炎症性肠病与蛋白尿

Inflammatory bowel disease and proteinuria

炎症性肠病是慢性复发性胃肠道炎性疾病,包括克罗恩病和溃疡性结肠炎,少数患者可出现肾脏损害,产生蛋白尿,肠黏膜来源的肿瘤坏死因子α可通过影响内皮结构和功能变化导致微血管内皮功能障碍,在蛋白尿形成中起着关键作用。本文从肠黏膜免疫紊乱和基因、微生物、饮食的肠-肾串联机制探讨炎症性肠病与蛋白尿关系,蛋白尿可能成为炎症性肠病活动度简便而无创的指标,最后描述了基于肠黏膜免疫的靶向治疗药物及粪菌移植对蛋白尿治疗的最新进展。

Inflammatory bowel disease is chronic recurrent inflammatory gastrointestinal tract illness,including Crohn’s disease and ulcerative colitis.Few patients develop renal damage and proteinuria.Tumor necrosis factor alpha from intestinal mucosa induces microvascular endothelial dysfunction by changing the structure and function of endothelium.Also it played a key role in the formation of proteinuria.This review attempted to explore the relationship between inflammatory bowel disease and proteinuria from the perspectives of intestinal mucosal immune disorder and gut-renal connection at the levels of gene,microorganism and diet.Proteinuria may become a simple and non-invasive marker of inflammatory bowel disease activity.Finally the latest developments of targeted therapeutic agents based upon intestinal mucosal immunity and fecal bacteria transplantation were summarized for managing proteinuria.