Department of Nephrology and Hypertension, Uniklinikum Erlangen und Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Am J Physiol Cell Physiol. 2023 Oct 1;325(4):C999-C1016. doi: 10.1152/ajpcell.00201.2023. Epub 2023 Sep 4.
Renal fibrosis is the final stage of most progressive kidney diseases. Chronic kidney disease (CKD) is associated with high comorbidity and mortality. Thus, preventing fibrosis and thereby preserving kidney function increases the quality of life and prolongs the survival of patients with CKD. Many processes such as inflammation or metabolic stress modulate the progression of kidney fibrosis. Hypoxia has also been implicated in the pathogenesis of renal fibrosis, and oxygen sensing in the kidney is of outstanding importance for the body. The dysregulation of oxygen sensing in the diseased kidney is best exemplified by the loss of stimulation of erythropoietin production from interstitial cells in the fibrotic kidney despite anemia. Furthermore, hypoxia is present in acute or chronic kidney diseases and may affect all cell types present in the kidney including tubular and glomerular cells as well as resident immune cells. Pro- and antifibrotic effects of the transcription factors hypoxia-inducible factors 1 and 2 have been described in a plethora of animal models of acute and chronic kidney diseases, but recent advances in sequencing technologies now allow for novel and deeper insights into the role of hypoxia and its cell type-specific effects on the progression of renal fibrosis, especially in humans. Here, we review existing literature on how hypoxia impacts the development and progression of renal fibrosis.
肾纤维化是大多数进行性肾脏疾病的终末阶段。慢性肾脏病(CKD)与高合并症和死亡率相关。因此,预防纤维化从而保留肾功能可提高 CKD 患者的生活质量并延长其生存期。许多过程,如炎症或代谢应激,可调节肾脏纤维化的进展。缺氧也与肾纤维化的发病机制有关,肾脏中的氧感应对机体具有重要意义。尽管存在贫血,但纤维化肾脏中的间质细胞产生促红细胞生成素的刺激丧失,这最能说明肾脏中氧感应的失调。此外,急性或慢性肾脏病中存在缺氧,并且可能影响肾脏中存在的所有细胞类型,包括肾小管和肾小球细胞以及固有免疫细胞。在多种急性和慢性肾脏病的动物模型中,已描述了转录因子缺氧诱导因子 1 和 2 的促纤维化和抗纤维化作用,但测序技术的最新进展现在可以深入了解缺氧及其对肾脏纤维化进展的细胞类型特异性影响,尤其是在人类中。在这里,我们回顾了关于缺氧如何影响肾纤维化发生和进展的现有文献。
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