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专家述评

造血干细胞治疗多囊肾的机制及治疗前景

Mechanisms and therapeutic prospects of hematopoietic stem cells in polycystic kidney disease

:545-553
 
       常染色体显性多囊肾病(ADPKD)是导致遗传性肾衰竭的主要病因之一,目前仍缺乏有效的手段来逆转其疾病进展。干细胞疗法因其在组织修复和免疫调节方面的潜力,成为研究的热点领域。本研究系统阐述了造血干细胞(HSCs)通过旁分泌作用、代谢重塑及免疫调控干预ADPKD病理进程的机制,并总结了其在急性肾损伤和慢性肾病中的临床转化证据。此外,文章比较分析了间充质干细胞(MSCs)和诱导多能干细胞(iPSCs)在ADPKD治疗中的独特优势与面临的挑战,为多模态干细胞疗法的开发提供理论支持。
    Autosomal dominant polycystic kidney disease(ADPKD)stands as a leading cause of inherited renal failure,with current therapeutic strategies lacking effective means to reverse disease progression.Stem cell therapy,owing to its potential in tissue repair and immunomodulation,has emerged as a focal point of research.This review systematically elucidates the mechanisms by which hematopoietic stem cells(HSCs)intervene in ADPKD pathology through paracrine effects,metabolic reprogramming,and immune regulation.Furthermore,it summarizes clinical translational evidence of HSCs in both acute kidney injury and chronic kidney disease.This article also comparatively analyzes the unique advantages and challenges of mesenchymal stem cells(MSCs)and induced pluripotent stem cells(iPSCs)in the context of ADPKD treatment,thereby providing theoretical support for the development of multimodal stem cell therapies.

专家综述

纳米载体药物用于缓解慢性肾脏病纤维化的研究进展

Recent advances in nanomedicines for alleviating chronic kidney disease fibrosis

:1-10
 
慢性肾脏病是一类具有高发病率、高死亡率的慢性疾病群。临床上一般采用血液透析和肾脏移植治疗终末期的慢性肾脏病。研究表明,小分子药物或核酸类药物在慢性肾脏病治疗中极具潜力,但是缺乏特异性导致肾脏纤维化治疗效果有限,亟需开发新的治疗策略。纳米载体因具有良好的理化性质,被广泛应用于生物医学领域。本文综述了近年来纳米载体递送小分子或核酸类药物在慢性肾脏病中的研究进展。
Chronic kidney disease (CKD) is a series of chronic disease groups associated with high morbidity and mortality. Hemodialysis and kidney transplantation are the only choices for end-stage renal disease. According to the literature report, it is shown that small molecule and nucleic acid drugs have great potential in CKD treatments with an unsatisfied therapeutic efficacy because of the lack of specific targeting. Thus, it is necessary to develop a new strategy. Nanocarriers have been widely used in biomedical fields due to their excellent physical and chemical properties. In this review, we have summarized the recent advances in applying functional nanocarriers to deliver the small molecules and nucleic acid drugs in the treatment of CKD.
论著

Cockcroft-Gault公式和中国人MDRD公式在红斑狼疮患者肾小球滤过率的评估

Evaluation of glomerular filtration rate by Cockcroft-Gault equation and Chinese MDRD equation in patients with lupus

:15-18
 
目的 探讨Cockcroft-Gault公式(CG公式)以及中国人MDRD公式(c-MDRD)在狼疮(SLE)患者肾小球滤过率(GFR)评估中的作用。方法 本研究纳入193名SLE患者。测量肾小球滤过率(mGFR)、血清肌酐(SCr),根据cMDRD公式,以及C-G公式分别得出估算肾小球滤过率(eGFR)。从不同方面对eGFR进行评估。结果 193名患者中, mGFR中位值为75.01 mL/(min·1.73 m2),eGFR-CG中位值70.22 mL/(min·1.73 m2),eGFR-cMDRD中位值70.67 mL/(min·1.73 m2)。患者分为mGFR≥60/(n=108)和mGFR<60 mL/(min·1.73 m2)(n=85)。对于总体病人而言, CG和 c-MDRD偏差值分别为0.64和3.91 mL/(min·1.73 m2)。在精确度以及准确度上,CG均优于c-MDRD。除了mGFR<60 mL/(min·1.73 m2)组中CG偏差值稍高于c-MDRD外,CG在分组后的表现仍然优于c-MDRD。结论 和中国人MDRD公式相比,CG公式更加适合用在SLE的GFR评估。
Objective Few studies has been conducted concerned Glomerular Filtration Rate(GFR) estimationequations about Cockcroft-Gault equation(CG equation)and Chinese Modification of Diet in Renal Disease equation(c-MDRD equation)in systemic lupus erythematosus(SLE). Our study aims to assess performance of two equations for renal function evaluation in patients with SLE.Methods 193 participants were enrolled in this study. Measured GFR was obtained by renal dynamic imaging method and Serum Creatinine (SCr)was determined for each participant. eGFR was gained by CG equation and c-MDRD equation respectively. Performance of equations were compared from different aspects.Results mGFR(median), eGFR-CG(median), eGFR-cMDRD(median)of the 193 participants were 75.01,70.22,70.67 mL/(min·1.73 m2)respectively. The participants were divided into two groups including mGFR≥60 (n=108)as well as mGFR<60 mL/(min·1.73 m2)(n=85). For overall participants, bias for CG equation and c-MDRD equation were 0.64, 3.91 mL/(min·1.73 m2) respectively. In terms of precision and accuracy, CG equation was better than c-MDRD equation. In subgroup, CG equation was still superior to c-MDRD equation except for bias in CG equation which is higher than c-MDRD equation in mGFR<60 ml(min·1.73 m2).Conclusion Compared with c-MDRD equation, CG performed better in GFR estimation in patients with SLE.
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