Department of Kidney Development, Institute of Molecular Embryology and Genetics, Kumamoto University, Kumamoto, Japan.
Transplantation. 2023 Sep 1;107(9):1883-1894. doi: 10.1097/TP.0000000000004526. Epub 2023 Aug 21.
The kidney is an important organ for maintenance of homeostasis in the human body. As renal failure progresses, renal replacement therapy becomes necessary. However, there is a chronic shortage of kidney donors, creating a major problem for transplantation. To solve this problem, many strategies for the generation of transplantable kidneys are under investigation. Since the first reports describing that nephron progenitors could be induced from human induced pluripotent stem cells, kidney organoids have been attracting attention as tools for studying human kidney development and diseases. Because the kidney is formed through the interactions of multiple renal progenitors, current studies are investigating ways to combine these progenitors derived from human induced pluripotent stem cells for the generation of transplantable kidney organoids. Other bioengineering strategies, such as decellularization and recellularization of scaffolds, 3-dimensional bioprinting, interspecies blastocyst complementation and progenitor replacement, and xenotransplantation, also have the potential to generate whole kidneys, although each of these strategies has its own challenges. Combinations of these approaches will lead to the generation of bioengineered kidneys that are transplantable into humans.
肾脏是人体维持内环境稳定的重要器官。随着肾衰竭的进展，肾脏替代治疗变得必要。然而，肾脏供体长期短缺，这给移植带来了重大问题。为了解决这个问题，许多生成可移植肾脏的策略正在研究中。自从首次报道描述肾祖细胞可以从人诱导多能干细胞中诱导产生以来，肾类器官已作为研究人类肾脏发育和疾病的工具而受到关注。由于肾脏是通过多种肾祖细胞的相互作用形成的，目前的研究正在探索将这些源自人诱导多能干细胞的祖细胞组合起来生成可移植的肾类器官的方法。其他生物工程策略，如支架的脱细胞和再细胞化、3 维生物打印、种间胚泡互补和祖细胞替换以及异种移植，也有可能生成整个肾脏，尽管这些策略各有挑战。这些方法的组合将导致生成可移植到人体的生物工程肾脏。
