KAGAMI Project, National Institute of Biomedical Innovation, Health and Nutrition (NIBIOHN), Osaka, Japan.
Reverse Translational Research Project, Center for Rare Disease Research, National Institute of Biomedical Innovation, Health and Nutrition (NIBIOHN), Osaka, Japan.
Clin Exp Nephrol. 2020 May;24(5):404-410. doi: 10.1007/s10157-020-01862-3. Epub 2020 Feb 29.
D-Amino acids are the recently detected enantiomers of L-amino acids. Accumulating evidence points their potential in solving the long-standing critical problems associated with the management of both chronic and acute kidney diseases. This includes estimating kidney function, early diagnosis and prognosis of chronic kidney disease, and disease monitoring. Among the D-amino acids, D-serine levels in the blood are strongly correlated with the glomerular filtration rate and are useful for estimating the function of the kidney. Urinary D-serine also reflects other conditions. The kidney proximal tubule reabsorbs serine with chiral-selectivity, with D-serine being reabsorbed much less efficiently than L-serine, and urinary excretion of D-serine is sensitive to the presence of kidney diseases. Therefore, assessing the intra-body dynamics of D-serine by measuring its level in blood and urinary excretion can be used to detect kidney diseases and assess pathophysiology. This new concept, the intra-body dynamics of D-serine, can be useful in the comprehensive management of kidney disease.
D-氨基酸是最近检测到的 L-氨基酸的对映异构体。越来越多的证据表明，它们在解决与慢性和急性肾脏疾病管理相关的长期关键问题方面具有潜力。这包括估计肾功能、慢性肾脏病的早期诊断和预后以及疾病监测。在 D-氨基酸中，血液中的 D-丝氨酸水平与肾小球滤过率强烈相关，可用于估计肾脏功能。尿 D-丝氨酸也反映了其他情况。肾脏近端小管以手性选择性重吸收丝氨酸，D-丝氨酸的重吸收效率远低于 L-丝氨酸，尿中 D-丝氨酸的排泄对肾脏疾病的存在敏感。因此，通过测量血液和尿中 D-丝氨酸的水平来评估 D-丝氨酸的体内动态，可以用于检测肾脏疾病并评估病理生理学。D-丝氨酸的体内动态这一新概念可用于肾脏疾病的综合管理。
