Department of Nephrology and Hemodialvsis Center, Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, PR China.
Med Hypotheses. 2013 Apr;80(4):463-5. doi: 10.1016/j.mehy.2012.12.041. Epub 2013 Feb 8.
Acute renal failure (ARF) is a rapid loss of kidney function. The reasons and mechanism by which this occurs has not been clarified so far thus creating obstacles to management of this disease. Presently, the experimental research using the accepted renal ischemia reperfusion injury (I/R injury) model represented for ARF focuses on several possible relevant factors such as reactive oxygen species, no-reflow phenomenon, apoptosis and extensive inflammatory response. The latter is much talked about currently. Some intracellular danger sensing proteins, such as the nucleotide binding domain leucine rich repeats-containing family proteins known as NLRs, adjust the inflammatory response through the formation of a multi-protein complex known as an inflammasome. The most classic family member of this complex is NALP3 confirmed to serve as a contributor to I/R injury. However, how it contributes to the pathology remains obscure. The extensive inflammatory response is considered to be modulated by the mitogen-activated protein kinases (MAPK) signaling pathway. NOD2, another family member of NLR, which shares similar structure with NALP3, indicated that it induced the activation of MAPK in response to a pathogen, thus we assumed that NALP3 performed the harmful process of I/R injury, resulting probably from the activation of the MAPK signaling pathway. If this hypothesis proves to be correct, it might benefit the management of ARF.
急性肾衰竭(ARF)是一种肾功能迅速丧失的疾病。其发生的原因和机制尚未阐明,这给该疾病的治疗带来了障碍。目前,使用公认的肾缺血再灌注损伤(I/R 损伤)模型进行的实验研究集中在几个可能相关的因素上,如活性氧、无复流现象、细胞凋亡和广泛的炎症反应。目前人们对后者讨论较多。一些细胞内危险感应蛋白,如核苷酸结合域富含亮氨酸重复序列家族蛋白(NLRs),通过形成一种称为炎性体的多蛋白复合物来调节炎症反应。该复合物的最典型家族成员 NALP3 已被证实可作为 I/R 损伤的贡献者。然而,其导致损伤的机制尚不清楚。广泛的炎症反应被认为是由丝裂原活化蛋白激酶(MAPK)信号通路调节的。NLR 的另一个家族成员 NOD2 与 NALP3 具有相似的结构,表明它可以通过激活 MAPK 来响应病原体,因此我们假设 NALP3 通过激活 MAPK 信号通路来发挥 I/R 损伤的有害作用。如果这一假设被证明是正确的,它可能有益于 ARF 的治疗。