Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, 50139 Florence, Italy.
Int J Mol Sci. 2021 Oct 14;22(20):11093. doi: 10.3390/ijms222011093.
Acute kidney injury (AKI) is characterized by a rapid deterioration of kidney function, representing a global healthcare concern. In addition, AKI survivors frequently develop chronic kidney disease (CKD), contributing to a substantial proportion of disease burden globally. Yet, over the past 30 years, the burden of CKD has not declined to the same extent as many other important non-communicable diseases, implying a substantial deficit in the understanding of the disease progression. The assumption that the kidney response to AKI is based on a high proliferative potential of proximal tubular cells (PTC) caused a critical confounding factor, which has led to a limited development of strategies to prevent AKI and halt progression toward CKD. In this review, we discuss the latest findings on multiple mechanisms of response related to cell cycle behavior of PTC upon AKI, with a specific focus on their biological relevance. Collectively, we aim to (1) provide a new perspective on interpreting cell cycle progression of PTC in response to damage and (2) discuss how this knowledge can be used to choose the right therapeutic window of treatment for preserving kidney function while avoiding CKD progression.
急性肾损伤 (AKI) 的特征是肾功能迅速恶化,是全球医疗保健关注的问题。此外,AKI 幸存者经常会发展为慢性肾脏病 (CKD),这在全球疾病负担中占很大比例。然而,在过去的 30 年中,CKD 的负担并没有像许多其他重要的非传染性疾病那样下降到相同程度,这表明人们对疾病进展的理解存在很大的不足。肾脏对 AKI 的反应基于近端肾小管细胞 (PTC) 的高增殖潜力的假设是一个关键的混杂因素,这导致预防 AKI 和阻止向 CKD 进展的策略的发展受到限制。在这篇综述中,我们讨论了与 AKI 时 PTC 的细胞周期行为相关的多种反应机制的最新发现,特别关注它们的生物学相关性。总的来说,我们旨在:(1) 提供一种新的视角来解释 PTC 对损伤的细胞周期进展;(2) 讨论如何利用这些知识来选择正确的治疗窗,以在避免 CKD 进展的同时保护肾功能。