肾脏疾病中的再生医学:现状与展望。
Regenerative medicine in kidney disease: where we stand and where to go.
机构信息
Nephrology Division, Department of Medicine, Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo 740, São Paulo, 04023-900, Brazil.
Postgraduate Program, Health Sciences-CBS, Universidade Cruzeiro do Sul, São Paulo, Brazil.
出版信息
Pediatr Nephrol. 2018 Sep;33(9):1457-1465. doi: 10.1007/s00467-017-3754-9. Epub 2017 Jul 22.
The kidney is a complex organ with more than 20 types of specialized cells that play an important role in maintaining the body's homeostasis. The epithelial tubular cell is formed during embryonic development and has little proliferative capacity under physiological conditions, but after acute injury the kidney does have regenerative capacity. However, after repetitive or severe lesions, it may undergo a maladaptation process that predisposes it to chronic kidney injury. Regenerative medicine includes various repair and regeneration techniques, and these have gained increasing attention in the scientific literature. In the future, not only will these techniques contribute to the repair and regeneration of the human kidney, but probably also to the construction of an entire organ. New mechanisms studied for kidney regeneration and repair include circulating stem cells as mesenchymal stromal/stem cells and their paracrine mechanisms of action; renal progenitor stem cells; the leading role of tubular epithelial cells in the tubular repair process; the study of zebrafish larvae to understand the process of nephron development, kidney scaffold and its repopulation; and, finally, the development of organoids. This review elucidates where we are in terms of current scientific knowledge regarding these mechanisms and the promises of future scientific perspectives.
肾脏是一个复杂的器官,有 20 多种专门的细胞类型,在维持身体内环境稳定方面发挥着重要作用。上皮管状细胞在胚胎发育过程中形成,在生理条件下增殖能力有限,但在急性损伤后肾脏确实具有再生能力。然而,在反复或严重损伤后,它可能会经历一种适应性不良的过程,使其易患慢性肾脏损伤。再生医学包括各种修复和再生技术,这些技术在科学文献中受到越来越多的关注。未来,这些技术不仅将有助于人类肾脏的修复和再生,而且可能有助于构建整个器官。研究肾脏再生和修复的新机制包括循环干细胞作为间充质基质/干细胞及其旁分泌作用机制;肾祖细胞;管状上皮细胞在管状修复过程中的主导作用;利用斑马鱼幼虫研究了解肾单位发育、肾脏支架及其再填充的过程;最后,类器官的开发。本文综述了目前关于这些机制的科学知识现状,以及未来科学前景的展望。