干细胞在急性肾损伤后肾脏修复中的作用

Effects of stem cells on kidney repair after acute kidney injury

急性肾损伤是多种原因引起的肾功能骤然下降的临床综合征,具有高发病率和高病死率的特点。急性肾损伤最主要的病理改变是肾小管上皮细胞坏死脱落阻塞管腔及基膜裸露。肾损伤修复依赖残存肾小管上皮细胞迁移、增殖、分化,覆盖暴露的肾小管基膜,从而恢复肾功能。干细胞是一类具有自我更新和多向分化潜能的克隆细胞,在肾损伤的修复中发挥重要作用。肾损伤动物模型的研究证实,坏死细胞的更替主要依赖成熟细胞分化,再次进入细胞周期,或依赖骨髓干细胞或肾脏器官特异性干细胞的修复作用。文章就骨髓干细胞和肾脏成体干细胞在急性肾损伤后肾脏修复中的作用进行综述。

Acute kidney injury （AKI） is a clinical syndrome of rapidly declining renal function induced by a number of different causes with high rates of morbidity and mortality. Main pathological changes of AKI are necrosis and shedding of renal tubular epithelial cells, lumen blockage, and basement membrane exposure. Kidney repair relies on the migration of surviving epithelial cells to cover the exposed area of the basement membrane and cell differentiation and proliferation to restore renal function. Stem cells are characterized by their ability to self-renew and to differentiate into a variety of cell types and play an important role in kidney repair. Animal models of kidney injury demonstrated that the replacement of necrotic cells mainly relies on surviving mature cells to differentiate and re-enter into cell cycle, or depends on bone marrow stem cells or kidney specific stem/progenitor ceils. This review summarizes the promoting effects of bone marrow stem cells and adult renal stem/progenitor cells on kidney repair of the acute kidney injury.