Nephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München-Innenstadt, Ziemssenstrasse 1, 80336 Munich, Germany.
Nat Rev Nephrol. 2014 Jun;10(6):347-58. doi: 10.1038/nrneph.2014.68. Epub 2014 Apr 29.
The immune system is an important guardian of tissue homeostasis. In response to injury, resident and infiltrating immune cells orchestrate all phases of danger control, resolution of inflammation and tissue regeneration or scar formation. As mammalian postnatal kidneys are not capable of de novo nephrogenesis, recovery is limited to the regeneration or repair of existing nephrons. The regenerative capacity of the nephron varies between compartments; the epithelial cells of the tubule regenerate more efficiently than the structurally highly organized podocytes. Cells of the surrounding environment modulate nephron regeneration by secreting paracrine mediators. This Review discusses immune mediators and pathways that regulate the intrinsic regenerative capacity of the nephron. Eliminating injurious triggers, modulating renal inflammation and specifically enhancing the regenerative capacity of nephrons might be a promising strategy to improve long-term outcomes in patients with acute kidney injury and/or chronic kidney disease.
免疫系统是组织动态平衡的重要守护者。在应对损伤时，固有免疫细胞和浸润免疫细胞共同协调危险控制的各个阶段，控制炎症反应，促进组织再生或瘢痕形成。哺乳动物出生后肾脏不能重新生成肾单位，因此恢复仅限于现有肾单位的再生或修复。肾单位的再生能力在不同部位有所差异，肾小管的上皮细胞比结构高度组织化的足细胞具有更高的再生效率。周围环境细胞通过分泌旁分泌介质来调节肾单位再生。本综述讨论了调节肾单位内在再生能力的免疫介质和途径。消除有害触发因素、调节肾脏炎症并特异性增强肾单位的再生能力，可能是改善急性肾损伤和/或慢性肾脏病患者长期预后的一种有前途的策略。
