Chagas Yumi Watanabe, Vaz de Castro Pedro Alves S, Simões-E-Silva Ana Cristina
Interdisciplinary Laboratory of Medical Investigation, Unit of Pediatric Nephrology, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Brazil.
Interdisciplinary Laboratory of Medical Investigation, Unit of Pediatric Nephrology, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Brazil.
Behav Brain Res. 2025 Apr 12;483:115465. doi: 10.1016/j.bbr.2025.115465. Epub 2025 Feb 6.
The complex relationship between chronic kidney disease (CKD) and neuroinflammation shows how important immunological processes are in mediating cognitive dysfunction and psychiatric symptoms in this disease. Proinflammatory cytokines and chemokines, such as IL-1β and IL-6, are capable of crossing the blood-brain barrier, and, consequently, may contribute to neuropsychiatric symptoms including anxiety, depression, and cognitive impairment in CKD patients. The peptides of the renin-angiotensin system (RAS), with their dual functions in inflammation and neuroprotection, also highlight the intricate immunological mechanisms operating within the kidney-brain axis. Understanding these immunological pathways is essential for developing targeted interventions to modulate neuroinflammation and improve cognitive outcomes in individuals with CKD. Further research in renal immunology and neuroinflammation holds promise for advancing our understanding of the intricate connections between kidney health, brain function, and immune responses in the context of CKD. This review summarizes the critical role of immunological factors in the pathophysiology of CKD-related cognitive impairment and psychiatric disorders.
慢性肾脏病（CKD）与神经炎症之间的复杂关系表明，免疫过程在介导该疾病的认知功能障碍和精神症状方面有多重要。促炎细胞因子和趋化因子，如白细胞介素-1β（IL-1β）和白细胞介素-6（IL-6），能够穿过血脑屏障，因此可能导致CKD患者出现包括焦虑、抑郁和认知障碍在内的神经精神症状。肾素-血管紧张素系统（RAS）的肽类在炎症和神经保护方面具有双重功能，这也凸显了肾-脑轴内复杂的免疫机制。了解这些免疫途径对于开发有针对性的干预措施以调节神经炎症并改善CKD患者的认知结果至关重要。肾脏免疫学和神经炎症方面的进一步研究有望增进我们对CKD背景下肾脏健康、脑功能和免疫反应之间复杂联系的理解。本综述总结了免疫因素在CKD相关认知障碍和精神疾病病理生理学中的关键作用。
