{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:52:04Z","timestamp":1791597124107,"version":"4.3.4"},"reference-count":120,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Administration of Traditional Chinese Medicine","award":["zyzdxk-2023192"],"award-info":[{"award-number":["zyzdxk-2023192"]}]},{"name":"Open Research Fund Program of Yunnan Key Laboratory for Dai and Yi Medicines","award":["2024SS24018"],"award-info":[{"award-number":["2024SS24018"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>In the context of the global diabetes epidemic, diabetic nephropathy (DN)\u2014a condition directly associated with diabetes\u2014has become the primary cause of end-stage renal disease, significantly impacting patients\u2019 quality of life and placing substantial demands on public healthcare resources. The pathogenesis of DN is characterized by metabolic disturbances induced by high glucose levels, hemodynamic abnormalities, and the synergistic amplification of various stress signals. These factors collectively contribute to the progressive loss of nephrons and irreversible renal dysfunction. Although current standard treatments can partially slow disease progression, they significantly fail to meet clinical needs. Therefore, there is an urgent necessity to identify multi-target intervention strategies that utilize novel mechanisms of action. Alkaloids, a class of natural nitrogen-containing compounds known for their significant structural diversity, have recently demonstrated multiple renoprotective effects in experimental models of DN. This review is based on a search of the PubMed, Web of Science and CNKI databases. The keywords alkaloids, diabetic nephropathy, diabetic nephropathies, diabetic kidney disease, inflammation, oxidative stress, fibrosis, autophagy and apoptosis were used to search for original research articles in both Chinese and English, published between 2010 and 2026, which investigated the mechanisms by which alkaloid compounds exert their anti-DN effects. Focusing on anti-inflammatory effects, anti-oxidative stress, anti-renal fibrosis, autophagy modulation, apoptosis regulation and ferroptosis inhibition, the review then summarized the relevant literature by systematizing the experimental models, intervention protocols, dosages and key results. This provided a new theoretical perspective and experimental basis for the clinical translation and new drug development of alkaloid compounds for the treatment of DN. The review provides a new theoretical perspective and an experimental basis for the clinical translation of, and new drug development based on, alkaloid compounds for the treatment of DN.<\/jats:p>","DOI":"10.3390\/ijms27198938","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:40:17Z","timestamp":1791596417000},"page":"8938","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multi-Target Regulation of Diabetic Nephropathy by Alkaloids: Molecular Targets, Signaling Pathways and Therapeutic Potential"],"prefix":"10.3390","volume":"27","author":[{"given":"Jiying","family":"Wang","sequence":"first","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Ethnic Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Li","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Chinese Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wentao","family":"Chen","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Ethnic Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingli","family":"Zhou","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Chinese Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongyu","family":"Li","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Chinese Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Zhou","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Chinese Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shifang","family":"Luo","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Ethnic Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Chinese Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Wu","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Chinese Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhuan","family":"Xie","sequence":"additional","affiliation":[{"name":"College of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peixin","family":"Guo","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Dai and Yi Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"},{"name":"College of Ethnic Medicine, Yunnan University of Chinese Medicine, Kunming 650500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.mcna.2023.03.004","article-title":"Diabetic Kidney Disease: An Update","volume":"107","author":"Gupta","year":"2023","journal-title":"Med. Clin. North Am."