Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Curr Opin Nephrol Hypertens. 2020 Nov;29(6):599-607. doi: 10.1097/MNH.0000000000000650.
Fibrosis is an important biomarker of chronic kidney injury, and a powerful predictor of renal outcome. Currently, the only method for measuring fibrotic burden is histologic analysis, which requires a kidney biopsy in humans, or kidney removal in animal models. These requirements have not only hindered our ability to manage patients effectively, but have also prevented a full understanding of renal fibrosis pathogenesis, and slowed the translation of new antifibrotic agents. The development of noninvasive fibrosis imaging tools could thus transform both clinical care and renal fibrosis research.
Conventional imaging modalities have historically failed to image fibrosis successfully. However, recent exciting technological advances have greatly enhanced their capabilities. New techniques, for example, may allow imaging of the physical consequences of scarring, as surrogate measures of renal fibrosis. Similarly, other groups have developed ways to directly image extracellular matrix, either with the use of contrast-enhanced probes, or using matrix components as endogenous contrast agents.
New developments in imaging technology have the potential to transform our ability to visualize renal fibrosis and to monitor its progression. In doing so, these advances could have major implications for kidney disease care, the development of new antiscarring agents, and our understanding of renal fibrosis in general.
纤维化是慢性肾损伤的一个重要生物标志物，也是肾脏预后的有力预测指标。目前，衡量纤维化负担的唯一方法是组织学分析，这在人体中需要进行肾活检，在动物模型中则需要切除肾脏。这些要求不仅阻碍了我们有效管理患者的能力，也阻止了我们对肾纤维化发病机制的全面理解，并减缓了新型抗纤维化药物的转化。因此，非侵入性纤维化成像工具的发展可以改变临床护理和肾纤维化研究。
传统的成像方式在过去未能成功地对纤维化进行成像。然而，最近令人兴奋的技术进步极大地提高了它们的能力。例如，新技术可能允许对疤痕的物理后果进行成像，作为肾脏纤维化的替代测量指标。同样，其他研究小组也开发了直接对细胞外基质成像的方法，使用的方法包括使用对比增强探针，或利用基质成分作为内源性对比剂。
成像技术的新发展有可能改变我们观察肾纤维化和监测其进展的能力。通过这种方式，这些进展可能对肾脏疾病的护理、新型抗瘢痕形成药物的开发以及我们对肾纤维化的总体理解产生重大影响。
