Kidney regeneration is a challenging but promisingstrategy aimed at reducing the progression to end-stagerenal disease （ESRD） and improving the quality of life of patients with ESRD. Adult stem cells are multipotent...Kidney regeneration is a challenging but promisingstrategy aimed at reducing the progression to end-stagerenal disease （ESRD） and improving the quality of life of patients with ESRD. Adult stem cells are multipotent stem cells that reside in various tissues, such as bone marrow and adipose tissue. Although intensive studies to isolate kidney stem/progenitor cells from the adult kidney have been performed, it remains controversial whether stem/progenitor cells actually exist in the mammalian adult kidney. The effcacy of mesenchymal stem cells （MSCs） in the recovery of kidney function has been demonstrated in animal nephropathy models, such as acute tubular injury, glomerulonephritis, renal artery stenosis, and remnant kidney. However, their benefcial effects seem to be mediated largely via their paracrine effects rather than their direct differentiation into renal parenchymal cells. MSCs not only secrete bioactive molecules directly into the circulation, but they also release various molecules, such as proteins, mRNA, and microRNA, in membrane-covered vesicles. A detailed analysis of these molecules and an exploration of the optimal combination of these molecules will enable the treatment of patients with kidney disease without using stem cells. Another option for the treatment of patients with kidney disease using adult somatic cells is a direct/indirect reprogramming of adult somatic cells into kidney stem/progenitor cells. Although many hurdles still need to be overcome, this strategy will enable bona fde kidney regeneration rather than kidney repair using remnant renal parenchymal cells.展开更多
Tissues are equipped with reasonable strategies for re-pair and regeneration and the renal proximal tubule （PT）is no exception. New information has become availableon the mode of PT regeneration in mammals. Unliketh...Tissues are equipped with reasonable strategies for re-pair and regeneration and the renal proximal tubule （PT）is no exception. New information has become availableon the mode of PT regeneration in mammals. Unlikethe intestinal epithelium with a high rate of turnovermaintained by the stem cell system, the kidney has lowturnover under normal physiological conditions. The PTseems to be maintained physiologically by hyperplasia,a regenerating system with self-renewal of mature tu-bular cells. This mode of regeneration is advantageousfor effective replenishment of randomly isolated andeliminated tubular cells by self-renewal of adjacentcells. On the other hand, it has been suggested thatdedifferentiation of mature tubular cells plays a role inregeneration after acute kidney injury. Recent studiesemploying genetic labeling and DNA-labeling tech-niques have confrmed that the proliferation of preex-isting injured mature tubular cells contributes mainlyto PT regeneration in ischemic reperfusion injury. Thismode of regeneration is beneficial with regard to therapid reparation of focally injured tubules often inducedby ischemic reperfusion injury. What happens, howeverwhen the PT is homogeneously injured with almost noremaining surviving cells？ Is the PT equipped with another backup regeneration system, e.g., the stem cell system？ Is it possible that certain types of renal injuries evoke a stem cell response whereas others do not？ This review focuses on all three possible modes of tis-sue regeneration （compensatory hyperplasia, dediffer-entiation and stem cell system） in mammals and their involvement in PT regeneration in health and disease.展开更多
文摘Kidney regeneration is a challenging but promisingstrategy aimed at reducing the progression to end-stagerenal disease （ESRD） and improving the quality of life of patients with ESRD. Adult stem cells are multipotent stem cells that reside in various tissues, such as bone marrow and adipose tissue. Although intensive studies to isolate kidney stem/progenitor cells from the adult kidney have been performed, it remains controversial whether stem/progenitor cells actually exist in the mammalian adult kidney. The effcacy of mesenchymal stem cells （MSCs） in the recovery of kidney function has been demonstrated in animal nephropathy models, such as acute tubular injury, glomerulonephritis, renal artery stenosis, and remnant kidney. However, their benefcial effects seem to be mediated largely via their paracrine effects rather than their direct differentiation into renal parenchymal cells. MSCs not only secrete bioactive molecules directly into the circulation, but they also release various molecules, such as proteins, mRNA, and microRNA, in membrane-covered vesicles. A detailed analysis of these molecules and an exploration of the optimal combination of these molecules will enable the treatment of patients with kidney disease without using stem cells. Another option for the treatment of patients with kidney disease using adult somatic cells is a direct/indirect reprogramming of adult somatic cells into kidney stem/progenitor cells. Although many hurdles still need to be overcome, this strategy will enable bona fde kidney regeneration rather than kidney repair using remnant renal parenchymal cells.
基金Supported by A Grant-In-Aid for Scientific Research(CNo.22590884)from the Ministry of Education,Culture,Sports,Science,and Technology of Japan
文摘Tissues are equipped with reasonable strategies for re-pair and regeneration and the renal proximal tubule （PT）is no exception. New information has become availableon the mode of PT regeneration in mammals. Unlikethe intestinal epithelium with a high rate of turnovermaintained by the stem cell system, the kidney has lowturnover under normal physiological conditions. The PTseems to be maintained physiologically by hyperplasia,a regenerating system with self-renewal of mature tu-bular cells. This mode of regeneration is advantageousfor effective replenishment of randomly isolated andeliminated tubular cells by self-renewal of adjacentcells. On the other hand, it has been suggested thatdedifferentiation of mature tubular cells plays a role inregeneration after acute kidney injury. Recent studiesemploying genetic labeling and DNA-labeling tech-niques have confrmed that the proliferation of preex-isting injured mature tubular cells contributes mainlyto PT regeneration in ischemic reperfusion injury. Thismode of regeneration is beneficial with regard to therapid reparation of focally injured tubules often inducedby ischemic reperfusion injury. What happens, howeverwhen the PT is homogeneously injured with almost noremaining surviving cells？ Is the PT equipped with another backup regeneration system, e.g., the stem cell system？ Is it possible that certain types of renal injuries evoke a stem cell response whereas others do not？ This review focuses on all three possible modes of tis-sue regeneration （compensatory hyperplasia, dediffer-entiation and stem cell system） in mammals and their involvement in PT regeneration in health and disease.