},{"key":"ref_2","unstructured":"(2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. Lancet, 402, 203\u2013234. Correction in Lancet 2023, 402, 1132. Correction in Lancet 2025, 405, 202."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1053\/j.ajkd.2017.10.026","article-title":"Update on Diabetic Nephropathy: Core Curriculum 2018","volume":"71","author":"Umanath","year":"2018","journal-title":"Am. J. Kidney Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/dom.14007","article-title":"An updated overview of diabetic nephropathy: Diagnosis, prognosis, treatment goals and latest guidelines","volume":"22","author":"Selby","year":"2020","journal-title":"Diabetes Obes. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101848","DOI":"10.1016\/j.disamonth.2024.101848","article-title":"Diabetic Kidney Disease","volume":"71","author":"Gaddy","year":"2025","journal-title":"Dis. Mon."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1055\/a-2435-8264","article-title":"Diabetic Nephropathy: Pathogenesis, Mechanisms, and Therapeutic Strategies","volume":"57","author":"Dwivedi","year":"2025","journal-title":"Horm. Metab. Res."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Guo, M., He, F., and Zhang, C. (2024). Molecular Therapeutics for Diabetic Kidney Disease: An Update. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms251810051"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"F807","DOI":"10.1152\/ajprenal.00266.2015","article-title":"Twenty years after ACEIs and ARBs: Emerging treatment strategies for diabetic nephropathy","volume":"309","author":"Johnson","year":"2015","journal-title":"Am. J. Physiol. Renal Physiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"631","DOI":"10.2215\/CJN.18881220","article-title":"SGLT2 Inhibitors in Diabetic Kidney Disease","volume":"16","author":"Zoungas","year":"2021","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S165","DOI":"10.2337\/dcS15-3006","article-title":"SGLT2 Inhibitors and the Diabetic Kidney","volume":"39","author":"Fioretto","year":"2016","journal-title":"Diabetes Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/dom.13983","article-title":"Non-steroidal mineralocorticoid antagonists: Prospects for renoprotection in diabetic kidney disease","volume":"22","author":"Bakris","year":"2020","journal-title":"Diabetes Obes. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Wang, N., and Zhang, C. (2024). Recent Advances in the Management of Diabetic Kidney Disease: Slowing Progression. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25063086"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"F327","DOI":"10.1152\/ajprenal.00115.2024","article-title":"Update: The role of epigenetics in the metabolic memory of diabetic complications","volume":"327","author":"Chen","year":"2024","journal-title":"Am. J. Physiol. Renal Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Al-Masri, S., Coelho, J.N., and Thomas, L. (2026). Molecular pathways and emerging therapeutic targets in the pathogenesis of diabetic kidney disease. Front. Physiol., 17.","DOI":"10.3389\/fphys.2026.1747053"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Abdelrahman, A.M., Awad, A.S., and Abdel-Rahman, E.M. (2024). Sodium-Glucose Co-Transporter 2 Inhibitors: Mechanism of Action and Efficacy in Non-Diabetic Kidney Disease from Bench to Bed-Side. J. Clin. Med., 13.","DOI":"10.20944\/preprints202401.0901.v1"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ponikvar-Svet, M., Zeiger, D.N., and Liebman, J.F. (2021). Alkaloids and Selected Topics in Their Thermochemistry. Molecules, 26.","DOI":"10.3390\/molecules26216715"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bhambhani, S., Kondhare, K.R., and Giri, A.P. (2021). Diversity in Chemical Structures and Biological Properties of Plant Alkaloids. Molecules, 26.","DOI":"10.3390\/molecules26113374"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"869","DOI":"10.3892\/etm.2015.2585","article-title":"Renoprotective effects of berberine as adjuvant therapy for hypertensive patients with type 2 diabetes mellitus: Evaluation via biochemical markers and color Doppler ultrasonography","volume":"10","author":"Dai","year":"2015","journal-title":"Exp. Ther. Med."},{"key":"ref_19","first-page":"3756","article-title":"Effects of berberine on the serum cystatin C levels and urine albumin\/creatine ratio in patients with type 2 diabetes mellitus","volume":"98","author":"Li","year":"2018","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"ref_20","unstructured":"Zeng, F. (2020). Clinical Observation Of Sinomenine in the Treatment of Early Diabetic Kidney Disease and Its Effect on Inflammatory Cytokines Speciality: Traditional Chinese Medicine. [Master\u2019s Degree, Hubei University of Chinese Medicine]."