Humes H D
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA.
Semin Nephrol. 2000 Jan;20(1):71-82.
The rapid understanding of the cellular and molecular basis of organ function and disease processes will be translated in the next millennium into new therapeutic approaches to a wide range of clinical disorders, including acute and chronic renal failure. Central to these new therapies are the developing fields of gene therapy, cell therapy, and tissue engineering. These new technologies are based on the ability to expand stem or progenitor cells in tissue culture to perform differentiated tasks and to introduce these cells into the patient either in extracorporeal circuits or as implantable constructs. Cell therapy devices are currently being developed to replace the filtrative, metabolic, and endocrinologic functions of the kidney lost in both acute and chronic renal failure. This article summarizes the current state of device development for a renal tubule assist device, a bioartificial hemofilter, and a regulatable erythropoietin cell therapy device. These individual devices have the promise to be combined to produce a wearable or implantable bioartificial kidney for full renal replacement therapy. These new approaches may result in therapeutic modalities that significantly diminish the morbidity and mortality in patients with acute renal failure or end-stage renal disease.
在下一个千年里，对器官功能和疾病过程的细胞及分子基础的快速理解将转化为针对包括急性和慢性肾衰竭在内的多种临床病症的新治疗方法。这些新疗法的核心是基因治疗、细胞治疗和组织工程等不断发展的领域。这些新技术基于在组织培养中扩增干细胞或祖细胞以执行分化任务并将这些细胞通过体外循环或作为可植入构建体引入患者体内的能力。目前正在开发细胞治疗装置，以替代急性和慢性肾衰竭中丧失的肾脏的滤过、代谢和内分泌功能。本文总结了肾小管辅助装置、生物人工血液滤过器和可调节促红细胞生成素细胞治疗装置的当前装置开发状态。这些单独的装置有望组合起来，制造出用于全肾替代治疗的可穿戴或可植入生物人工肾。这些新方法可能会产生显著降低急性肾衰竭或终末期肾病患者发病率和死亡率的治疗方式。
