尿足细胞标记物在特发性膜性肾病诊疗中的研究进展

Research progress on urinary podocyte markers in the diagnosis and treatment of idiopathic membranous nephropathy

足细胞作为特异性终末分化细胞参与维持多项肾脏正常功能,其损伤与特发性膜性肾病(IMN)等足细胞病发病进展密切相关。随着IMN发病率的不断上升,研究者们已取得一系列研究突破,包括抗磷脂酶A2受体(PLA2R)抗体、抗Ⅰ型血小板域蛋白(THSD7A)抗体等,然而由于成本高昂、技术复杂以及结果滞后,目前的检测方法仍然无法有效反映细胞损伤的动态变化。因此IMN在早期诊断、进展监测方面仍需要一种便捷准确、变化及时的检查指标,对尿液中的足细胞及其相关损伤标记物进行监测,可以无创且直观地反映足细胞的损伤,从而辅助IMN的临床诊断及病情监测。本文主要对尿足细胞相关标记蛋白、RNA及外泌体等指标在IMN诊疗中的临床应用前景进行分析。

Podocytes,as specific terminally differentiated cells,are involved in maintaining multiple normal kidney functions,and their damage is closely related to the pathogenesis and progression of podocyte diseases such as idiopathic membranous nephropathy(IMN).With the rising incidence rate of IMN,researchers have made a series of research breakthroughs,including anti-phospholipase A2 receptor(PLA2R)antibodies,antithrombospondin type I domain-containing protein 7A(THSD7A)antibodies,etc.However,due to the high cost,complex technology,and lagging results,the current detection methods still cannot effectively reflect the dynamic changes of cell damage.Therefore,in terms of early diagnosis and progress monitoring,IMN still needs a convenient,accurate,and timely changed examination index to monitor podocytes and their related damage markers in urine,which can noninvasively and intuitively reflect podocyte damage,thereby assisting in clinical diagnosis and disease monitoring of IMN.This article mainly analyzes the clinical application prospects of relevant urinary podocalyxin,RNA,and exosomes in the diagnosis and treatment of IMN.