},{"key":"ref_21","first-page":"1211","article-title":"Influence of chuanxiongqin injection on tubular function and renal interstitial fibrosis of patients with Diabetic nephropathy","volume":"20","author":"Junfeng","year":"2014","journal-title":"J. Hainan Med. Univ."},{"key":"ref_22","first-page":"1958","article-title":"Clinical Observation of Total Alkaloids from Mulberry Branches on the Treatment of Diabetes Nephropathy with Phlegm Turbid and Blood Stasis","volume":"36","author":"Yunyu","year":"2024","journal-title":"Clin. J. Tradit. Chin. Med."},{"key":"ref_23","first-page":"3969","article-title":"Expert Consensus on Screening and Prevention of Diabetic Microvascular Disease for Primary Care","volume":"27","author":"Microcirculation","year":"2024","journal-title":"Chin. Gen. Pract."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Liu, D., Zhao, L., Wang, Y., Wang, L., Wu, D., and Liu, Y. (2025). Berberine: A Rising Star in the Management of Type 2 Diabetes-Novel Insights into Its Anti-Inflammatory, Metabolic, and Epigenetic Mechanisms. Pharmaceuticals, 18.","DOI":"10.3390\/ph18121890"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"153860","DOI":"10.1016\/j.phymed.2021.153860","article-title":"Tetramethylpyrazine alleviates diabetes-induced high platelet response and endothelial adhesion via inhibiting NLRP3 inflammasome activation","volume":"96","author":"Zhang","year":"2022","journal-title":"Phytomedicine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"107356","DOI":"10.1016\/j.jddst.2025.107356","article-title":"Piperine cocrystals ameliorates type 2 diabetes by regulating glycolipid metabolism and reshaping gut microbiota in mice","volume":"113","author":"Liu","year":"2025","journal-title":"J. Drug Deliv. Sci. Technol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s40659-018-0157-8","article-title":"Berberine ameliorates diabetic nephropathy by inhibiting TLR4\/NF-\u03baB pathway","volume":"51","author":"Zhu","year":"2018","journal-title":"Biol. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.mce.2010.07.023","article-title":"Berberine attenuates lipopolysaccharide-induced extracelluar matrix accumulation and inflammation in rat mesangial cells: Involvement of NF-\u03baB signaling pathway","volume":"331","author":"Jiang","year":"2011","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Jin, X., He, T., Zhang, T., Wang, X., Chen, X., Cong, B., and Gao, W. (2025). Research on Sinomenine Inhibiting the cGAS-STING Signaling Pathway to Alleviate Renal Inflammatory Injury in db\/db Mice. Pharmaceuticals, 18.","DOI":"10.3390\/ph18070934"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1007\/s13577-022-00750-0","article-title":"Sinomenine alleviates glomerular endothelial permeability by activating the C\/EBP-\u03b1\/claudin-5 signaling pathway","volume":"35","author":"Zhang","year":"2022","journal-title":"Hum. Cell"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.lfs.2016.06.002","article-title":"Cepharanthine and Piperine ameliorate diabetic nephropathy in rats: Role of NF-\u03baB and NLRP3 inflammasome","volume":"157","author":"Samra","year":"2016","journal-title":"Life Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"990","DOI":"10.21037\/atm-20-5548","article-title":"Tetrandrine mediates renal function and redox homeostasis in a streptozotocin-induced diabetic nephropathy rat model through Nrf2\/HO-1 reactivation","volume":"8","author":"Su","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_33","first-page":"44","article-title":"Neferine inhibits the progression of diabetic nephropathy by modulating the miR-17-5p\/nuclear factor E2-related factor 2 axis","volume":"44","author":"Hongmei","year":"2024","journal-title":"J. Tradit. Chin. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"153488","DOI":"10.1016\/j.phymed.2021.153488","article-title":"Epiberberine ameliorated diabetic nephropathy by inactivating the angiotensinogen (Agt) to repress TGF\u03b2\/Smad2 pathway","volume":"83","author":"Xiao","year":"2021","journal-title":"Phytomedicine"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Chang, L., Wang, Q., Ju, J., Li, Y., Cai, Q., Hao, L., and Zhou, Y. (2020). Magnoflorine Ameliorates Inflammation and Fibrosis in Rats With Diabetic Nephropathy by Mediating the Stability of Lysine-Specific Demethylase 3A. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.580406"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"115747","DOI":"10.1016\/j.biopha.2023.115747","article-title":"Trigonelline inhibits tubular epithelial-mesenchymal transformation in diabetic kidney disease via targeting Smad7","volume":"168","author":"Gong","year":"2023","journal-title":"Biomed. Pharmacother."