Okusa Mark D, Rosner Mitchell H, Kellum John A, Ronco Claudio
Division of Nephrology, Center for Immunity, Inflammation and Regenerative Medicine, University of Virginia Health System, Charlottesville, Virginia;
Center for Critical Care Nephrology and Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; and.
J Am Soc Nephrol. 2016 Jan;27(1):44-8. doi: 10.1681/ASN.2015030233. Epub 2015 Oct 30.
The opportunity to make advances in the prevention and treatment of AKI has never been greater than it is today. Major advances have been made in the understanding of the biology of AKI, the design of clinical trials, and the use of diagnostic and prognostic biomarkers. These advances have been supplemented by the coordinated effort of societies, federal agencies, and industry, such that we are poised in the ensuing years to positively address the unrelenting harm that this disorder has created. Over the past decade, major advances have been made in understanding the pathophysiology of AKI, mainly through the study of small animal models. However, translating these findings to human AKI remains a barrier, which is typified by the absence of effective therapeutic agents. The purpose of the Acute Dialysis Quality Initiative (ADQI) XIII was to harmonize human and animal studies and determine what is known about potential therapeutic targets and what gaps in knowledge remain. A series of invited reviews will distill key concepts from this initiative that focus on different pathogenic features of AKI, including hemodynamics, immunity and inflammation, cellular and molecular pathways, progression, and regeneration and repair. This series will convey the status of our knowledge of the pathophysiology of human AKI and propose therapeutic targets for further investigation.
在急性肾损伤(AKI)的预防和治疗方面取得进展的机会,从未像现在这样大。在对AKI生物学的理解、临床试验设计以及诊断和预后生物标志物的使用方面都取得了重大进展。社会、联邦机构和行业的协同努力进一步推动了这些进展,因此在接下来的几年里,我们有能力积极应对这种疾病所造成的持续伤害。在过去十年中,主要通过对小动物模型的研究,在理解AKI的病理生理学方面取得了重大进展。然而,将这些发现转化为人类AKI的治疗方法仍然是一个障碍,这突出表现在缺乏有效的治疗药物。急性透析质量倡议(ADQI)第十三工作组的目的是协调人类和动物研究,并确定关于潜在治疗靶点的已知信息以及仍然存在的知识空白。一系列特邀综述将提炼该倡议的关键概念,这些概念聚焦于AKI的不同致病特征,包括血流动力学、免疫与炎症、细胞和分子途径、疾病进展以及再生与修复。本系列将阐述我们对人类AKI病理生理学的了解现状,并提出有待进一步研究的治疗靶点。