透析加速了中间血管化,部分原因是触发了光滑肌肉细胞亡
Rukshana C Shroff1, Rosamund McNair, Nichola Figg
1Nephrology Unit, Great Ormond Street Hospital, University College London Institute of Child Health, King's College London, London SE5 9NU.
Circulation
|October 8, 2008
概括
血管化在透析前开始,但透析期间血管光滑肌细胞 (VSMC) 亡会引发明显的化和损伤. 识别导致VSMC死亡的因素是预防的关键.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血管生物学 血管生物学
- 儿科医学 儿科医学
背景情况:
- 血管化是5期慢性病 (CKD) 发病率和死亡率的重要风险因素.
- 在儿科CKD中,血管化的早期病原和体内启动机制尚不清楚.
研究的目的:
- 量化动脉 (Ca) 负载在V期CKD (预透析和透析) 的儿童.
- 为了将Ca负载与临床,生化和血管测量相关联.
- 阐明在儿科CKD中血管化背后的机制.
主要方法:
- 从前透析和透析儿科CKD患者的动脉组织样本被分析含量.
- 收集了临床和生化数据,包括血清和产品.
- 评估了诸如动脉内心介质厚度和大动脉硬度等血管指标.
- 进行了组织学检查,针对特定标记物的免疫组织化学 (性酸酶,Runx2, osterix,annexin VI) 和电子显微镜,以评估血管光滑肌细胞 (VSMC) 亡,骨质变化和化开始.
主要成果:
- 在透析前和透析患者中都观察到动脉 (Ca) 负载升高,与血清和酸盐产品相关.
- 透析患者表现出动脉内心介质厚度增加和大动脉硬.
- 组织学分析显示了完整的透析前血管,而透析血管显示了由于亡而导致的显著血管光滑肌细胞 (VSMC) 损失.
- 透析容器显示性酸酶活性和Runx2和鸟的表达增加,表明VSMC骨质变化.
- 膀标记物和矿物化抑制剂在透析血管中增加,在明显化之前.
- 电子显微镜在受损VSMC的囊泡内发现了酸纳米晶体,表明它们在启动化中的作用.
结论:
- 动脉的积累始于儿科CKD的透析前阶段.
- 透析期间血管光滑肌细胞 (VSMC) 亡是危及防御机制的关键事件,导致明显的化.
- 这种VSMC亡最终导致临床上可检测的血管损伤.
- 在透析患者中确定诱导VSMC死亡的因素对于预防血管化及其相关并发症至关重要.
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