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13098-022-00798-w","article-title":"Trigonelline reverses high glucose-induced proliferation, fibrosis of mesangial cells via modulation of Wnt signaling pathway","volume":"14","author":"Chen","year":"2022","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"117499","DOI":"10.1016\/j.biopha.2024.117499","article-title":"Rutaecarpine alleviates inflammation and fibrosis by targeting CK2\u03b1 in diabetic nephropathy","volume":"180","author":"Chen","year":"2024","journal-title":"Biomed. Pharmacother."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"178549","DOI":"10.1016\/j.ejphar.2026.178549","article-title":"Hirsutine attenuates renal injury in diabetic kidney disease by regulating Th17 cell differentiation via the TGF\u03b2\/SMAD Pathway","volume":"1015","author":"Pei","year":"2026","journal-title":"Eur. J. Pharmacol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"152362","DOI":"10.1016\/j.bbrc.2025.152362","article-title":"Chelerythrine ameliorates renal injury in diabetic nephropathy rats by enhancing autophagy and modulating AMPK\/mTOR signaling with concurrent anti-inflammatory and anti-fibrotic actions","volume":"778","author":"Cui","year":"2025","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"172763","DOI":"10.1016\/j.ejphar.2019.172763","article-title":"Tetramethylpyrazine alleviates diabetic nephropathy through the activation of Akt signalling pathway in rats","volume":"865","author":"Rai","year":"2019","journal-title":"Eur. J. Pharmacol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"111954","DOI":"10.1016\/j.intimp.2024.111954","article-title":"Harmine alleviated STZ-induced rat diabetic nephropathy: A potential role via regulating AMPK\/Nrf2 pathway and deactivating ataxia-telangiectasia mutated (ATM) signaling","volume":"132","author":"Tabaa","year":"2024","journal-title":"Int. Immunopharmacol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Yu, X., Li, Y., Zhang, Y., Yin, K., Chen, X., and Zhu, X. (2024). Leonurine Ameliorates Diabetic Nephropathy through GPX4-Mediated Ferroptosis of Endothelial Cells. Front. Biosci. Landmark, 29.","DOI":"10.31083\/j.fbl2907270"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"431","DOI":"10.4239\/wjd.v5.i4.431","article-title":"Inflammation in diabetic kidney disease","volume":"5","year":"2014","journal-title":"World J. Diabetes"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Zhang, R.M., and Caramori, M.L. (2026). Inflammation and Diabetic Kidney Disease. Int. J. Mol. Sci., 27.","DOI":"10.3390\/ijms27021097"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.cytogfr.2025.05.007","article-title":"Exploring inflammatory and fibrotic mechanisms driving diabetic nephropathy progression","volume":"84","author":"Ansari","year":"2025","journal-title":"Cytokine Growth Factor Rev."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"116525","DOI":"10.1016\/j.intimp.2026.116525","article-title":"Taurine attenuates diabetic nephropathy by suppressing the HMGB1\/TLR4\/MyD88\/NF-\u03baB axis in mice","volume":"177","author":"Lin","year":"2026","journal-title":"Int. Immunopharmacol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"31478","DOI":"10.1038\/s41598-025-07066-7","article-title":"Capilliposide A attenuates diabetic nephropathy via modulation of NF-\u03baB\/TLR4 and apoptotic pathways","volume":"15","author":"Man","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"157030","DOI":"10.1016\/j.phymed.2025.157030","article-title":"Multiple target and regulatory pathways of berberine","volume":"146","author":"Zhou","year":"2025","journal-title":"Phytomedicine"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"117880","DOI":"10.1016\/j.bmc.2024.117880","article-title":"Current development and structure-activity relationship study of berberine derivatives","volume":"112","author":"Luo","year":"2024","journal-title":"Bioorg. Med. Chem."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1007\/s11033-026-11967-9","article-title":"Berberine and its structural diversity: Structure-activity relationships, molecular mechanisms, and drug discovery opportunities","volume":"53","author":"Albukhari","year":"2026","journal-title":"Mol. Biol. Rep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"6246","DOI":"10.2174\/0109298673323738240830055548","article-title":"Research, Development and Pharmacological Activity of Sinomenine and Its Derivatives","volume":"32","author":"Zong","year":"2025","journal-title":"Curr. Med. Chem."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"906","DOI":"10.2174\/1389557517666171123212557","article-title":"A Systematic Review on the Sinomenine Derivatives","volume":"18","author":"Tang","year":"2018","journal-title":"Mini Rev. Med. Chem."