Figure 12.
Schematic representation of the comprehensive findings. In diabetic kidney, hyperglycemia results in the downregulation of PPARγ and the upregulation of RXRα, RXRβ and RARγ1, which contribute to elevated PAI-1, MMP-9 and MMP-13 levels. The changes lead to the elevated expression of Col IV, fibronectin and laminin and decreased elastin expression, causing excessive ECM accumulation, leading to renal fibrosis in the diabetic kidney. Supplementation of an H2S donor, GYY, ameliorates adverse ECM remodeling by reversing the altered expression of PAI-1, MMP-9 and MMP-13 via the modulation of RXR signaling.