【摘要翻译】肾脏缺血预处理
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Current Opinion in Nephrology and Hypertension 2002, 11:43-48
Kidney ischemic preconditioning
Joseph V. Bonventre
Massachusetts General Hospital
Ischemic injury to the kidney is associated with high morbidity and mortality. Improving the ability of the kidney to tolerate ischemic injury would have important implications. A significant amount of data now exists to suggest that there may be intrinsic mechanisms brought to bear by the kidney when exposed to a toxic or ischemic insult, which protect it against a subsequent exposure to ischemia. While it is frequently stated that this phenomenon, termed ischemic preconditioning, was first described in the heart, in fact there is almost a century of literature on the kidney that supports the concept that prior injury protects against a second insult. The protective effect of preconditioning is greater than most reported protective effects with pharmacological interventions in animals. There is compelling evidence in other organs that preconditioning occurs in humans. It therefore behoves us to understand the endogenous processes that the kidney has developed to protect itself against an ischemic insult. Armed with this understanding we can then attempt to mimic these processes and thereby prevent and treat ischemic acute renal failure.
肾脏缺血性损伤的死亡率和致残率都相当高，因此提高肾脏对缺血性损伤的耐受性具有重要的意义。现有的大量资料显示，当遭受中毒性或缺血性损害时，肾脏可能存在着一种内源性保护机制使它在再次经受缺血时，能够产生抵抗。这种现象经常被称为缺血预处理，首先是在心脏被报道。事实上，已经有近一个世纪的资料支持认为，肾脏在经历第一次损伤后，可对第二次损伤产生保护作用。动物实验证实，预处理的保护作用比大多数报道的用药物进行干预的保护作用都要强。有大量资料显示人体其他几种器官都存在着预处理效应，这自然促使我们认为肾脏也具有保护它免受缺血性损害的这种内源性机制。在这种思路指导下，我们试图去模拟这些过程，并由此可以预防和治疗缺血性急性肾功能衰竭。
Kidney ischemic preconditioning
Joseph V. Bonventre
Massachusetts General Hospital
Ischemic injury to the kidney is associated with high morbidity and mortality. Improving the ability of the kidney to tolerate ischemic injury would have important implications. A significant amount of data now exists to suggest that there may be intrinsic mechanisms brought to bear by the kidney when exposed to a toxic or ischemic insult, which protect it against a subsequent exposure to ischemia. While it is frequently stated that this phenomenon, termed ischemic preconditioning, was first described in the heart, in fact there is almost a century of literature on the kidney that supports the concept that prior injury protects against a second insult. The protective effect of preconditioning is greater than most reported protective effects with pharmacological interventions in animals. There is compelling evidence in other organs that preconditioning occurs in humans. It therefore behoves us to understand the endogenous processes that the kidney has developed to protect itself against an ischemic insult. Armed with this understanding we can then attempt to mimic these processes and thereby prevent and treat ischemic acute renal failure.
肾脏缺血性损伤的死亡率和致残率都相当高，因此提高肾脏对缺血性损伤的耐受性具有重要的意义。现有的大量资料显示，当遭受中毒性或缺血性损害时，肾脏可能存在着一种内源性保护机制使它在再次经受缺血时，能够产生抵抗。这种现象经常被称为缺血预处理，首先是在心脏被报道。事实上，已经有近一个世纪的资料支持认为，肾脏在经历第一次损伤后，可对第二次损伤产生保护作用。动物实验证实，预处理的保护作用比大多数报道的用药物进行干预的保护作用都要强。有大量资料显示人体其他几种器官都存在着预处理效应，这自然促使我们认为肾脏也具有保护它免受缺血性损害的这种内源性机制。在这种思路指导下，我们试图去模拟这些过程，并由此可以预防和治疗缺血性急性肾功能衰竭。
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