Grande J P
Department of Internal Medicine, Mayo Foundation, Rochester, Minnesota 55905, USA.
Lupus. 1998;7(9):604-10. doi: 10.1191/096120398678920721.
Lupus nephritis results from an acute inflammatory and immunological response to renal immune complex deposition. The acute response is characterized by activation of circulating leukocytes and renal parenchymal cells, triggering the production of pro-inflammatory cytokines and growth factors. In all too many cases, this response is followed by a chronic response, which is characterized by excessive deposition of collagen and other extracellular matrix macromolecules and the development of end-stage renal disease. Mechanisms underlying this chronic response in progressive renal disease are not adequately defined. In this overview, potential roles of reactive oxygen species (ROS) generation and transforming growth factor-beta (TGF-beta) production in the pathogenesis of lupus nephritis are considered. ROS and TGF-beta may be key elements of a pathway leading to persistent and excessive matrix deposition in progressive lupus nephritis. Further studies to define the role of this pathway in lupus nephritis may lead to the development of additional, more specific therapeutic targets to prevent progression of renal disease.
狼疮性肾炎是由对肾脏免疫复合物沉积的急性炎症和免疫反应引起的。急性反应的特征是循环白细胞和肾实质细胞的激活,引发促炎细胞因子和生长因子的产生。在太多情况下,这种反应之后会出现慢性反应,其特征是胶原蛋白和其他细胞外基质大分子过度沉积以及终末期肾病的发展。进行性肾病中这种慢性反应的潜在机制尚未得到充分阐明。在本综述中,我们考虑了活性氧(ROS)生成和转化生长因子-β(TGF-β)产生在狼疮性肾炎发病机制中的潜在作用。ROS和TGF-β可能是导致进行性狼疮性肾炎中持续和过度基质沉积的途径的关键要素。进一步研究该途径在狼疮性肾炎中的作用可能会导致开发更多、更具体的治疗靶点,以预防肾病进展。