Renal therapy using tissue-engineered constructs and gene delivery
Renal therapy using tissue-engineered constructs and gene delivery
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DOI：
10.1007/s003450050013
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发表时间：
2000-02-01
影响因子：
3.4
通讯作者：
Atala, A
中科院分区：
文献类型：
--
作者：
Amiel, GE;Yoo, JJ;Atala, A
目前可用的肾脏替代疗法对大多数患者不是最佳的。除了移植器官本身的短缺外，肾移植和免疫抑制治疗也会引起严重的并发症。透析忽略了肾脏的吸收、体内平衡、代谢和内分泌功能，只能部分替代其过滤功能，导致发病率和死亡率。组织工程技术的应用可以改善肾功能替代的许多方面。确定能够指导组织发育的生长因子以及用于其输送的技术将有助于人体组织工程。组织工程策略与基因治疗的结合可能允许用指定的cDNA转染病变组织以消除固有或获得性缺陷。除了能够排泄尿样溶质的三维肾单元外，用于替代肾脏功能单一方面的设备已经在实验中使用。这些策略的结合可能会在未来形成组织工程肾脏。急性肾功能衰竭（ARF）对降低患者发病率和死亡率具有重要影响。本文回顾了目前肾脏替代疗法的选择，即血液透析、腹膜透析和移植，并讨论了组织工程如何作为改进当前透析设备的手段和肾脏替代疗法的创新模式。
Currently available renal replacement therapies are not optimal for most patients. In addition to the inherent shortage of transplant organs, significant complications are associated with renal transplantation and immunosuppressive therapy. Dialysis neglects the resorptive, homeostatic, metabolic, and endocrinologic functions of the kidney and only partially replaces its filtration properties, resulting in morbidity and mortality. Application of tissue-engineering techniques may improve many aspects of renal function replacement. Identification of the growth factors capable of directing tissue development and of the technique to be used for their delivery would aid in the engineering of human tissue. The combination of tissue-engineering strategies with gene therapy might allow the transfection of diseased tissues with designated cDNA to eliminate inherent or acquired defects. Devices that have been targeted at replacing a single aspect of renal function, in addition to three-dimensional renal units that are capable of excreting urine-like solutes, have been used experimentally. Combination of these strategies may allow the formation of tissue-engineered kidneys in the future. acute renal failure (ARF) would have a significant impact on the reduction of patient morbidity and mortality.This article reviews the current options for renal replacement therapy, i.e., hemodialysis, peritoneal dialysis, and transplantation, and discusses how tissue engineering may be applied as a means of improving current dialysis devices and as an innovative modality for renal replacement therapy.