Herrera Guillermo A, Turbat-Herrera Elba A, Teng Jiamin
Contrib Nephrol. 2011;169:6-22. doi: 10.1159/000314774. Epub 2011 Jan 20.
Mesangial homeostasis is an integral component of normal glomerular function. Alterations in mesangial homeostasis occur frequently, not only in primary glomerular disorders, but also in association with primary tubular interstitial and vascular pathology, although generally the disturbances are not as marked in the latter situations. Mesangial changes could be transitory and reversible or permanent and irreversible, depending on the type and degree of damage inflicted and the reparative ability of the mesangium at a given time. Understanding mesangial pathobiology is crucial for comprehending the reactive and pathological processes that occur in glomeruli. The mesangium is usually the first to react to injurious glomerular events and is often the last to return to normal after the pathological insult has ceased and repair mechanisms have been activated. This is obvious in renal biopsy specimens where mesangial hypercellularity and/or matrix expansion are very common findings in primary glomerular disorders and, as a reactive phenomenon, in primary interstitial and vascular diseases. Repairing mesangial damage represents a fundamental process needed for restoring glomerular function. Since a component of the mesangial damage frequently includes the loss of mesangial cells, a way to revamp mesangial cellularity is essential for restoring mesangial homeostasis. This fact should be taken into account when designing therapies aimed at restoring mesangial integrity and homeostasis.
系膜稳态是正常肾小球功能的一个重要组成部分。系膜稳态的改变频繁发生，不仅见于原发性肾小球疾病，也与原发性肾小管间质和血管病变相关，尽管在后一种情况下，这种紊乱通常不那么明显。系膜变化可能是短暂可逆的，也可能是永久不可逆的，这取决于所造成损伤的类型和程度以及系膜在特定时间的修复能力。了解系膜病理生物学对于理解肾小球中发生的反应性和病理过程至关重要。系膜通常是对肾小球损伤事件最早做出反应的部位，并且在病理损伤停止且修复机制被激活后，往往是最后恢复正常的部位。这在肾活检标本中很明显，在原发性肾小球疾病以及作为一种反应性现象的原发性间质和血管疾病中，系膜细胞增多和/或基质扩张是非常常见的发现。修复系膜损伤是恢复肾小球功能所需的一个基本过程。由于系膜损伤的一个组成部分通常包括系膜细胞的丢失，因此恢复系膜细胞数量的方法对于恢复系膜稳态至关重要。在设计旨在恢复系膜完整性和稳态的治疗方法时，应考虑到这一事实。
