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肾结石管理的最新进展与治疗方法

Recent Progression and Treatment Approaches for the Kidney Stone Management.

作者信息

Sharma Kritika, Nagpal Riya, Pandey Lakshita, Mittal Mahima, Sharma Ajay, Lal Yadav Ramji, Gupta Ghanshyam Das, Sharma Kalicharan

机构信息

Department of Pharmaceutical Chemistry, SPS, Delhi Pharmaceutical Sciences and Research University, New Delhi-110017, India.

Department of Pharmacognosy and Phytochemistry, SPS, Delhi Pharmaceutical Sciences and Research University, New Delhi-110017, India.

出版信息

Curr Drug Targets. 2025;26(9):591-612. doi: 10.2174/0113894501346592250505050431.

Abstract

BACKGROUND

Kidney stones have always been a significant matter in the healthcare sector worldwide, with a high prevalence rate, especially in women. Urolithiasis is the solid mineral deposits in the renal calyces and kidney pelvis. Expounding upon the pathophysiology, various mechanisms such as supersaturation, crystallization, and aggregation are explored. Some new targets can potentially stop the disease's underlying cause that has been found.

AIM

To compile the Recent Progression and treatment approaches for kidney stone management.

MATERIAL AND METHODS

A systematic review was conducted using a comprehensive literature search on the roles of osteopontin, vitamin D, nephrocalcin, and other factors in kidney stone formation in Google Scholar, PubMed, Elsevier, etc. OPN is a multifunctional protein that limits the formation of stones by participating in resorption. The other is the concentration of vitamin D, which raises calcium absorption and causes kidney stones to form. Further, the review encapsulates the spectrum of treatment approaches encompassing phytoconstituents, pharmacotherapy, and minimally invasive procedures, including surgical interventions.

RESULTS

From the Phytochemical-based literature survey, Rubicodifolin, L-ascorbic acid, Thymoquinone, etc., show promising activity in managing kidney stone. Apart from that, we have found such data that has been published in reputed journals. This synthetic drug-based approach shows traditional drug-based targeting. Where Nifedipine, Chlorthalidone, Allopurinol, etc., were used for symptomatic relief. Peptide-based approach reveals that several peptides for the treatment of kidney stone, where Lumasiran, a phase III clinical trial peptide molecule, targets glycolate oxidase and reduces calcium oxalate crystal levels.

CONCLUSION

To implement more effective treatments, it is necessary to identify and develop a targeted therapy for the druggable targets. Various such druggable targets have been reported such as osteopontin which has come out as a protein with various functions including involvement in the inhibition of crystal adherence to the renal epithelium. Another such target is vitamin D and nephrocalcin.

摘要

背景

肾结石一直是全球医疗保健领域的一个重要问题,患病率很高,尤其是在女性中。尿石症是肾盏和肾盂中的固体矿物质沉积。在阐述病理生理学过程中,探讨了诸如过饱和、结晶和聚集等各种机制。已经发现了一些可能阻止该疾病根本原因的新靶点。

目的

汇编肾结石管理的最新进展和治疗方法。

材料和方法

通过在谷歌学术、PubMed、爱思唯尔等数据库中全面检索有关骨桥蛋白、维生素D、肾钙蛋白及其他因素在肾结石形成中的作用的文献,进行了一项系统综述。骨桥蛋白是一种多功能蛋白质,通过参与再吸收来限制结石的形成。另一个因素是维生素D的浓度,它会提高钙的吸收并导致肾结石形成。此外,该综述涵盖了包括植物成分、药物治疗和微创手术(包括手术干预)在内的各种治疗方法。

结果

从基于植物化学的文献调查来看,红景天苷、L - 抗坏血酸、百里醌等在肾结石管理方面显示出有前景的活性。除此之外,我们还发现了在知名期刊上发表的此类数据。这种基于合成药物的方法显示出传统药物靶向性。硝苯地平、氯噻酮、别嘌醇等用于缓解症状。基于肽的方法表明,有几种肽可用于治疗肾结石,其中处于III期临床试验的肽分子鲁马西兰靶向乙醇酸氧化酶并降低草酸钙晶体水平。

结论

为了实施更有效的治疗,有必要针对可成药靶点识别并开发靶向治疗。已经报道了各种这样的可成药靶点,例如骨桥蛋白,它是一种具有多种功能的蛋白质,包括参与抑制晶体附着于肾上皮。另一个这样的靶点是维生素D和肾钙蛋白。

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