Rahman M A, Stork J E, Dunn M J
Department of Medicine, Case Western Reserve University, Cleveland, Ohio.
Kidney Int Suppl. 1987 Oct;22:S40-8.
There is accumulating evidence showing alterations of renal eicosanoid synthesis in glomerular disease. Despite the complexity of their role in glomerulonephritis, these compounds appear to play a major part in the inflammatory response and in control of renal hemodynamics. The role of eicosanoids in the filtration of macromolecules has not been established, but there is indirect evidence of their involvement in mediating proteinuria. Dietary manipulation, either by high EPA, high linoleic acid, or EFA-deficient diet, in experimental glomerulonephritis have shown promising results as summarized in Table 1. The therapeutic potential of alterations in dietary fatty acid to modulate the inflammatory response appears to be of great value. Table 2 summarizes the effects of different dietary fatty acid alterations on eicosanoid synthesis. Nonetheless, we should point out that most of the studies of alterations in dietary fatty acids did not document changes in glomerular synthesis of prostaglandin, thromboxane, or HETES. Further studies examining the effects of different fatty acid regimens on glomerular eicosanoid synthesis and the role of these eicosanoids in the development of glomerulonephritis will provide valuable information. These findings could determine the specific type of dietary manipulation to inhibit or stimulate the production of selected eicosanoids.
越来越多的证据表明，肾小球疾病中肾脏类花生酸合成存在改变。尽管它们在肾小球肾炎中的作用复杂，但这些化合物似乎在炎症反应和肾脏血流动力学控制中起主要作用。类花生酸在大分子滤过中的作用尚未确定，但有间接证据表明它们参与介导蛋白尿。在实验性肾小球肾炎中，通过高EPA、高亚油酸或缺乏必需脂肪酸的饮食进行饮食干预已显示出有前景的结果，总结于表1。饮食脂肪酸改变调节炎症反应的治疗潜力似乎具有重要价值。表2总结了不同饮食脂肪酸改变对类花生酸合成的影响。然而，我们应该指出，大多数饮食脂肪酸改变的研究并未记录前列腺素、血栓素或羟基二十碳四烯酸在肾小球合成中的变化。进一步研究不同脂肪酸方案对肾小球类花生酸合成的影响以及这些类花生酸在肾小球肾炎发展中的作用将提供有价值的信息。这些发现可以确定抑制或刺激特定类花生酸产生的具体饮食干预类型。
