The danger control concept in kidney disease: mesangial cells
The danger control concept in kidney disease: mesangial cells
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DOI：
10.5301/jn.5000247
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发表时间：
2013-05-01
影响因子：
3.4
通讯作者：
Anders, Hans-Joachim
中科院分区：
文献类型：
--
作者：
Migliorini, Adriana;Ebid, Rainer;Anders, Hans-Joachim
肾脏重塑是对肾脏损伤的内在或外在触发因素的反应。损伤启动了一套普遍的反应程序，这些程序是通过进化积极选择的，以控制潜在的危及生命的危险，并恢复体内平衡，包括组织修复。这些危险控制程序是（i）凝血，以控制出血的风险;（ii）炎症，以控制感染的风险;（iii）上皮修复;（iv）间质修复;和（v）疤痕消退或最小化。在这篇综述中，我们着重于肾小球系膜细胞在肾小球疾病中的作用，以及它们的行为如何遵循这些危险控制程序。我们综述了系膜细胞在肾小球凝血和纤溶中的作用，以及它们在引发肾小球炎症和系膜增生性疾病中的作用。此外，我们还讨论了系膜如何自我修复，足细胞损伤如何引发“间质愈合”--一种导致肾小球纤维化和硬化的反应。因此，我们可以更好地了解肾小球系膜细胞的肾小球病理学的贡献，当我们了解他们的行为，试图支持进化保守的普遍危险控制程序。然而，这些机制往往导致适应不良的过程，破坏复杂的肾小球超微结构，而不是帮助恢复组织的稳态。
Kidney remodeling is a response to intrinsic or extrinsic triggers of kidney injury. Injury initiates a set of universal response programs that were positively selected through evolution to control potentially life-threatening dangers and to regain homeostasis, including tissue repair. These danger control programs are (i) clotting, to control the risk of bleeding; (ii) inflammation, to control the risk of infection; (iii) epithelial repair; (iv) mesenchymal repair; and (v) scar resolution or minimization. In this review we focus on the role of mesangial cells in glomerular disorders and how their behaviors follow these danger control programs. We review the role of mesangial cells in glomerular coagulation and fibrinolysis, as well as their role in triggering glomerular inflammation and mesangioproliferative disorders. Furthermore, we discuss how the mesangium self-repairs, how podocyte injury triggers a "mesenchymal healing"-kind of response that leads to glomerular fibrosis and sclerosis. Thus, we can better appreciate the contribution of mesangial cells to glomerular pathology when we understand their behavior as an attempt to support the evolutionally conserved universal danger control programs. However, these mechanisms often result in maladaptive processes that destroy the complex glomerular ultrastructure rather than help to regain tissue homeostasis.