Corridon Peter R, Ko In Kap, Yoo James J, Atala Anthony
Wake Forest Institute for Regenerative Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1083, USA.
Department of Physiology & Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Curr Stem Cell Rep. 2017 Jun;3(2):68-76. doi: 10.1007/s40778-017-0079-3. Epub 2017 Apr 12.
Historically, there have been many advances in the ways in which we treat kidney diseases. In particular, hemodialysis has set the standard for treatment since the early 1960s and continues today as the most common form of treatment for acute, chronic, and end-stage conditions. However, the rising global prevalence of kidney diseases and our limited understanding of their etiologies have placed significant burdens on current clinical management regimens. This has resulted in a desperate need to improve the ways in which we treat the underlying and ensuing causes of kidney diseases for those who are unable to receive transplants.
One way of possibly addressing these issues is through the use of improved bioartificial kidneys. Bioartificial kidneys provide an extension to conventional artificial kidneys and dialysis systems, by incorporating aspects of living cellular and tissue function, in an attempt to better mimic normal kidneys. Recent advancements in genomic, cellular, and tissue engineering technologies are facilitating the improved design of these systems.
In this review, we outline various research efforts that have focused on the development of regenerated organs, implantable constructs, and whole bioengineered kidneys, as well as the transitions from conventional dialysis to these novel alternatives. As a result, we envision that these pioneering efforts can one day produce bioartificial renal technologies that can either perform or reintroduce essential function, and thus provide practical options to treat and potentially prevent kidney diseases.
从历史上看,我们治疗肾脏疾病的方式有了许多进展。特别是,自20世纪60年代初以来,血液透析就设定了治疗标准,至今仍是治疗急性、慢性和终末期疾病最常见的治疗形式。然而,全球肾脏疾病患病率的上升以及我们对其病因的有限了解给当前的临床管理方案带来了沉重负担。这导致迫切需要改进我们治疗那些无法接受移植的患者肾脏疾病的潜在病因及后续病因的方式。
解决这些问题的一种可能方法是使用改进的生物人工肾。生物人工肾通过纳入活细胞和组织功能的各个方面,对传统人工肾和透析系统进行了扩展,试图更好地模拟正常肾脏。基因组学、细胞和组织工程技术的最新进展促进了这些系统的改进设计。
在本综述中,我们概述了各种研究工作,这些工作专注于再生器官、可植入构建体和全生物工程肾脏的开发,以及从传统透析向这些新型替代方法的转变。因此,我们设想这些开创性的努力有朝一日能够产生能够执行或重新引入基本功能的生物人工肾脏技术,从而为治疗和潜在预防肾脏疾病提供切实可行的选择。