The Lymphatic System in Kidney Disease.
The Lymphatic System in Kidney Disease.
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DOI：
10.34067/kid.0000000000000120
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发表时间：
2023-06-01
期刊：
影响因子：
--
通讯作者：
Cantley LG
中科院分区：
文献类型：
--
作者：
Baker ML;Cantley LG
淋巴系统的高容量血管几乎从身体的每个部位排出外渗的液体和大分子。然而，淋巴系统不仅仅是用于流体去除的被动管道，还通过在流体、大分子和运输免疫细胞返回体循环之前将其呈递给区域引流淋巴结中的监视细胞，在免疫监视和免疫应答调节中发挥关键和积极的作用。该系统在肾脏内外的许多疾病状态中的潜在作用越来越多地被探索其治疗潜力。在肾脏中，疏水剂在液体和大分子清除中起关键作用，以维持正常肾功能的ongland和静水压力梯度，以及塑造肾脏免疫力，并可能平衡促进健康器官维持和对损伤反应的生理途径。在包括阿基在内的许多肾脏疾病状态中，对预先存在的淋巴网络的需求增加，以清除损伤相关的组织水肿和炎性浸润。由巨噬细胞、受损的驻留细胞和肾组织中的其他驱动因素刺激的淋巴管生成在阿基、CKD和移植的情况下非常普遍。越来越多的证据表明，淋巴管生成在阿基和肾移植排斥中可能是有害的，这可能将淋巴管生成定位为新疗法的另一个靶点，以改善结果。然而，在何种程度上淋巴管生成是保护性的，而不是适应不良的肾脏在各种设置仍然知之甚少，因此一个领域的积极研究。
The high-capacity vessels of the lymphatic system drain extravasated fluid and macromolecules from nearly every part of the body. However, far from merely a passive conduit for fluid removal, the lymphatic system also plays a critical and active role in immune surveillance and immune response modulation through the presentation of fluid, macromolecules, and trafficking immune cells to surveillance cells in regional draining lymph nodes before their return to the systemic circulation. The potential effect of this system in numerous disease states both within and outside of the kidney is increasingly being explored for their therapeutic potential. In the kidneys, the lymphatics play a critical role in both fluid and macromolecule removal to maintain oncotic and hydrostatic pressure gradients for normal kidney function, as well as in shaping kidney immunity, and potentially in balancing physiological pathways that promote healthy organ maintenance and responses to injury. In many states of kidney disease, including AKI, the demand on the preexisting lymphatic network increases for clearance of injury-related tissue edema and inflammatory infiltrates. Lymphangiogenesis, stimulated by macrophages, injured resident cells, and other drivers in kidney tissue, is highly prevalent in settings of AKI, CKD, and transplantation. Accumulating evidence points toward lymphangiogenesis being possibly harmful in AKI and kidney allograft rejection, which would potentially position lymphatics as another target for novel therapies to improve outcomes. However, the extent to which lymphangiogenesis is protective rather than maladaptive in the kidney in various settings remains poorly understood and thus an area of active research.
影响因子：
4
作者：
Masood F;Bhattaram R;Rosenblatt MI;Kazlauskas A;Chang JH;Azar DT
通讯作者：
Azar DT