Department of Anaesthesiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Clin Chim Acta. 2022 Jun 1;531:418-425. doi: 10.1016/j.cca.2022.05.001. Epub 2022 May 11.
Diabetic kidney disease (DKD) is the most common cause of renal failure and a major contributor to the socioeconomic burden in chronic kidney disease (CKD) patients worldwide. The pathogenesis of DKD involves all the structures in the nephron, and it is indicated by proteinuria, hypertension, and progressive decline in renal function, leading to substantial morbidity and mortality. Due to the limitations of currently available standard markers (albuminuria and glomerular filtration rate) in the diagnosis and clinical grading of DKD, it's time to have novel biomarkers for early detection, targeted and effective therapy to prevent the progression. Microparticles (MPs) are extracellular vesicles measuring 0.1-1 µm derived by cytoskeletal reorganization in the form of cytoplasmic blebs which alters the phospholipid cytochemistry of the cell membrane. They are shed during cell activation and apoptosis as well as plays an important role in cell-to-cell communication. Over the last few decades, both plasma and urinary MPs have been investigated, validated and the preliminary research looks promising. With alterations in their number and composition documented in clinical situations involving both Type1 and 2 diabetes mellitus, microparticles assay appears to be promising in early diagnosis and prognostication of DKD. We cover the basics of microparticles and their involvement in DKD in this review article.
糖尿病肾病（DKD）是全球慢性肾脏病（CKD）患者肾功能衰竭的最常见原因，也是社会经济负担的主要原因。DKD 的发病机制涉及到肾单位的所有结构，其特征是蛋白尿、高血压和肾功能进行性下降，导致发病率和死亡率显著增加。由于目前可用的标准标志物（蛋白尿和肾小球滤过率）在 DKD 的诊断和临床分级中的局限性，现在需要新的生物标志物来进行早期检测、靶向和有效的治疗，以预防疾病进展。微颗粒（MPs）是细胞骨架重组形成的直径为 0.1-1μm 的细胞外囊泡，改变了细胞膜的磷脂细胞化学。它们在细胞激活和细胞凋亡过程中脱落，并在细胞间通讯中发挥重要作用。在过去的几十年中，人们已经对血浆和尿液中的 MPs 进行了研究、验证，初步研究结果看起来很有前景。在涉及 1 型和 2 型糖尿病的临床情况下，已经记录到它们数量和组成的改变，微颗粒检测似乎在 DKD 的早期诊断和预后中有很大的应用前景。本文综述了微颗粒的基本原理及其在 DKD 中的作用。
