环境污染与IgA肾病的研究进展

Research progress on environmental pollution and IgA nephropathy

IgA肾病(IgAN)为中国人慢性肾脏病(CKD)的常见原因,以其临床表现及预后异质性大为特点。本研究聚焦于环境污染与IgA肾病发生发展的临床关联及机制研究,对最新进展进行总结。空气污染中的细颗粒物(PM_(2.5)),已被多项研究证实与CKD的发生、疾病进展有关联。尤其对于IgAN患者而言,长期暴露于高水平的PM_(2.5),患者进展至肾衰的风险增加14%,提示环境污染可能是IgA肾病进展的危险因素之一。其次,重金属是最主要的水污染物,其中的铅、砷等长期暴露与IgA肾病的发病风险增加相关,但机制尚未阐明。环境污染物可能通过多途径影响免疫系统和肾脏功能,导致IgA肾病的发生及进展。我们需要更深入地探讨这些临床关联及潜在的作用机制,以便制定更有效防治策略来延缓IgAN进展。

IgA nephropathy(IgAN)is one of the common causes of chronic kidney disease(CKD)in China.It is characterized by great heterogeneity in clinical manifestations and prognosis.This study focuses on the clinical associations and mechanisms of environmental pollution and IgAN and summaries the latest advancement.Fine particulate matter(PM_(2.5))in air pollution has been confirmed to be associated with the incidence and disease progression of CKD by several studies.Especially for IgAN patients,long-term exposure to high levels of PM_(2.5)increase the risk of progression to renal failure by 14%.This suggests that environmental pollution may be one of the risk factors for the progression of IgAN.Secondly,heavy metals are the most important water pollutants.Of these,long-term exposure to lead and arsenic is associated with an increased risk of IgA nephropathy.However,the mechanism has not been elucidated.In conclusion,environmental pollutants may affect the immune system and kidney function through multiple pathways,leading to the progression of IgAN.Subsequently,we need to explore these clinical associations and the potential mechanisms in order to provide more effective prevention and treatment strategies to slow down the progression of IgAN.