巨噬细胞与糖尿病肾病

Macrophages and diabetic nephropathy

糖尿病肾病是一种慢性炎性疾病,而巨噬细胞是重要的炎性细胞,在糖尿病肾病的发生、发展中起重要作用.血液中的单核细胞在选择素、细胞间黏附分子-1（ICAM-1）、血管细胞黏附分子-1（VCAM-1）、单核细胞趋化蛋白-1（MCP-1）及骨桥蛋白等细胞黏附分子或趋化因子作用下经历滚动、黏附、迁移等过程,浸润于肾组织而分化成巨噬细胞,体内持续高血糖等因素使其活化,释放转化生长因子-β（TGF-β）、肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-1、IL-6、IL-18等细胞因子,促进肾小球系膜细胞分泌细胞外基质及成纤维细胞增殖,引起系膜细胞外基质沉淀、肾小球硬化及间质纤维化等肾损伤,从而促进糖尿病肾病的发展.调控巨噬细胞的浸润与活化可能是防治糖尿病肾病的新途径。

Diabetic nephropathy is a chronic inflammatory disease while macrophages are the key inflammatory cells and play important roles in the development and progression of diabetic nephropathy.The adhesion molecules or chemotactic factors,such as selectins,intercellular cell adhesion molecule-l,vascular cell adhesion molecule-1,monocyte chemotactic protein-1,and oesteopontin,induce peripheral blood monocytes rolling,adhesion and migration to kidney.Then most of these monocytes differentiate into macrophages.Under the sustained hyperglycemia,the infiltrative macrophages are activated,and release some cytokines such as transforming growth factor-β,tumor necrosis factor-α,interleukin-1,interleukin-6 and interleukin-18.These cytokines lead to the deposition of mesangial extracellular matrix,glomerular sclerosis and interstitial fibrosis through promoting the secretion of extracellular matrix from glomerular mesangial cells and the proliferation of fibroblast.Thus,the development of diabetic nephropathy is promoted.Regulating the infiltration and activation of macrophages may provide a new therapeutic approach for diabetic nephropathy.