Simon E E
Renal Division, Jewish Hospital at Washington University, St Louis, MO.
Nephrol Dial Transplant. 1994;9 Suppl 4:26-33.
Many cell adhesion molecules probably contribute to the pathogenesis of acute renal failure. This review focuses on the potential importance of integrins. Integrins are a family of molecules that mediate cell-matrix and cell-cell adhesion, and are found on almost all cells. After acute renal injury, tubule epithelial cell-cell contacts (mediated by many molecules including uvomorulin and possibly integrins) are disrupted, as is the cytoskeleton. Detachment of viable tubule epithelial cells from the basement membrane has also been documented following acute renal injury. Such detachment would lead to back-leak of glomerular filtrate and could also be important in the production of cellular casts. As the attachment of the cytoskeleton to integrin is critical to cell-matrix adhesion, it is likely that cytoskeletal disruption is one of the mechanisms contributing to cell detachment. Integrins are also likely to be important in repair, as integrins will probably participate in migration along the basement membrane and may also influence cell function during the redifferentiation process. Finally, leukocyte integrins will probably play a role in the migration of leukocytes into areas of injury and also be critically important to their function.
许多细胞黏附分子可能与急性肾衰竭的发病机制有关。本综述重点关注整合素的潜在重要性。整合素是一类介导细胞与基质以及细胞与细胞黏附的分子，几乎存在于所有细胞上。急性肾损伤后，肾小管上皮细胞间的接触（由包括桥粒芯蛋白以及可能的整合素在内的多种分子介导）会被破坏，细胞骨架也会被破坏。急性肾损伤后，也有文献记载存活的肾小管上皮细胞会从基底膜脱离。这种脱离会导致肾小球滤过液的回漏，并且在细胞管型的形成中可能也很重要。由于细胞骨架与整合素的附着对于细胞与基质的黏附至关重要，细胞骨架破坏很可能是导致细胞脱离的机制之一。整合素在修复过程中可能也很重要，因为整合素可能会参与沿基底膜的迁移，并且在再分化过程中可能也会影响细胞功能。最后，白细胞整合素可能在白细胞迁移到损伤区域中发挥作用，并且对其功能也至关重要。
