足细胞病与相关循环因子的表达

肾小球足细胞的损伤不仅是遗传性肾小球病的发病基础,还在很多后天的肾小球疾病中发挥重要作用。常见的足细胞病以微小病变性肾病(Minimal Change Disease,MCD)和局灶阶段性肾小管硬化(Focal Segmental glomerulosclerosis,FSGS)为主,有实验证明,足细胞损伤同时参与了各种不同类型的肾小球疾病,比如糖尿病肾病,HIV相关肾病,膜性肾病及其他获得性肾小球病等,因此,了解足细胞病损伤的机制尤为重要。临床观察提出局灶节段行肾小球硬化患者体内可能存在一种与大量蛋白尿发生有关的循环因子,相关的动物实验和体外观察同时也证实了循环因子的存在。越来越多的研究支持T细胞功能不全,细胞因子异常释放可能是循环因子的来源之一。如果能对患者循环因子进行检测,借助它来指导治疗方案的选择(免疫抑制剂、血浆置换),可能成为局灶节段行肾小球硬化诊断和治疗中的一个突破。本文以国内外研究文献为基础,对文献资料进行分析、归纳和总结,综述了足细胞病中相关循环因子的表达,探讨足细胞病发生及复发的机理,为足细胞病的定向治疗提供帮助。

Podocytes and the Express of Associate Recycling Factors

Podocyte disorders may not only underlie these hereditary glomerulopathies but also play crucial role in a broad spectrum of acquired glomerular diseases. It is well known that podocytes are a major target in Minimal Change Disease and Focal Segmental glomerulosclerosis, and increasing evidence indicates that podocyte injury is also involved in a variety of other glomerular diseases, such as diabetic nephropathy, HIV nephropathy, membranous nephropathy and other acquired glomerular diseases. So, it is important to know the injury mechanism of the podocytes. Clinical observation is put forward in patients with FSGS there may be a circulating factor associated with a large number of proteinuria, then the animal experiment and in vitro observation confirmed the existence of circulating factors. A growing number of studies support the T cell dysfunction, abnormal cytokine release may be one of the source of the circulation factor. If it can detect circulating factors on the patients, use it to guide the choice of treatment (immune inhibitors, plasma exchange), may become a breakthrough in the diagnosis and treatment of FSGS. In this paper, based on domestic and international research literature, literature analysis and summarized the research status of the review of podocytes and associated recycling factors, discuss the injury and recurrence mechanismof the podocytes,for the help to the trearment of podocytes.