摘要
慢性肾小球肾炎病变的主要原因是肾小球滤过膜的基础结构病变,肾小球滤过膜包括内皮细胞、基底膜和上皮细胞(也称足细胞)三个部分。肾小球足细胞损伤和丢失是肾小球硬化的关键因素之一[1]。微炎症状态[2]、高血糖、高血压、氧化应激及一氧化氮等因素均可直接损伤足细胞,其作用机制可能与调控α3β1整合素引起的细胞信号通路表达改变有关。整合素表达与细胞外基质(ECM)如纤维连接蛋白、Ⅳ型胶原等的代谢密切相关,足细胞与基底膜、足细胞与足细胞之间以及足细胞与基质的相互作用是维持肾小球滤过作用最为重要的形态学基础。因此,我们认为整合素在足细胞及基底膜表达是否正常是影响肾小球滤过作用的重要细胞信号通路。应用中医整体观念认识整合素在肾小球滤过作用的重要性是辨证论治慢性肾脏病的理论基础,是阐述应用中医中医药辨证论治理论治疗慢性肾脏病的关键问题。因而,探索整合素与足细胞损伤在肾脏病发生、发展中的病理发展过程对肾小球肾炎为代表的慢性肾脏病的防治具有重要意义。
It is the key reason that the damage of the filter membrane to the chronic kidney disease （CKD）. The filter membrane includes endothelial cell, basement membrane and epithelial cell （podocyte）. The damage and the loss of glomerular podocyte is the key factor of glomerular sclerosis. Micro inflammation state, hyperglycemia, hypertension, oxidative stress and nitric oxide are the factors which may be the directly lead to the damage of podoeyte. We believe that the mechanism of action may be the inhibi- tion of nephrin expression and the integrin. Some studies found that the expression of integrin and extracallular matrix （ECM） me- tabolism closely related. ECM includes many compositions. The main composition of ECM such as fiber connection protein, colla- gen type IV set up the basement membrane, which is the important architecture t between the podocyte and podocyte, the podo- eyte and basement membrane. It is the most important morphological basis to maintain glomerular filtration action. So we think that both the integrin and podocyte~ damage let the occurrence, development of kidney disease for chronic glomerulonephritis. The integrin may be the most important cell signal pathway which control the fuction of the glomerular filtration action through the ac- tion of cell signal transduce. We use the concept of integrity to understand why the integrin is the key contribution at the function of glomerular filtration. It is the guidance to set up the prescription of Chinese herbs. It may he a representative of treatment to prevent and control the chronic kidney disease （CKD）.
出处
《时珍国医国药》
CAS
CSCD
北大核心
2014年第1期145-148,共4页
Lishizhen Medicine and Materia Medica Research
基金
国家自然科学基金面上项目(No.81273723)
江苏省中医药管理局资助项目(No.LZ13235)
苏州市科学技术局应用基础研究计划(No.SYS201016)
关键词
关键词
整合素
信号通路
慢性肾脏病
中医药
理论探讨
Integrin
Signal pathway
Chronic kidney disease
Traditional chinese medicine
Theory research
