Department of Pharmacology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki, Kita, Kagawa, 761-0793, Japan.
Clin Exp Nephrol. 2020 Dec;24(12):1091-1102. doi: 10.1007/s10157-020-01951-3. Epub 2020 Aug 11.
Sepsis is a major cause of acute kidney injury (AKI) among patients in the intensive care unit. However, the numbers of basic science papers for septic AKI account for only 1% of all publications on AKI. This may be partially attributable to the specific pathophysiology of septic AKI as compared to that of the other types of AKI because it shows only modest histological changes despite functional decline and often requires real-time functional analysis. To increase the scope of research in this field, this article reviews the basic research information that has been reported thus far on the subject of septic AKI, mainly from the viewpoint of functional dysregulation, including some knowledge acquired with multiphoton intravital imaging. Moreover, the efficacy and limitation of the potential novel therapies are discussed. Finally, the author proposes several points that should be considered when designing the study, such as monitoring the long-term effects of the intervention and reflecting the clinical settings for identifying the molecular mechanisms and for challenging the intervention effects.
脓毒症是重症监护病房中急性肾损伤(AKI)的主要原因。然而,关于脓毒症 AKI 的基础科学论文数量仅占 AKI 所有出版物的 1%。这可能部分归因于脓毒症 AKI 的特定病理生理学与其他类型 AKI 的不同,因为尽管功能下降,但它仅显示出适度的组织学变化,而且通常需要实时功能分析。为了增加该领域的研究范围,本文综述了迄今为止关于脓毒症 AKI 的基础研究信息,主要从功能失调的角度进行综述,包括使用多光子活体成像获得的一些知识。此外,还讨论了潜在新型疗法的疗效和局限性。最后,作者提出了在设计研究时应考虑的几点,例如监测干预的长期效果并反映临床环境,以确定分子机制并挑战干预效果。