Organ Crosstalk in Diabetic Cardiorenal Syndrome: Molecular Mechanisms, Prostanoid Signaling, and Therapeutic Opportunities

The field of renal physiology and pathophysiology increasingly recognizes that kidney health and disease cannot be studied in isolation but rather as products of complex communication among multiple organs. In diabetes, this dynamic interorgan network becomes pathologically amplified, leading to diabetic cardiorenal syndrome—a condition characterized by reciprocal injury of the kidney and heart within a background of metabolic, inflammatory, and vascular stress. Recent findings highlight the roles of the renin–angiotensin–aldosterone system, oxidative stress, overactivation of the sympathetic nervous system, and mitochondrial dysfunction as key drivers of maladaptive signaling. In parallel, gut-derived metabolites such as trimethylamine N-oxide and indoxyl sulfate, exosome-mediated molecular transfer, and arachidonic acid metabolites—especially prostanoids—have emerged as pivotal mediators influencing renal hemodynamics, inflammation, and fibrosis. Despite these insights, the integrative mechanisms translating local metabolic disturbances to system-level renal injury remain incompletely understood. Deciphering these links is critical to identify new therapeutic targets that interrupt the self-perpetuating cycle of organ crosstalk in diabetic kidney disease.This Research Topic aims to advance a comprehensive understanding of renal physiology and pathophysiology in the context of diabetic cardiorenal syndrome. It seeks to delineate how molecular, cellular, and systemic signals converge to orchestrate kidney dysfunction through heart–kidney–metabolic communication. Central goals include clarifying the role of prostanoid signaling pathways, identifying novel mediators and biomarkers of kidney–heart interaction, and evaluating interventions that modulate these interorgan circuits. Investigations that bridge basic, translational, and clinical domains are encouraged,especially those employing integrative technologies such as multi-omics, imaging, and advanced in vitro models. The overarching objective is to translate mechanistic discoveries into precise diagnostic tools and therapeutic strategies that mitigate diabetic cardiorenal progression.The Research Topic encompasses mechanistic, experimental, and translational studies focusing on diabetic cardiorenal syndrome through a renal-centric lens. It excludes non-diabetic organ crosstalk disorders but embraces all relevant aspects of interorgan signaling contributing to diabetic kidney disease. To gather further insights within these boundaries, we welcome articles addressing, but not limited to, the following themes:o Kidney-centered signaling mechanisms in diabetes: roles of the renin–angiotensin–aldosterone system, sympathetic nervous system, oxidative stress, inflammasome activation, and nutrient-sensing pathwayso Pathogenic bidirectional communication between kidney and heart, including molecular mediators, immune cell migration, and neurohormonal controlo Gut microbiota dysbiosis and microbiota-derived metabolites (such as trimethylamine N-oxide and indoxyl sulfate) in regulating renal inflammation and fibrosiso Involvement of exosomes, extracellular vesicles, and non-coding RNAs in kidney–heart and kidney–systemic dialogueo Arachidonic acid metabolites and prostanoid pathways as key regulators of cardiovascular–metabolic–renal functiono Translational models (animal, kidney organoids, and organ-on-chip) simulating diabetic cardiorenal interactionso Biomarker discovery and validation for early prediction and risk stratification of diabetic cardiorenal complicationso Targeted therapeutic interventions, including pharmacologic, dietary, and lifestyle approaches to disrupt maladaptive organ signalingo Mechanistic analysis of renal effects of sodium–glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, mineralocorticoid receptor antagonists, and novel drug candidateso Application of systems biology and multi-omics integration for understanding renal pathophysiology within multi-organ metabolic disease Topic editors: Mengsi Hu, Cuilin Zhu, Sauri Hernandez-Resendiz, GianLuca Colussi Source: https://www.frontiersin.org/research-topics/81751/organ-crosstalk-in-diabetic-cardiorenal-syndrome-molecular-mechanisms-prostanoid-signaling-and-therapeutic-opportunities