2026
Copyright
© 2026 Jiang, Chen, Chang, Duan, Wang, Sun, Chen, Ma, Zhang, Jiang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Hongwei Jiang; Hetao Chen
Disclaimer
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