Pediatric Nephrology Institution, Rambam Health Care Campus, Haifa 3109601, Israel.
Faculty of Medicine, Technion-Israeli Institute of Technology, Haifa 3109601, Israel.
Cells. 2023 Nov 27;12(23):2714. doi: 10.3390/cells12232714.
Chronic kidney disease (CKD) constitutes a worldwide epidemic, affecting approximately 10% of the global population, and imposes significant medical, psychological, and financial burdens on society. Individuals with CKD often face elevated morbidity and mortality rates, mainly due to premature cardiovascular events. Chronic inflammation has been shown to play a significant role in the progression of CKD, as well as in the acceleration of CKD-related complications, including atherosclerosis, cardiovascular disease (CVD), protein-energy wasting, and the aging process. Over the past two decades, a substantial body of evidence has emerged, identifying chronic inflammation as a central element of the uremic phenotype. Chronic inflammation has been shown to play a significant role in the progression of CKD, as well as in the acceleration of CKD-related complications in dialysis patients, including atherosclerosis, CVD, protein-energy wasting, and the aging process. Remarkably, chronic inflammation also impacts patients with CKD who have not yet required renal replacement therapy. While extensive research has been conducted on the involvement of both the adaptive and innate immune systems in the pathogenesis of CKD-related complications, this wealth of data has not yet yielded well-established, effective treatments to counteract this ongoing pathological process. In the following review, we will examine the established components of the innate immune system known to be activated in CKD and provide an overview of the current therapeutic approaches designed to mitigate CKD-related chronic inflammation.
慢性肾脏病(CKD)是一种全球性的流行疾病,影响着全球约 10%的人口,给社会带来了巨大的医疗、心理和经济负担。CKD 患者的发病率和死亡率较高,主要是由于心血管事件的发生较为提前。慢性炎症被认为在 CKD 的进展以及 CKD 相关并发症(包括动脉粥样硬化、心血管疾病(CVD)、蛋白质能量消耗和衰老过程)的加速中起着重要作用。在过去的二十年中,大量证据表明慢性炎症是尿毒症表型的核心因素之一。慢性炎症在 CKD 的进展以及透析患者的 CKD 相关并发症(包括动脉粥样硬化、CVD、蛋白质能量消耗和衰老过程)的加速中起着重要作用。值得注意的是,慢性炎症也会影响尚未需要肾脏替代治疗的 CKD 患者。尽管广泛研究了适应性和固有免疫系统在 CKD 相关并发症发病机制中的作用,但这些大量的数据尚未产生有效的治疗方法来对抗这一持续的病理过程。在接下来的综述中,我们将检查已知在 CKD 中被激活的固有免疫系统的既定组成部分,并概述旨在减轻 CKD 相关慢性炎症的当前治疗方法。