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Cescato, M., Zhu, Y.Y.J., Le Corre, L., Py, B.F., Georgin-Lavialle, S., and Rodero, M.P. (2024). Implication of the LRR Domain in the Regulation and Activation of the NLRP3 Inflammasome. Cells, 13.","DOI":"10.3390\/cells13161365"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1038\/s12276-026-01656-9","article-title":"Molecular mechanisms of NLRP3 inflammasome activation","volume":"58","author":"Shin","year":"2026","journal-title":"Exp. Mol. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1038\/s42003-026-10207-x","article-title":"Sensing the spectrum: Diverse stimuli for the NLRP3 inflammasome","volume":"9","author":"Xiao","year":"2026","journal-title":"Commun. Biol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Jin, J., and Zhang, M. (2024). Exploring the role of NLRP3 inflammasome in diabetic nephropathy and the advancements in herbal therapeutics. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1397301"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1007\/s11033-025-11116-8","article-title":"The NLRP3 inflammasome: A pivotal orchestrator of multisystem diseases-from molecular mechanisms to therapeutic innovation","volume":"52","author":"Xiao","year":"2025","journal-title":"Mol. Biol. Rep."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/bs.ai.2017.02.002","article-title":"A Mechanistic Understanding of Pyroptosis: The Fiery Death Triggered by Invasive Infection","volume":"135","author":"Liu","year":"2017","journal-title":"Adv. Immunol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Ortega, M.A., De Leon-Oliva, D., Garc\u00eda-Montero, C., Fraile-Martinez, O., Boaru, D.L., de Castro, A.V., Saez, M.A., Lopez-Gonzalez, L., Bujan, J., and Alvarez-Mon, M.A. (2023). Reframing the link between metabolism and NLRP3 inflammasome: Therapeutic opportunities. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1232629"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"292","DOI":"10.3892\/mmr.2025.13657","article-title":"Role of the NLRP3 inflammasome in diabetes and its complications (Review)","volume":"32","author":"Jiao","year":"2025","journal-title":"Mol. Med. Rep."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"8399","DOI":"10.2147\/JIR.S524246","article-title":"NLRP3 Inflammasome-Mediated Pyroptosis in Diabetic Nephropathy: Pathogenic Mechanisms and Therapeutic Targets","volume":"18","author":"Chen","year":"2025","journal-title":"J. Inflamm. Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"116356","DOI":"10.1016\/j.intimp.2026.116356","article-title":"Cepharanthine protects against lipopolysaccharide-induced acute lung injury in mice by blocking NLRP3 inflammasome activation","volume":"174","author":"Wang","year":"2026","journal-title":"Int. Immunopharmacol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"116935","DOI":"10.1016\/j.intimp.2026.116935","article-title":"Cepharanthine inhibits NLRP3 inflammasome-induced pyroptosis through ARIH2-mediated degradation of NLRP3","volume":"184","author":"Wang","year":"2026","journal-title":"Int. Immunopharmacol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1002\/ptr.6855","article-title":"Piperine: A review of its biological effects","volume":"35","author":"Haq","year":"2021","journal-title":"Phytother. Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"158448","DOI":"10.1016\/j.phymed.2026.158448","article-title":"Piperine inhibits NLRP3 inflammasome activation and alleviates inflammatory disease","volume":"159","author":"Guo","year":"2026","journal-title":"Phytomedicine"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"101558","DOI":"10.1016\/j.jpha.2026.101558","article-title":"Targeting posttranslational modifications of oxidative stress pathways for the treatment of diabetic nephropathy","volume":"16","author":"Zhou","year":"2026","journal-title":"J. Pharm. Anal."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Liu, X., Zhang, C., Fu, Y., Xie, L., Kong, Y., and Yang, X. (2025). Inflammation, Apoptosis, and Fibrosis in Diabetic Nephropathy: Molecular Crosstalk in Proximal Tubular Epithelial Cells and Therapeutic Implications. Curr. Issues Mol. Biol., 47.","DOI":"10.3390\/cimb47110885"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"166714","DOI":"10.1016\/j.bbadis.2023.166714","article-title":"Nrf2 signaling in diabetic nephropathy, cardiomyopathy and neuropathy: Therapeutic targeting, challenges and future prospective","volume":"1869","author":"Hashemi","year":"2023","journal-title":"Biochim. Biophys. Acta Mol. Basis Dis."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Huang, W., Zhong, Y., Gao, B., Zheng, B., and Liu, Y. (2023). Nrf2-mediated therapeutic effects of dietary flavones in different diseases. Front. Pharmacol., 14.","DOI":"10.3389\/fphar.2023.1240433"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"109732","DOI":"10.1016\/j.biopha.2019.109732","article-title":"Keap1\/Nrf2\/ARE signaling unfolds therapeutic targets for redox imbalanced-mediated diseases and diabetic nephropathy","volume":"123","author":"Adelusi","year":"2020","journal-title":"Biomed. Pharmacother."