Bobulescu Ion Alexandru
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 775390-8885, USA.
Curr Opin Nephrol Hypertens. 2010 Jul;19(4):393-402. doi: 10.1097/MNH.0b013e32833aa4ac.
Lipid accumulation in nonadipose tissues is increasingly recognized to contribute to organ injury through a process termed lipotoxicity, but whether this process occurs in the kidney is still uncertain. This article briefly summarizes the normal role of lipids in renal physiology and the current evidence linking excess lipids and lipotoxicity to renal dysfunction.
Evidence suggesting that renal lipid accumulation and lipotoxicity may lead to kidney dysfunction has mounted significantly over recent years. Abnormal renal lipid content has been described in a number of animal models and has been successfully manipulated using pharmacologic or genetic strategies. There is some heterogeneity among studies with regard to the mechanisms, consequences, and localization of lipid accumulation in the kidney, explainable at least in part by inherent differences between animal models. The relevance of these findings for human pathophysiology remains to be established.
Current knowledge on renal lipid physiology and pathophysiology is insufficient, but provides a strong foundation and incentive for further exploration. The future holds significant challenges in this area, especially with regard to applicability of research findings to the human kidney in vivo, but also the opportunity to transform our understanding of an array of kidney disorders.
非脂肪组织中的脂质蓄积通过一种称为脂毒性的过程导致器官损伤,这一点日益受到认可,但该过程是否发生在肾脏仍不确定。本文简要总结了脂质在肾脏生理学中的正常作用,以及目前将过量脂质和脂毒性与肾功能障碍联系起来的证据。
近年来,有证据表明肾脏脂质蓄积和脂毒性可能导致肾功能障碍,这一证据显著增加。在许多动物模型中都描述了肾脏脂质含量异常,并且已通过药理学或遗传学策略成功对其进行了调控。关于肾脏脂质蓄积的机制、后果和定位,各研究之间存在一些异质性,这至少部分可以通过动物模型之间的固有差异来解释。这些发现与人类病理生理学的相关性仍有待确定。
目前关于肾脏脂质生理学和病理生理学的知识不足,但为进一步探索提供了坚实的基础和动力。该领域未来面临重大挑战,尤其是研究结果在人类活体肾脏中的适用性,但也有机会改变我们对一系列肾脏疾病的理解。