Evolutionary Nephrology.
Evolutionary Nephrology.
复制标题
进化肾脏科。
DOI：
10.1016/j.ekir.2017.01.012
复制
发表时间：
2017-05
影响因子：
6
通讯作者：
Chevalier RL
中科院分区：
文献类型：
--
作者：
Chevalier RL
进行性肾病发生于肾元丢失、超滤和不完全修复，这一过程被称为“适应不良”。在过去的20年里，一个新的学科出现了，它扩展了研究的视野：进化医学。与生理（体内平衡）适应相反，进化适应是生殖成功的结果，反映了自然选择。生理适应不良反应的进化解释可以从表型与环境的不匹配或进化权衡中出现。对陆地环境的进化适应导致了脆弱的能量消耗肾小管和缺氧、高渗的微环境。自然选择有利于成功的能量投资策略：能量被分配到维持生殖年龄的肾元完整性，但在40岁之后，随着衰老的增加，能量会下降。慢性肾脏疾病的危险因素包括胎儿生长受限或早产（生活史权衡导致肾单位减少），APOL1突变的进化选择（提供对锥虫感染的抵抗力，权衡）和现代生活经历（西方饮食不匹配导致糖尿病和高血压）。目前，基因组学、表观遗传学和发育生物学的进展已经揭示了肾脏疾病的近因，但减缓肾脏疾病的尝试仍然难以捉摸。进化医学通过解决肾脏疾病的最终原因提供了一种补充方法。出生时肾单位数量的显著变化、肾单位的异质性以及整个生命历程中对肾损伤易感性的变化是进化过程的结果。分子遗传学、进化发育生物学、发育规划和生活史理论的综合应用可能为慢性肾脏疾病的预防和治疗提供新的策略。
Progressive kidney disease follows nephron loss, hyperfiltration, and incomplete repair, a process described as “maladaptive.” In the past 20 years, a new discipline has emerged that expands research horizons: evolutionary medicine. In contrast to physiologic (homeostatic) adaptation, evolutionary adaptation is the result of reproductive success that reflects natural selection. Evolutionary explanations for physiologically maladaptive responses can emerge from mismatch of the phenotype with environment or from evolutionary tradeoffs. Evolutionary adaptation to a terrestrial environment resulted in a vulnerable energy-consuming renal tubule and a hypoxic, hyperosmolar microenvironment. Natural selection favors successful energy investment strategy: energy is allocated to maintenance of nephron integrity through reproductive years, but this declines with increasing senescence after ∼40 years of age. Risk factors for chronic kidney disease include restricted fetal growth or preterm birth (life history tradeoff resulting in fewer nephrons), evolutionary selection for APOL1 mutations (which provide resistance to trypanosome infection, a tradeoff), and modern life experience (Western diet mismatch leading to diabetes and hypertension). Current advances in genomics, epigenetics, and developmental biology have revealed proximate causes of kidney disease, but attempts to slow kidney disease remain elusive. Evolutionary medicine provides a complementary approach by addressing ultimate causes of kidney disease. Marked variation in nephron number at birth, nephron heterogeneity, and changing susceptibility to kidney injury throughout the life history are the result of evolutionary processes. Combined application of molecular genetics, evolutionary developmental biology (evo-devo), developmental programming, and life history theory may yield new strategies for prevention and treatment of chronic kidney disease.
登录
查看更多内容
影响因子：
158.5
作者：
BRENNER, BM;MEYER, TW;HOSTETTER, TH
通讯作者：
HOSTETTER, TH
影响因子：
13.6
作者：
Arcolino, Fanny Oliveira;Zia, Silvia;Levtchenko, Elena
通讯作者：
Levtchenko, Elena
影响因子：
11.1
作者：
Barker, D. J. P.
通讯作者：
Barker, D. J. P.
DOI：
10.1126/science.1226467
发表时间：
2012-11-02
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Baudisch A;Vaupel JW
通讯作者：
Vaupel JW
DOI：
10.1152/ajprenal.00092.2014
发表时间：
2014-06-01
影响因子：
4.2
作者：
Beeman, Scott C.;Cullen-McEwen, Luise A.;Bennett, Kevin M.
通讯作者：
Bennett, Kevin M.