Inflammation-Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome.

Inflammation-Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome.
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DOI:
10.1155/2018/2180373
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发表时间:
2018
影响因子:
4.1
通讯作者:
Tanase C
Tanase C
中科院分区:
医学3区
文献类型:
--
作者:
Mihai S;Codrici E;Popescu ID;Enciu AM;Albulescu L;Necula LG;Mambet C;Anton G;Tanase C

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持续的低度炎症现在被认为是慢性肾脏疾病(CKD)的标志性特征,参与这些患者全因死亡率的发展。尽管临床护理已经取得了实质性的改善,但CKD仍然是一个主要的公共卫生负担,影响10-15%的人口,其患病率不断上升。由于其潜在的性质,CKD很少在早期阶段被诊断出来,并且一旦发展,其进展是不可逆的。有许多因素导致CKD炎症状态的形成,包括促炎细胞因子的产生增加、氧化应激和酸中毒、慢性和复发性感染、脂肪组织代谢改变,最后但并非最不重要的是,肠道微生物群生态失调,这是一种被低估的微炎症来源。在这种情况下,一个巨大的进步是由组学方法的不断发展,专门设计用于识别生物标志物,用于早期诊断和随访。最新的组学进展可以为解读疾病病理生理学提供新的见解;因此,使用最先进的蛋白质组学技术鉴定循环生物标志物组可以改善CKD的早期诊断、监测和诊断。这篇综述旨在总结关于炎症和CKD之间关系的最新知识,强调当前的蛋白质组学方法,以及炎症体和肠道微生物群失调参与CKD的设置,最终导致CKD和肾脏恶性肿瘤之间令人不安的双向联系,在炎症性疾病的背景下提出。
Persistent, low-grade inflammation is now considered a hallmark feature of chronic kidney disease (CKD), being involved in the development of all-cause mortality of these patients. Although substantial improvements have been made in clinical care, CKD remains a major public health burden, affecting 10–15% of the population, and its prevalence is constantly growing. Due to its insidious nature, CKD is rarely diagnosed in early stages, and once developed, its progression is unfortunately irreversible. There are many factors that contribute to the setting of the inflammatory status in CKD, including increased production of proinflammatory cytokines, oxidative stress and acidosis, chronic and recurrent infections, altered metabolism of adipose tissue, and last but not least, gut microbiota dysbiosis, an underestimated source of microinflammation. In this scenario, a huge step forward was made by the increasing progression of omics approaches, specially designed for identification of biomarkers useful for early diagnostic and follow-up. Recent omics advances could provide novel insights in deciphering the disease pathophysiology; thus, identification of circulating biomarker panels using state-of-the-art proteomic technologies could improve CKD early diagnosis, monitoring, and prognostics. This review aims to summarize the recent knowledge regarding the relationship between inflammation and CKD, highlighting the current proteomic approaches, as well as the inflammasomes and gut microbiota dysbiosis involvement in the setting of CKD, culminating with the troubling bidirectional connection between CKD and renal malignancy, raised on the background of an inflammatory condition.
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