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Tanase, D.M., Gosav, E.M., Anton, M.I., Floria, M., Seritean Isac, P.N., Hurjui, L.L., Tarniceriu, C.C., Costea, C.F., Ciocoiu, M., and Rezus, C. (2022). Oxidative Stress and NRF2\/KEAP1\/ARE Pathway in Diabetic Kidney Disease (DKD): New Perspectives. Biomolecules, 12.","DOI":"10.3390\/biom12091227"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"152464","DOI":"10.1016\/j.bbrc.2025.152464","article-title":"Integrated network pharmacology, molecular docking and pharmacodynamic studies reveal protective effects and mechanisms of tetrandrine against sepsis-induced acute lung injury","volume":"779","author":"Wang","year":"2025","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"13539","DOI":"10.3892\/mmr.2025.13539","article-title":"Action and mechanisms of neferine in inflammatory diseases (Review)","volume":"32","author":"Zhang","year":"2025","journal-title":"Mol. Med. Rep."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Sinha, S.K., and Nicholas, S.B. (2023). Pathomechanisms of Diabetic Kidney Disease. J. Clin. Med., 12.","DOI":"10.3390\/jcm12237349"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Chen, F., Lyu, L., Xing, C., Chen, Y., Hu, S., Wang, M., and Ai, Z. (2025). The pivotal role of TGF-\u03b2\/Smad pathway in fibrosis pathogenesis and treatment. Front. Oncol., 15.","DOI":"10.3389\/fonc.2025.1649179"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Yu, X.Y., Sun, Q., Zhang, Y.M., Zou, L., and Zhao, Y.Y. (2022). TGF-\u03b2\/Smad Signaling Pathway in Tubulointerstitial Fibrosis. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.860588"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.cbi.2018.07.008","article-title":"New insights into TGF-\u03b2\/Smad signaling in tissue fibrosis","volume":"292","author":"Hu","year":"2018","journal-title":"Chem. Biol. Interact."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.7150\/ijbs.7.1056","article-title":"Diverse roles of TGF-\u03b2\/Smads in renal fibrosis and inflammation","volume":"7","author":"Lan","year":"2011","journal-title":"Int. J. Biol. Sci."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/j.biopha.2018.02.090","article-title":"Central role of dysregulation of TGF-\u03b2\/Smad in CKD progression and potential targets of its treatment","volume":"101","author":"Chen","year":"2018","journal-title":"Biomed. Pharmacother."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"116996","DOI":"10.1016\/j.bcp.2025.116996","article-title":"HDAC6 is involved in diabetic nephropathy by regulating TGF\u03b2\/Smads and NF-\u03baB signaling pathways","volume":"239","author":"Li","year":"2025","journal-title":"Biochem. Pharmacol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"109081","DOI":"10.1016\/j.intimp.2022.109081","article-title":"Magnoflorine from Tinospora crispa upregulates innate and adaptive immune responses in Balb\/c mice","volume":"111","author":"Ahmad","year":"2022","journal-title":"Int. Immunopharmacol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"104632","DOI":"10.1016\/j.phrs.2020.104632","article-title":"Magnoflorine: A review of its pharmacology, pharmacokinetics and toxicity","volume":"152","author":"Xu","year":"2020","journal-title":"Pharmacol. Res."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Nguyen, V., Taine, E.G., Meng, D., Cui, T., and Tan, W. (2024). Pharmacological Activities, Therapeutic Effects, and Mechanistic Actions of Trigonelline. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25063385"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.phrs.2018.12.019","article-title":"Rutaecarpine: A promising cardiovascular protective alkaloid from Evodia rutaecarpa (Wu Zhu Yu)","volume":"141","author":"Tian","year":"2019","journal-title":"Pharmacol. Res."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Bhuia, M.S., Wilairatana, P., Ferdous, J., Chowdhury, R., Bappi, M.H., Rahman, M.A., Mubarak, M.S., and Islam, M.T. (2023). Hirsutine, an Emerging Natural Product with Promising Therapeutic Benefits: A Systematic Review. Molecules, 28.","DOI":"10.3390\/molecules28166141"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Han, Y.P., Liu, L.J., Yan, J.L., Chen, M.Y., Meng, X.F., Zhou, X.R., and Qian, L.B. (2023). Autophagy and its therapeutic potential in diabetic nephropathy. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1139444"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s00018-017-2639-1","article-title":"Autophagy in diabetic kidney disease: Regulation, pathological role and therapeutic potential","volume":"75","author":"Yang","year":"2018","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.1007\/s13300-024-01641-3","article-title":"Targeting Autophagy: A Promising Therapeutic Strategy for Diabetes Mellitus and Diabetic Nephropathy","volume":"15","author":"Li","year":"2024","journal-title":"Diabetes Ther."