Kawanishi Hideki
Tsuchiya General Hospital, 3-30 Nakajima-cho Naka-ku, Hiroshima 730-8655, Japan.
J Clin Med. 2024 Jan 23;13(3):647. doi: 10.3390/jcm13030647.
The purpose of blood purification therapy is to remove uremic toxins, and middle molecules (MMs) are a specific target. An MM is defined as a solute that passes through the glomerulus with a molecular weight in the range of 0.5-58 kDa, and new classifications of "small-middle 0.5-15 kDa," "medium-middle 15-25 kDa," and "large-middle 25-58 kDa" were proposed. In Japan, the removal of α1-microglobulin (αMG) in the large-middle range has been the focus, but a new theory of removal has been developed, emphasizing the antioxidant effect of αMG as a physiological function. Clinical proof of this mechanism will lead to further development of blood purification therapies.
血液净化疗法的目的是清除尿毒症毒素，而中分子物质（MMs）是一个特定的目标。中分子物质被定义为分子量在0.5 - 58 kDa范围内通过肾小球的溶质，并提出了“小中分子0.5 - 15 kDa”、“中中分子15 - 25 kDa”和“大中分子25 - 58 kDa”的新分类。在日本，大中分子范围内α1 - 微球蛋白（αMG）的清除一直是重点，但已发展出一种新的清除理论，强调αMG作为一种生理功能的抗氧化作用。这一机制的临床证据将推动血液净化疗法的进一步发展。
