Pathogenic Impact of VEGF-A/VEGFR-2 Downregulation in Diabetic Microangiopathy: A Systematic Review of Renal and Neurocognitive Outcomes
DOI:
https://doi.org/10.69980/ajpr.v28i5.562Keywords:
Diabetic nephropathy, VEGF-A, VEGFR-2, glomerular endothelial dysfunction, podocyte-endothelial interaction, angiogenic imbalance, capillary rarefaction, renal microvasculature, proteinuria, precision nephrology, Diabetic Nephropathy, Cognitive Decline, Endothelial Dysfunction.Abstract
Diabetic nephropathy (DN) constitutes a leading cause of end-stage renal disease (ESRD) globally, with vascular endothelial growth factor A (VEGF-A) and its primary receptor VEGFR-2 playing central roles in glomerular endothelial homeostasis. Despite the pro-angiogenic roles of VEGF-A in maintaining microvascular integrity, its aberrant regulation — especially downregulation — has emerged as a potential mechanism of renal microvascular rarefaction, capillary dropout, and progressive glomerulosclerosis in DN.Also , emerging evidence suggests that VEGF-A/VEGFR-2 downregulation in diabetes not only contributes to renal microvascular injury but also plays a pivotal role in neurovascular unit disruption and cognitive impairment. This systematic review critically appraises five exclusive high-impact studies that illuminate the consequences, mechanisms, and therapeutic implications of VEGF-A/VEGFR-2 downregulation in DN. The review emphasizes the clinicopathological trajectories associated with VEGF signaling perturbation, identifies translational targets, and integrates nephrology-specific clinical correlations.
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