外泌体miRNA在狼疮性肾炎中的作用研究进展

Research progress on the role of extracellular miRNA in lupus nephritis

狼疮性肾炎(LN)是系统性红斑狼疮(SLE)继发的肾脏损害,是我国终末期肾衰竭的重要原因之一。约50%以上SLE患者有肾损害的临床表现,可为无症状性蛋白尿和(或)血尿,或表现为高血压、肾病综合征、急性肾炎综合征等,肾活检则显示肾受累几乎为100%,免疫复合物形成与沉积是引起狼疮性肾炎的主要机制。尽管进行有效的抗炎和免疫抑制治疗,仍有太多患者以慢性肾脏病(CKD)或终末期肾脏病(ESRD)告终。作为近些年来研究的热点,外泌体在激活抗肿瘤免疫中的作用备受关注,研究认为外泌体及其携带的miRNA可能以细胞间通讯的方式参与肾脏生理病理过程,在介导自身免疫疾病的炎症级联反应中发挥了一定作用,因此,外泌体的潜在临床价值可能是作为生物标志物和潜在的治疗工具。该文就外泌体miRNA在狼疮性肾炎的发病机制以及治疗中的作用的最新研究进展进行综述。

Lupus nephritis(LN)is a renal damage secondary to systemic lupus erythematosus(SLE)and one of the important causes of end-stage renal failure in China.About more than 50%of SLE patients have clinical manifestations of renal damage,either as asymptomatic proteinuria and/or hematuria,or as hypertension,nephrotic syndrome,acute nephritis syndrome,etc,and renal biopsy shows almost 100%renal involvement,and immune complex formation and deposition is the main mechanism causing lupus nephritis.Despite effective anti-inflammatory and immunosuppressive therapy,too many patients end up with chronic kidney disease(CKD)or end-stage renal disease(ESRD).As a hot topic of research in recent years,the role of exosomes in activating antitumor immunity has attracted much attention.Studies suggest that exosomes and the miRNAs they carry may involve in renal physiopathological processes in the form of intercellular communication and play a role in mediating the inflammatory cascade response in autoimmune diseases.Therefore,the potential clinical value of exosomes may be used as biomarkers and potential therapeutic tools.This article reviews the latest research progress on the role of extracellular miRNAs in the pathogenesis and treatment of lupus nephritis.