Zheng Long, Gao Wenjun, Hu Chao, Yang Cheng, Rong Ruiming
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Shanghai Key laboratory of Organ Transplantation, 180 Fenglin Road, Shanghai 200032, China.
Curr Protein Pept Sci. 2019;20(8):770-776. doi: 10.2174/1389203720666190507102529.
Acute kidney injury (AKI) is a systemic disease characterized by acute loss of renal function and accumulation of end products of nitrogen metabolism. Ischemic AKI is the most common cause of AKI, and inflammatory responses are inevitablely involved in ischemic AKI. In the process of ischemic AKI, multiple factors are involved in activating and recruitment of immune cell to the injured kidney. These factors include DAMPs and HIFs released from the injured kidney, increased expression of adhesion molecules, the production of chemokines and cytokines, activation of complement system and TLRs as well as the permeability dysfunction of the renal vascular endothelium. Immune cells of both the innate and adaptive immune systems, such as neutrophils, dendritic cells, macrophages and lymphocytes contribute to the pathogenesis of renal injury after ischemia reperfusion injury (IRI), with some of their subpopulations also participating in the repair process. Numerous studies of immune cells involved in the pathogenesis of AKI have enhanced the understanding of their possible mechanisms in AKI which might become the potential targets for the treatment of ischemic AKI. This review describes the function of the immune cells in the pathogenesis and repair of ischemic AKI and emphasizes the treatment of ischemic AKI potentially targeting them.
急性肾损伤(AKI)是一种全身性疾病,其特征为肾功能急性丧失以及氮代谢终产物蓄积。缺血性AKI是AKI最常见的病因,炎症反应不可避免地参与其中。在缺血性AKI过程中,多种因素参与免疫细胞向受损肾脏的激活和募集。这些因素包括受损肾脏释放的损伤相关分子模式(DAMPs)和缺氧诱导因子(HIFs)、黏附分子表达增加、趋化因子和细胞因子的产生、补体系统和Toll样受体(TLRs)的激活以及肾血管内皮的通透性功能障碍。固有免疫系统和适应性免疫系统的免疫细胞,如中性粒细胞、树突状细胞、巨噬细胞和淋巴细胞,均参与缺血再灌注损伤(IRI)后肾损伤的发病机制,其部分亚群也参与修复过程。众多关于参与AKI发病机制的免疫细胞的研究增进了我们对其在AKI中可能机制的理解,这些机制可能成为缺血性AKI治疗的潜在靶点。本综述描述了免疫细胞在缺血性AKI发病机制和修复中的作用,并强调了针对它们的缺血性AKI治疗方法。