Almasry Yazan, Alodhaibi Ibrahim, Nammor Talah, Lerman Amir, Lerman Lilach O, Zhu Xiang-Yang
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, 55901, USA.
College of Medicine, Alfaisal University, 11543, Riyadh, Saudi Arabia.
J Nephrol. 2024 Nov;37(8):2151-2160. doi: 10.1007/s40620-024-02121-4. Epub 2024 Oct 10.
Kidney injury is a major medical burden and one of the most common reasons for hospitalization and poor life quality. Kidney injury can include acute kidney injury, chronic kidney disease, and immune-mediated kidney diseases most of which have no definitive therapy. The spleen is a secondary lymphoid organ in the reticuloendothelial system that plays an important role in protecting the body from various diseases. Notably, spleen tyrosine kinase, a non-receptor tyrosine kinase, is a crucial player that aids in immunity and protection and is highly expressed in the kidney and hematopoietic cells. It has been shown that alterations in spleen tyrosine kinase function or expression could lead to a wide range of diseases and abnormalities. Over the past decade, the role of spleen and spleen tyrosine kinase in multiple kidney diseases has emerged. Evidence suggests that modulating the spleno-renal connection through activation of the cholinergic anti-inflammatory pathway can be a promising strategy for protecting against kidney injury. Imitating the protective function of the spleen through interleukin-10-extracellular vesicles can also be of therapeutic value. In addition, evidence showed that inhibition of the spleen tyrosine kinase leads to amelioration of the kidney injury. However, further exploration and long-term studies are needed to unravel the spleno-renal connection, as well as the efficacy of spleen tyrosine kinase inhibitors, before they can be used as means for treatment of kidney injury.
肾损伤是一项重大的医疗负担，也是住院治疗和生活质量低下的最常见原因之一。肾损伤可包括急性肾损伤、慢性肾脏病和免疫介导性肾脏病，其中大多数尚无确切的治疗方法。脾脏是网状内皮系统中的二级淋巴器官，在保护机体免受各种疾病侵害方面发挥着重要作用。值得注意的是，脾酪氨酸激酶作为一种非受体酪氨酸激酶，是免疫和保护过程中的关键参与者，在肾脏和造血细胞中高度表达。研究表明，脾酪氨酸激酶功能或表达的改变可能导致多种疾病和异常情况。在过去十年中，脾脏和脾酪氨酸激酶在多种肾脏疾病中的作用逐渐显现。有证据表明，通过激活胆碱能抗炎途径调节脾肾联系可能是预防肾损伤的一种有前景的策略。通过白细胞介素-10细胞外囊泡模拟脾脏的保护功能也可能具有治疗价值。此外，有证据表明抑制脾酪氨酸激酶可改善肾损伤。然而，在将其用作治疗肾损伤的手段之前，还需要进一步探索和长期研究来阐明脾肾联系以及脾酪氨酸激酶抑制剂的疗效。
