Rahardjo Harrina E, Märker Viktoria, Tsikas Dimitrios, Kuczyk Markus A, Ückert Stefan, Bannowsky Andreas
Department of Urology, Cipto Mangunkusumo Hospital, School of Medicine, University of Indonesia, Jakarta 10430, Indonesia.
Department of Urology & Urological Oncology, Division of Surgery, Hannover Medical School, 30625 Hannover, Germany.
J Clin Med. 2023 Jul 19;12(14):4770. doi: 10.3390/jcm12144770.
Fibrosis is a disease condition characterized by abnormalities of the extracellular matrix, such as accumulation of the transforming growth factor β, infiltration by myofibroblasts, deposition of collagen, and a generalized dysregulation of collagen maturation. It can severely impair the function of organs by replacing normal tissue with a highly collagenized matrix, thereby reducing the elasticity and compliance of tissues. Fibrotic diseases of the genitourinary tract present relevant problems in healthcare, and their principles of pathophysiology remain unclarified; hence, the armamentarium for prevention and treatment is limited. These diseases include renal fibrosis, Peyronie's disease and ureteral and urethral strictures due to perturbations in the process of wound healing in response to injuries. Such deteriorations may contribute to obstructive uropathies or sexual dysfunction. This review provides a brief overview of the most frequent fibrotic diseases of the genitourinary system and of how the pathophysiology is related to symptoms, and also highlights potential therapeutic strategies to address the abnormal deposition of collagen. Although the understanding of factors associated with fibrotic conditions of the urinary and genital tract is still limited, some beneficial advances have been made. Further research will serve to provide a more comprehensive insight into factors responsible for the development of fibrotic tissue deposition.
纤维化是一种以细胞外基质异常为特征的疾病状态,例如转化生长因子β的积累、肌成纤维细胞浸润、胶原蛋白沉积以及胶原蛋白成熟的普遍失调。它会通过用高度胶原化的基质取代正常组织来严重损害器官功能,从而降低组织的弹性和顺应性。泌尿生殖道的纤维化疾病在医疗保健中存在相关问题,其病理生理学原理仍未阐明;因此,预防和治疗手段有限。这些疾病包括肾纤维化、佩罗尼氏病以及因损伤后伤口愈合过程受到干扰而导致的输尿管和尿道狭窄。此类病变可能导致梗阻性尿路疾病或性功能障碍。本综述简要概述了泌尿生殖系统最常见的纤维化疾病,以及病理生理学与症状的关联方式,还强调了针对胶原蛋白异常沉积的潜在治疗策略。尽管对与泌尿生殖道纤维化状况相关因素的理解仍然有限,但已经取得了一些有益进展。进一步的研究将有助于更全面地洞察导致纤维化组织沉积的因素。