改善急性肾损伤和慢性肾脏病线粒体功能的药理学方法。
Pharmacologic Approaches to Improve Mitochondrial Function in AKI and CKD.
作者信息
Szeto Hazel H
机构信息
Mitochondrial Therapeutics Consulting, New York, New York
出版信息
J Am Soc Nephrol. 2017 Oct;28(10):2856-2865. doi: 10.1681/ASN.2017030247. Epub 2017 Aug 4.
AKI is associated with high morbidity and mortality, and it predisposes to the development and progression of CKD. Novel strategies that minimize AKI and halt the progression of CKD are urgently needed. Normal kidney function involves numerous different cell types, such as tubular epithelial cells, endothelial cells, and podocytes, working in concert. This delicate balance involves many energy-intensive processes. Fatty acids are the preferred energy substrates for the kidney, and defects in fatty acid oxidation and mitochondrial dysfunction are universally involved in diverse causes of AKI and CKD. This review provides an overview of ATP production and energy demands in the kidney and summarizes preclinical and clinical evidence of mitochondrial dysfunction in AKI and CKD. New therapeutic strategies targeting mitochondria protection and cellular bioenergetics are presented, with emphasis on those that have been evaluated in animal models of AKI and CKD. Targeting mitochondrial function and cellular bioenergetics upstream of cellular damage may offer advantages compared with targeting downstream inflammatory and fibrosis processes.
急性肾损伤(AKI)与高发病率和死亡率相关,并且它易引发慢性肾脏病(CKD)的发生和进展。迫切需要新的策略来尽量减少急性肾损伤并阻止慢性肾脏病的进展。正常的肾功能涉及多种不同类型的细胞协同工作,如肾小管上皮细胞、内皮细胞和足细胞。这种微妙的平衡涉及许多能量密集型过程。脂肪酸是肾脏首选的能量底物,脂肪酸氧化缺陷和线粒体功能障碍普遍参与急性肾损伤和慢性肾脏病的各种病因。本综述概述了肾脏中的ATP生成和能量需求,并总结了急性肾损伤和慢性肾脏病中线粒体功能障碍的临床前和临床证据。提出了针对线粒体保护和细胞生物能量学的新治疗策略,重点是那些在急性肾损伤和慢性肾脏病动物模型中已得到评估的策略。与针对下游炎症和纤维化过程相比,针对细胞损伤上游的线粒体功能和细胞生物能量学可能具有优势。
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