Hara Akinori, Wada Takashi
Rinsho Byori. 2017 Jan;65(1):100-105.
During the exploration of factors that interfere with the erythropoietin (EPO) -EPO receptor (EPOR) interaction in anemia, a novel inhibitory factor of EPO, anti-EPOR antibody, has been detected in anemic pa- tients with immune-mediated diseases. The study also demonstrated that the antibodies were observed in some patients with chronic kidney disease (CKD). EPOR is known to be expressed not only in bone mar- row erythroblasts, but also in other organs including the kidneys. In addition, previous studies showed that EPO may contribute to protecting the kidneys from injury by binding EPOR on renal resident cells as well as through the correction of anemia. Based on this background, we recently examined the clinical significance of anti-EPOR antibodies in patients with CKD. With regard to patients with lupus nephritis, who showed the highest antibody levels among the patients examined, the antibodies were associated with overall disease activity and cell infiltration in the injured kidney, and they were inversely related to the preserved renal function. Here, we discuss the discovery of anti-EPOR antibodies in patients with anemia and CKD, and the possibil- ity of their use as an additional biomarker for the deterioration of the renal function. [Review].
在探索贫血中干扰促红细胞生成素(EPO)-促红细胞生成素受体(EPOR)相互作用的因素时,在患有免疫介导疾病的贫血患者中检测到一种新型的EPO抑制因子——抗EPOR抗体。该研究还表明,在一些慢性肾脏病(CKD)患者中也观察到了这些抗体。已知EPOR不仅在骨髓成红细胞中表达,还在包括肾脏在内的其他器官中表达。此外,先前的研究表明,EPO可能通过与肾固有细胞上的EPOR结合以及纠正贫血来保护肾脏免受损伤。基于这一背景,我们最近研究了CKD患者中抗EPOR抗体的临床意义。在接受检查的患者中,狼疮性肾炎患者的抗体水平最高,这些抗体与整体疾病活动及受损肾脏中的细胞浸润有关,且与保留的肾功能呈负相关。在此,我们讨论贫血和CKD患者中抗EPOR抗体的发现,以及将其用作肾功能恶化的额外生物标志物的可能性。[综述]