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"5207","DOI":"10.2174\/0929867325666180406120051","article-title":"Targeting AMPK in Diabetes and Diabetic Complications: Energy Homeostasis, Autophagy and Mitochondrial Health","volume":"26","author":"Madhavi","year":"2019","journal-title":"Curr. Med. Chem."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.krcp.2016.02.004","article-title":"Adenosine monophosphate-activated protein kinase in diabetic nephropathy","volume":"35","author":"Kim","year":"2016","journal-title":"Kidney Res. Clin. Pract."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Wang, Y., Liu, Z., Shu, S., Cai, J., Tang, C., and Dong, Z. (2020). AMPK\/mTOR Signaling in Autophagy Regulation During Cisplatin-Induced Acute Kidney Injury. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.619730"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Gonzalez, C.D., Carro Negueruela, M.P., Nicora Santamarina, C., Resnik, R., and Vaccaro, M.I. (2021). Autophagy Dysregulation in Diabetic Kidney Disease: From Pathophysiology to Pharmacological Interventions. Cells, 10.","DOI":"10.3390\/cells10092497"},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Dusabimana, T., Park, E.J., Je, J., Jeong, K., Yun, S.P., Kim, H.J., Kim, H., and Park, S.W. (2021). Geniposide Improves Diabetic Nephropathy by Enhancing ULK1-Mediated Autophagy and Reducing Oxidative Stress through AMPK Activation. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22041651"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s11892-017-0879-y","article-title":"Regulating Autophagy as a Therapeutic Target for Diabetic Nephropathy","volume":"17","author":"Kitada","year":"2017","journal-title":"Curr. Diabetes Rep."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Li, L., Zou, J., Zhou, T., Liu, X., Tan, D., Xiang, Q., and Yu, R. (2025). mTOR-mediated nutrient sensing and oxidative stress pathways regulate autophagy: A key mechanism for traditional Chinese medicine to improve diabetic kidney disease. Front. Pharmacol., 16.","DOI":"10.3389\/fphar.2025.1578400"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"He, Y., Fan, T., Zhuge, R., Li, H., Li, G., Zhou, L., Xu, L., Hao, X., Gu, W., and Wang, J. (2025). Chelerythrine Chloride Alleviated Lipopolysaccharide-Induced Acute Lung Injury by Inhibiting Glycolytic Pathway Through Targeting Glyceraldehyde-3-Phosphate Dehydrogenase. Molecules, 30.","DOI":"10.3390\/molecules30122572"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e3596","DOI":"10.1002\/dmrr.3596","article-title":"Role of renal tubular programed cell death in diabetic kidney disease","volume":"39","author":"Zhou","year":"2023","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Vringer, E., and Tait, S.W.G. (2019). Mitochondria and Inflammation: Cell Death Heats Up. Front. Cell Dev. Biol., 7.","DOI":"10.3389\/fcell.2019.00100"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1038\/s41418-022-01094-w","article-title":"Mitochondria and cell death-associated inflammation","volume":"30","author":"Vringer","year":"2023","journal-title":"Cell Death Differ."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"e937766","DOI":"10.12659\/MSM.937766","article-title":"Programmed Cell Death in Diabetic Nephropathy: A Review of Apoptosis, Autophagy, and Necroptosis","volume":"28","author":"Erekat","year":"2022","journal-title":"Med. Sci. Monit."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"113005","DOI":"10.1016\/j.biopha.2022.113005","article-title":"Tetramethylpyrazine: A review on its mechanisms and functions","volume":"150","author":"Lin","year":"2022","journal-title":"Biomed. Pharmacother."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1007\/s12272-020-01283-6","article-title":"Pharmacological effects of harmine and its derivatives: A review","volume":"43","author":"Zhang","year":"2020","journal-title":"Arch. Pharm. Res."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Wei, M., Liu, X., Tan, Z., Tian, X., Li, M., and Wei, J. (2023). Ferroptosis: A new strategy for Chinese herbal medicine treatment of diabetic nephropathy. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1188003"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"2346543","DOI":"10.1080\/07853890.2024.2346543","article-title":"Targeting ferroptosis as a prospective therapeutic approach for diabetic nephropathy","volume":"56","author":"Wu","year":"2024","journal-title":"Ann. Med."