Department of Nephrology, Yijishan Hospital of Wannan Medical College, Wuhu, China.
Ren Fail. 2022 Dec;44(1):615-624. doi: 10.1080/0886022X.2022.2036620.
Hyperuricemia is an independent risk factor for the progression of chronic kidney disease. High levels of uric acid can lead to a series of pathological conditions, such as gout, urinary stones, inflammation, and uric acid nephropathy. There is a close relationship between uric acid and the NLRP3 inflammasome. NLRP3 inflammasome activation can cause cell damage and even death through endoplasmic reticulum stress, lysosome destruction, mitochondrial dysfunction, and the interaction between the Golgi apparatus and extracellular vesicles. In addition, the NLRP3 inflammasome acts as a molecular platform, triggering the activation of caspase-1 and the lysis of IL-1β, IL-18 and Gasdermin D (GSDMD) through different molecular mechanisms. Cleaved NT-GSDMD forms pores in the cell membrane and triggers pyrophosphorylation, thereby inducing cell death and releasing many intracellular proinflammatory molecules. In recent years, studies have found that hyperuricemia or uric acid crystals can activate NLRP3 inflammasomes, and the activation of NLRP3 inflammasomes plays an important role in kidney disease. This article reviews the possible pathophysiological mechanisms by which uric acid activates inflammasomes and induces kidney damage at the cellular and molecular levels.
高尿酸血症是慢性肾脏病进展的独立危险因素。尿酸水平升高可导致一系列病理状态,如痛风、尿路结石、炎症和尿酸肾病。尿酸与 NLRP3 炎性小体密切相关。NLRP3 炎性小体的激活可通过内质网应激、溶酶体破坏、线粒体功能障碍以及高尔基体与细胞外囊泡之间的相互作用导致细胞损伤甚至死亡。此外,NLRP3 炎性小体作为分子平台,通过不同的分子机制触发 caspase-1 的激活和 IL-1β、IL-18 和 Gasdermin D(GSDMD)的裂解。裂解的 NT-GSDMD 在细胞膜上形成孔,并引发焦磷酸化,从而诱导细胞死亡并释放许多细胞内促炎分子。近年来的研究发现,高尿酸血症或尿酸晶体可激活 NLRP3 炎性小体,而 NLRP3 炎性小体的激活在肾脏病中起着重要作用。本文综述了尿酸在细胞和分子水平激活炎性小体并诱导肾脏损伤的可能病理生理机制。