Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
School of Basic Medicine, Xinjiang Second Medical College, Karamay, China.
Front Immunol. 2024 Mar 13;15:1333170. doi: 10.3389/fimmu.2024.1333170. eCollection 2024.
Hypertensive nephropathy (HTN) is the second leading cause of end-stage renal disease (ESRD) and a chronic inflammatory disease. Persistent hypertension leads to lesions of intrarenal arterioles and arterioles, luminal stenosis, secondary ischemic renal parenchymal damage, and glomerulosclerosis, tubular atrophy, and interstitial fibrosis. Studying the pathogenesis of hypertensive nephropathy is a prerequisite for diagnosis and treatment. The main cause of HTN is poor long-term blood pressure control, but kidney damage is often accompanied by the occurrence of immune inflammation. Some studies have found that the activation of innate immunity, inflammation and acquired immunity is closely related to the pathogenesis of HTN, which can cause damage and dysfunction of target organs. There are more articles on the mechanism of diabetic nephropathy, while there are fewer studies related to immunity in hypertensive nephropathy. This article reviews the mechanisms by which several different immune cells and inflammatory cytokines regulate blood pressure and renal damage in HTN. It mainly focuses on immune cells, cytokines, and chemokines and inhibitors. However, further comprehensive and large-scale studies are needed to determine the role of these markers and provide effective protocols for clinical intervention and treatment.
高血压肾病(HTN)是终末期肾病(ESRD)的第二大主要原因,也是一种慢性炎症性疾病。持续的高血压会导致肾内小动脉和小动脉的病变、管腔狭窄、继发性缺血性肾实质损伤以及肾小球硬化、肾小管萎缩和间质纤维化。研究高血压肾病的发病机制是诊断和治疗的前提。HTN 的主要原因是长期血压控制不佳,但肾脏损伤常伴有免疫炎症的发生。一些研究发现,固有免疫、炎症和获得性免疫的激活与 HTN 的发病机制密切相关,可导致靶器官的损伤和功能障碍。关于糖尿病肾病的发病机制已有较多的文献报道,而高血压肾病相关免疫方面的研究较少。本文综述了几种不同免疫细胞和炎症细胞因子在 HTN 中调节血压和肾脏损伤的机制,主要集中在免疫细胞、细胞因子和趋化因子及其抑制剂方面,但仍需要进一步全面和大规模的研究来确定这些标志物的作用,并为临床干预和治疗提供有效的方案。