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"173574","DOI":"10.1016\/j.ejphar.2020.173574","article-title":"Ferroptosis involves in renal tubular cell death in diabetic nephropathy","volume":"888","author":"Wang","year":"2020","journal-title":"Eur. J. Pharmacol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1038\/s41419-021-03452-x","article-title":"Characterization of ferroptosis in kidney tubular cell death under diabetic conditions","volume":"12","author":"Kim","year":"2021","journal-title":"Cell Death Dis."},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Liu, S., Sun, C., Tang, H., Peng, C., and Peng, F. (2024). Leonurine: A comprehensive review of pharmacokinetics, pharmacodynamics, and toxicology. Front. Pharmacol., 15.","DOI":"10.3389\/fphar.2024.1428406"},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Xie, K., Ma, Y., Din, J., Jin, Y., Zhang, S., Liu, S., Yu, C., Wu, X., Xing, C., and Wang, L. (2025). Research and advances in mouse models of diabetic nephropathy: A narrative review. BMC Nephrol., 26.","DOI":"10.1186\/s12882-025-04432-5"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1159\/000363300","article-title":"Recent advances in animal models of diabetic nephropathy","volume":"126","author":"Betz","year":"2014","journal-title":"Nephron Exp. Nephrol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1080\/17425255.2023.2203857","article-title":"Approaching strategy to increase the oral bioavailability of berberine, a quaternary ammonium isoquinoline alkaloid: Part 1. Physicochemical and pharmacokinetic properties","volume":"19","author":"Murakami","year":"2023","journal-title":"Expert Opin. Drug Metab. Toxicol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1080\/17425255.2023.2203858","article-title":"Approaching strategy to increase the oral bioavailability of berberine, a quaternary ammonium isoquinoline alkaloid: Part 2. development of oral dosage formulations","volume":"19","author":"Murakami","year":"2023","journal-title":"Expert Opin. Drug Metab. Toxicol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"118112","DOI":"10.1016\/j.carbpol.2021.118112","article-title":"Brij-functionalized chitosan nanocarrier system enhances the intestinal permeability of P-glycoprotein substrate-like drugs","volume":"266","author":"Xiong","year":"2021","journal-title":"Carbohydr. Polym."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"9092","DOI":"10.1039\/D4RA08718F","article-title":"Cortistatin and plakinamine steroidal alkaloids from the marine sponges of the genus Corticium: Insights into their chemistry, pharmacology, pharmacokinetics and structure activity relationships (SARs)","volume":"15","author":"Tammam","year":"2025","journal-title":"RSC Adv."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"115031","DOI":"10.1016\/j.ejmech.2022.115031","article-title":"Natural product evodiamine-inspired medicinal chemistry: Anticancer activity, structural optimization and structure-activity relationship","volume":"247","author":"Wang","year":"2023","journal-title":"Eur. J. Med. Chem."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"9843","DOI":"10.2147\/IJN.S459510","article-title":"Evodiamine: A Extremely Potential Drug Development Candidate of Alkaloids from Evodia rutaecarpa","volume":"19","author":"Lin","year":"2024","journal-title":"Int. J. Nanomed."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1517\/13543776.2016.1118060","article-title":"Pharmacological effects of berberine and its derivatives: A patent update","volume":"26","author":"Jin","year":"2016","journal-title":"Expert Opin. Ther. Pat."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jchromb.2016.07.038","article-title":"Pharmacokinetic studies of novel berberine derivatives with ultra-performance liquid chromatography-tandem mass spectrometry","volume":"1031","author":"Wang","year":"2016","journal-title":"J. Chromatogr. B Anal. Technol. Biomed. Life Sci."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1007\/s11095-025-03920-5","article-title":"Metabolic Insights into Drug Absorption: Unveiling Piperine\u2019s Transformative Bioenhancing Potential","volume":"42","author":"Tripathi","year":"2025","journal-title":"Pharm. Res."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Balewski, \u0141., and Kornicka, A. (2025). Recent Advances in Synthetic Isoquinoline-Based Derivatives in Drug Design. Molecules, 30.","DOI":"10.3390\/molecules30244760"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/19\/8938\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:47:52Z","timestamp":1791596872000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/19\/8938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":120,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["ijms27198938"],"URL":"https:\/\/doi.org\/10.3390\/ijms27198938","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]}}}