Renal interstitial fibrosis: mechanisms and evaluation.
Renal interstitial fibrosis: mechanisms and evaluation.
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DOI：
10.1097/mnh.0b013e3283521cfa
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发表时间：
2012-05
影响因子：
3.2
通讯作者：
Colvin RB
中科院分区：
文献类型：
--
作者：
Farris AB;Colvin RB
肾小管间质损伤是复杂的，涉及许多独立和重叠的细胞和分子通路，肾间质纤维化和肾小管萎缩（IF/TA）是最后的共同通路。此外，有多种方法来评估IFTA。涉及的细胞包括小管上皮细胞、成纤维细胞、纤维细胞、肌成纤维细胞、单核/巨噬细胞和肥大细胞，它们具有复杂且尚未完全表征的细胞-分子相互作用。涉及的分子介质众多，涉及转化生长因子（TGF-β）、骨形态发生蛋白（BMP）、血小板衍生生长因子（PDGF）和肝细胞生长因子（HGF）等途径。最近的基因组学方法揭示了这些细胞和分子途径中的一些。病理评价IFTA是评估慢性疾病严重程度的核心；然而，有多种方法用于评估IFTA。IFTA的大多数评估依赖于特殊染色的病理学评估，如三色、天狼星红和III型胶原免疫组织化学。视觉病理学家的评估可能容易在观察者之间和观察者之间发生变化，但有些方法采用计算机形态测量，对于最佳方法没有明确的共识。IFTA是由细胞类型和分子途径的协调而产生的。对IFTA的最佳定性和定量评价意见不一。
Tubulointerstitial injury in the kidney is complex, involving a number of independent and overlapping cellular and molecular pathways, with renal interstitial fibrosis and tubular atrophy (IF/TA) as the final common pathway. Furthermore, there are multiple ways to assess IFTA. Cells involved include tubular epithelial cells, fibroblasts, fibrocytes, myofibroblasts, monocyte/macrophages, and mast cells with complex and still incompletely characterized cell-molecular interactions. Molecular mediators involved are numerous and involve pathways such as transforming growth factor (TGF-β), bone morphogenic protein (BMP), platelet-derived growth factor (PDGF), and hepatocyte growth factor (HGF). Recent genomic approaches have shed insight into some of these cellular and molecular pathways. Pathologic evaluation of IFTA is central in assessing the severity of chronic disease; however, there are a variety of methods used to assess IFTA. Most assessment of IFTA relies on pathologist assessment of special stains such as trichrome, Sirius Red, and collagen III immunohistochemistry. Visual pathologist assessment can be prone to inter- and interobserver variability, but some methods employ computerized morphometery, without a clear consensus as to the best method. IFTA results from on orchestration of cell types and molecular pathways. Opinions vary on the optimal qualitative and quantitative assessment of IFTA.