Ammar Lama A, Nahlawi Mohamad I, Shayya Nizar W, Ghadieh Hilda E, Azar Nadim S, Harb Frédéric, Eid Assaad A
Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon.
American University of Beirut Diabetes, American University of Beirut, Beirut, Lebanon.
Front Cardiovasc Med. 2021 Jan 28;7:630917. doi: 10.3389/fcvm.2020.630917. eCollection 2020.
Immunomodulatory approaches are defined as all interventions that modulate and curb the immune response of the host rather than targeting the disease itself with the aim of disease prevention or treatment. A better understanding of the immune system continues to offer innovative drug targets and methods for immunomodulatory interventions. Cardiorenal syndrome is a clinical condition that defines disorders of the heart and kidneys, both of which communicate with one another through multiple pathways in an interdependent relationship. Cardiorenal syndrome denotes the confluence of heart-kidney relationships across numerous interfaces. As such, a dysfunctional heart or kidney has the capacity to initiate disease in the other organ via common hemodynamic, neurohormonal, immunological, and/or biochemical feedback pathways. Understanding how immunomodulatory approaches are implemented in diabetes-induced cardiovascular and renal diseases is important for a promising regenerative medicine, which is the process of replacing cells, tissues or organs to establish normal function. In this article, after a brief introduction on the immunomodulatory approaches in diseases, we will be reviewing the epidemiology and classifications of cardiorenal syndrome. We will be emphasizing on the hemodynamic factors and non-hemodynamic factors linking the heart and the kidneys. In addition, we will be elaborating on the immunomodulatory pathways involved in diabetes-induced cardiorenal syndrome namely, RAS, JAK/STAT, and oxidative stress. Moreover, we will be addressing possible therapeutic approaches that target the former pathways in an attempt to modulate the immune system.
免疫调节方法被定义为所有调节和抑制宿主免疫反应而非针对疾病本身以预防或治疗疾病为目的的干预措施。对免疫系统的深入了解不断为免疫调节干预提供创新的药物靶点和方法。心肾综合征是一种临床病症,它定义了心脏和肾脏的功能紊乱,二者通过多种相互依存的途径相互沟通。心肾综合征表示跨多个界面的心肾关系的汇合。因此,心脏或肾脏功能失调有能力通过共同的血流动力学、神经激素、免疫和/或生化反馈途径在另一个器官引发疾病。了解免疫调节方法如何在糖尿病诱发的心血管和肾脏疾病中实施对于有前景的再生医学很重要,再生医学是替换细胞、组织或器官以建立正常功能的过程。在本文中,在简要介绍疾病中的免疫调节方法之后,我们将回顾心肾综合征的流行病学和分类。我们将重点关注连接心脏和肾脏的血流动力学因素和非血流动力学因素。此外,我们将详细阐述糖尿病诱发的心肾综合征所涉及的免疫调节途径,即肾素-血管紧张素系统(RAS)、Janus激酶/信号转导和转录激活因子(JAK/STAT)以及氧化应激。此外,我们将探讨针对上述途径的可能治疗方法,试图调节免疫系统。