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肥胖相关肾小球病:炎症机制及相关治疗的最新进展

Obesity-related glomerulopathy: recent advances in inflammatory mechanisms and related treatments.

作者信息

Guan Yucan, Wei Xianping, Li Jicui, Zhu Yuexin, Luo Ping, Luo Manyu

机构信息

Department of Nephropathy, The Second Hospital of Jilin University, 218 Ziquiang Street, Nanguan District, Changchun, Jilin 130041, China.

出版信息

J Leukoc Biol. 2024 Apr 29;115(5):819-839. doi: 10.1093/jleuko/qiae035.

Abstract

Obesity-related glomerulopathy, which is an obesity-triggered kidney damage, has become a significant threat to human health. Several studies have recently highlighted the critical role of inflammation in obesity-related glomerulopathy development. Additionally, excess adipose tissue and adipocytes in patients with obesity produce various inflammatory factors that cause systemic low-grade inflammation with consequent damage to vascular endothelial cells, exacerbating glomerular injury. Therefore, we conducted a comprehensive review of obesity-related glomerulopathy and addressed the critical role of obesity-induced chronic inflammation in obesity-related glomerulopathy pathogenesis and progression, which leads to tubular damage and proteinuria, ultimately impairing renal function. The relationship between obesity and obesity-related glomerulopathy is facilitated by a network of various inflammation-associated cells (including macrophages, lymphocytes, and mast cells) and a series of inflammatory mediators (such as tumor necrosis factor α, interleukin 6, leptin, adiponectin, resistin, chemokines, adhesion molecules, and plasminogen activator inhibitor 1) and their inflammatory pathways. Furthermore, we discuss a recently discovered relationship between micronutrients and obesity-related glomerulopathy inflammation and the important role of micronutrients in the body's anti-inflammatory response. Therefore, assessing these inflammatory molecules and pathways will provide a strong theoretical basis for developing therapeutic strategies based on anti-inflammatory effects to prevent or delay the onset of kidney injury.

摘要

肥胖相关性肾小球病是一种由肥胖引发的肾脏损害,已成为对人类健康的重大威胁。最近的几项研究强调了炎症在肥胖相关性肾小球病发展中的关键作用。此外,肥胖患者体内过多的脂肪组织和脂肪细胞会产生各种炎症因子,导致全身低度炎症,进而损害血管内皮细胞,加重肾小球损伤。因此,我们对肥胖相关性肾小球病进行了全面综述,并阐述了肥胖诱导的慢性炎症在肥胖相关性肾小球病发病机制和进展中的关键作用,这种炎症会导致肾小管损伤和蛋白尿,最终损害肾功能。肥胖与肥胖相关性肾小球病之间的关系是由各种炎症相关细胞(包括巨噬细胞、淋巴细胞和肥大细胞)网络以及一系列炎症介质(如肿瘤坏死因子α、白细胞介素6、瘦素、脂联素、抵抗素、趋化因子、黏附分子和纤溶酶原激活物抑制剂1)及其炎症途径促成的。此外,我们还讨论了最近发现的微量营养素与肥胖相关性肾小球病炎症之间的关系以及微量营养素在机体抗炎反应中的重要作用。因此,评估这些炎症分子和途径将为基于抗炎作用制定治疗策略以预防或延缓肾损伤的发生提供有力的理论依据。

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