Reverse Translational Research Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Saito-Asagi 7-6-8, Ibaraki, Osaka, 5670085, Japan.
KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Saito-Asagi 7-6-8, Ibaraki, Osaka, 5670085, Japan.
Clin Exp Nephrol. 2023 Nov;27(11):891-900. doi: 10.1007/s10157-023-02384-4. Epub 2023 Jul 27.
D-Serine, a rare enantiomer of serine, is a biomarker of kidney disease and function. The level of D-serine in the human body is precisely regulated through the urinary clearance of the kidney, and its clearance serves as a new measure of glomerular filtration rate with a lower bias than creatinine clearance. D-Serine also has a direct effect on the kidneys and mediates the cellular proliferation of tubular cells via mTOR signaling and induces kidney remodeling as a compensatory reaction to the loss of kidney mass. In living kidney donors, the removal of the kidney results in an increase in blood D-serine level, which in turn accelerates kidney remodeling and augments kidney clearance, thus reducing blood levels of D-serine. This feedback system strictly controls D-serine levels in the body. The function of D-serine as a biomarker and modulator of kidney function will be the basis of precision medicine for kidney diseases.
D-丝氨酸是丝氨酸的一种罕见对映异构体，是肾脏疾病和功能的生物标志物。人体内 D-丝氨酸的水平通过肾脏的尿清除率精确调节，其清除率作为肾小球滤过率的新指标，其偏倚低于肌酐清除率。D-丝氨酸对肾脏也有直接作用，通过 mTOR 信号介导管状细胞的细胞增殖，并作为对肾质量损失的代偿反应诱导肾脏重塑。在活体肾脏供体中，肾脏的切除会导致血液 D-丝氨酸水平升高，这反过来又加速了肾脏重塑和增加了肾脏清除率，从而降低了血液中的 D-丝氨酸水平。这种反馈系统严格控制体内 D-丝氨酸的水平。D-丝氨酸作为肾脏功能的生物标志物和调节剂的功能将成为肾脏疾病精准医学的基础。
