Bilirubin, a new therapeutic for kidney transplant?
Bilirubin, a new therapeutic for kidney transplant?
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DOI：
10.1016/j.trre.2018.06.003
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发表时间：
2018-10-01
影响因子：
4
通讯作者：
Hinds, Terry D., Jr.
中科院分区：
文献类型：
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作者：
Sundararaghavan, Vikram L.;Binepal, Sivjot;Hinds, Terry D., Jr.
在终末期肾病患者中，肾移植与许多益处相关，包括增加日常活动和更好的生存率。然而，超过20%的肾移植在五年内导致排斥反应。排斥反应主要是由于过敏性免疫系统和缺血/再灌注损伤。胆红素已被证明是一种有效的抗氧化剂，能够潜在地逆转或预防缺血和再灌注产生的活性氧的损伤。此外，胆红素具有几种免疫调节作用，可以抑制免疫系统以促进器官接受。胆红素升高也被证明对肾血流动力学有积极影响，这在移植后至关重要。最后，胆红素水平与成功移植的生物标志物相关。在这篇综述中，我们讨论了许多潜在的有益影响，胆红素对肾脏接受移植的基础上，大量的临床试验和动物模型。外源性胆红素输送或增加移植前或移植后的内源性水平可能具有治疗益处。(C)2018作者爱思唯尔公司出版
In patients with end-stage renal disease, kidney transplantation has been associated with numerous benefits, including increased daily activity, and better survival rates. However, over 20% of kidney transplants result in rejection within five years. Rejection is primarily due to a hypersensitive immune system and ischemia/reperfusion injury. Bilirubin has been shown to be a potent antioxidant that is capable of potentially reversing or preventing damage from reactive oxygen species generated from ischemia and reperfusion. Additionally, bilirubin has several immunomodulatory effects that can dampen the immune system to promote organ acceptance. Increased bilirubin has also been shown to have a positive impact on renal hemodynamics, which is critical posttransplantation. Lastly, bilirubin levels have been correlated with biomarkers of successful transplantation. In this review, we discuss a multitude of potentially beneficial effects that bilirubin has on kidney acceptance of transplantation based on numerous clinical trials and animal models. Exogenous bilirubin delivery or increasing endogenous levels pre- or post-transplantation may have therapeutic benefits. (C) 2018 The Authors. Published by Elsevier Inc.