Kierulf-Lassen Casper, Nieuwenhuijs-Moeke Gertrude J, Krogstrup Nicoline V, Oltean Mihai, Jespersen Bente, Dor Frank J M F
Department of Clinical Medicine, Aarhus University Hospital, Skejby, Denmark.
Eur Surg Res. 2015;55(3):151-83. doi: 10.1159/000437352. Epub 2015 Sep 2.
Ischemia-reperfusion injury is the leading cause of acute kidney injury in a variety of clinical settings such as renal transplantation and hypovolemic and/or septic shock. Strategies to reduce ischemia-reperfusion injury are obviously clinically relevant. Ischemic conditioning is an inherent part of the renal defense mechanism against ischemia and can be triggered by short periods of intermittent ischemia and reperfusion. Understanding the signaling transduction pathways of renal ischemic conditioning can promote further clinical translation and pharmacological advancements in this era. This review summarizes research on the molecular mechanisms underlying both local and remote ischemic pre-, per- and postconditioning of the kidney. The different types of conditioning strategies in the kidney recruit similar powerful pro-survival mechanisms. Likewise, renal ischemic conditioning mobilizes many of the same protective signaling pathways as in other organs, but differences are recognized.
缺血再灌注损伤是肾移植、低血容量性和/或感染性休克等多种临床情况下急性肾损伤的主要原因。减少缺血再灌注损伤的策略显然具有临床相关性。缺血预处理是肾脏抗缺血防御机制的固有组成部分，可由短时间的间歇性缺血和再灌注触发。了解肾脏缺血预处理的信号转导途径可促进这一领域在当今时代的进一步临床转化和药理学进展。本综述总结了关于肾脏局部和远程缺血预处理、围处理及后处理潜在分子机制的研究。肾脏中不同类型的预处理策略会启动相似的强大促存活机制。同样，肾脏缺血预处理调动了许多与其他器官相同的保护性信号通路，但也存在差异。
