肾脏疾病中的中性粒细胞与中性粒细胞胞外陷阱

Neutrophils and NETs in kidney disease.

作者信息

Nakazawa Daigo, Masuda Sakiko, Nishibata Yuka, Watanabe-Kusunoki Kanako, Tomaru Utano, Ishizu Akihiro

机构信息

Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.

出版信息

Nat Rev Nephrol. 2025 Mar 18. doi: 10.1038/s41581-025-00944-3.

Abstract

Neutrophils, conventionally regarded as a homogeneous immune cell population, have emerged as a heterogeneous group of cells with distinct gene profiles and immune properties. Activated neutrophils release a spectrum of bioactive substances, including cytokines, chemokines, proteolytic enzymes, reactive oxygen species and neutrophil extracellular traps (NETs), which are composed of decondensed DNA and antimicrobial proteins. NETs have a pivotal role in innate immunity, including in preventing the ascent of uropathogenic bacteria into the kidneys, as they efficiently trap pathogenic microorganisms. However, although indispensable for defence against pathogens, NETs also pose risks of self-damage owing to their cytotoxicity, thrombogenicity and autoantigenicity. Accordingly, neutrophils and NETs have been implicated in the pathogenesis of various disorders that affect the kidneys, including acute kidney injury, vasculitis, systemic lupus erythematosus, thrombotic microangiopathy and in various aetiologies of chronic kidney disease. Pathological alterations in the glomerular vascular wall can promote the infiltration of neutrophils, which can cause tissue damage and inflammation through their interactions with kidney-resident cells, including mesangial cells and podocytes, leading to local cell death. Targeting neutrophil activation and NET formation might therefore represent a new therapeutic strategy for these conditions.

摘要

中性粒细胞,传统上被视为一种同质的免疫细胞群体,现已成为一组具有不同基因谱和免疫特性的异质性细胞。活化的中性粒细胞会释放一系列生物活性物质,包括细胞因子、趋化因子、蛋白水解酶、活性氧和中性粒细胞胞外陷阱(NETs),后者由解聚的DNA和抗菌蛋白组成。NETs在固有免疫中起关键作用,包括防止尿路致病性细菌上行至肾脏,因为它们能有效捕获致病微生物。然而,尽管NETs对于抵御病原体不可或缺,但由于其细胞毒性、血栓形成性和自身抗原性,它们也会带来自我损伤的风险。因此,中性粒细胞和NETs与影响肾脏的各种疾病的发病机制有关,包括急性肾损伤、血管炎、系统性红斑狼疮、血栓性微血管病以及慢性肾脏病的各种病因。肾小球血管壁的病理改变可促进中性粒细胞浸润,中性粒细胞通过与肾脏固有细胞(包括系膜细胞和足细胞)相互作用,可导致组织损伤和炎症,进而导致局部细胞死亡。因此,针对中性粒细胞活化和NET形成可能代表了针对这些病症的一种新的治疗策略。

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