Mitochondrial function and disturbances in the septic kidney.

Mitochondrial function and disturbances in the septic kidney.
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DOI:
10.1016/j.semnephrol.2015.01.011
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发表时间:
2015-01
影响因子:
3.3
通讯作者:
Dong, Zheng
Dong, Zheng
中科院分区:
医学2区
文献类型:
--
作者:
Parikh, Samir M.;Yang, Yuan;He, Liyu;Tang, Chengyuan;Zhan, Ming;Dong, Zheng

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每毫克组织中,只有心脏的线粒体数量超过肾脏。毫不奇怪,肾线粒体最密集地集中在肾单位的上皮细胞中,在这些部位,溶质逆着电化学梯度移动的化学功对ATP产生了巨大而恒定的需求。肾上皮线粒体的紊乱似乎是各种形式的急性肾损伤(阿基)的标志。脓毒症中多器官功能障碍综合征(MODS)的发病机制是复杂的,但大量的实验和观察性人体数据支持双重概念,即线粒体功能障碍导致滤过受损,线粒体结构和功能的恢复对于脓毒症相关阿基的恢复至关重要。这些见解提出了新的方法来诊断,分层,预防甚至治疗这种常见的致命并发症。本综述将(1)描述健康线粒体的结构和功能以及肾脏能量代谢与溶质转运的关系;(2)概述线粒体病理学与肾脏疾病之间的联系;(3)总结脓毒性阿基中观察到的线粒体病变;(4)分析线粒体过程(包括分裂/融合、线粒体自噬和生物发生)在脓毒性阿基的发展和从该疾病中恢复中的作用;和(5)探索治疗性靶向线粒体以预防或治疗脓毒性阿基的潜力。
Per milligram of tissue, only the heart exceeds the kidney’s abundance of mitochondria. Not surprisingly, renal mitochondria are most densely concentrated in the epithelium of the nephron, at sites where the chemical work of moving solutes against electrochemical gradients places large and constant demands for ATP. Derangements of renal epithelial mitochondria appear to be a hallmark for diverse forms of acute kidney injury (AKI). The pathogenesis of multiple-organ dysfunction syndrome (MODS) in sepsis is complex, but a substantial body of experimental and observational human data supports the twin concepts that mitochondrial dysfunction contributes to impaired filtration and that recovery of mitochondrial structure and function is essential for recovery from sepsis-associated AKI. These insights have suggested novel methods to diagnose, stratify, prevent, or even treat this common and deadly complication of critical illness. This review will (1) describe the structure and functions of healthy mitochondria and how renal energy metabolism relates to solute transport; (2) provide an overview of the evidence linking mitochondrial pathology to renal disease; (3) summarize the mitochondrial lesions observed in septic AKI; (4) analyze the role of mitochondrial processes including fission/fusion, mitophagy, and biogenesis in the development of septic AKI and the recovery from this disease; and (5) explore the potential for therapeutically targeting mitochondria to prevent or treat septic AKI.
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