巨噬细胞活化综合征:最新肾脏研究结果综述

IF 0.2 Q4 UROLOGY & NEPHROLOGY
Sarah Hosseinpoor, Mansour Salesi
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引用次数: 0

摘要

巨噬细胞活化综合征的发病机制是巨噬细胞和 T 细胞过度活化,导致细胞因子和趋化因子失控释放,从而引起多器官功能障碍。巨噬细胞活化综合征的诊断标准包括发热、脾肿大、全血细胞减少、高甘油三酯血症和/或低纤维蛋白原血症、嗜血细胞增多症、自然杀伤细胞活性低或缺乏、铁蛋白水平升高和可溶性白细胞介素-2受体水平升高。肾脏受累包括肾小球病变,包括系膜扩张、毛细血管内膜增生和血栓性微血管病变。MAS 的肾活检还可能显示巨噬细胞浸润和活化的证据,如肾小球和间质中存在嗜血细胞巨噬细胞。这些巨噬细胞可能含有被吞噬的红细胞、血小板和其他细胞,表明正在进行噬血细胞吞噬。肾活检中出现噬血细胞巨噬细胞高度提示 MAS,并有助于将其与其他原因引起的急性肾损伤 (AKI) 区分开来。巨噬细胞活化综合征相关肾脏受累的治疗包括治疗潜在的自身免疫性疾病和控制全身炎症。这可能包括使用免疫抑制剂,如皮质类固醇、改变病情抗风湿药和生物制剂。在肾功能障碍严重的病例中,可能需要采取肾脏替代疗法等支持性措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Macrophage activation syndrome: a review of recent renal findings
The pathogenesis of Macrophage activation syndrome consists of excessive macrophage and T-cell activation, leading to the uncontrolled release of cytokines and chemokines, which can cause multi-organ dysfunction. The diagnostic criteria for MAS include fever, splenomegaly, cytopenia, hypertriglyceridemia and/or hypofibrinogenemia, hemophagocytosis, low or absent natural killer cell activity, elevated ferritin levels, and elevated soluble interleukin-2 receptor levels. Kidney involvement in this disease included glomerular changes, including mesangial expansion, endocapillary proliferation, and thrombotic microangiopathy. Renal biopsy in MAS may also show evidence of macrophage infiltration and activation, such as the presence of hemophagocytic macrophages within the glomeruli and interstitium. These macrophages may contain phagocytosed erythrocytes, platelets, and other cells, indicating ongoing hemophagocytosis. The presence of hemophagocytic macrophages on renal biopsy is highly suggestive of MAS and can help differentiate it from other causes of acute kidney injury (AKI). Management of macrophage activation syndrome-associated kidney involvement involves treating the underlying autoimmune disorder and controlling the systemic inflammation. This may include the use of immunosuppressive medications, such as corticosteroids, disease-modifying anti-rheumatic drugs, and biological agents. Supportive measures, such as renal replacement therapy, may be necessary in severe cases of renal dysfunction.
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来源期刊
Journal of Renal Injury Prevention
Journal of Renal Injury Prevention UROLOGY & NEPHROLOGY-
CiteScore
1.60
自引率
0.00%
发文量
36
期刊介绍: The Journal of Renal Injury Prevention (JRIP) is a quarterly peer-reviewed international journal devoted to the promotion of early diagnosis and prevention of renal diseases. It publishes in March, June, September and December of each year. It has pursued this aim through publishing editorials, original research articles, reviews, mini-reviews, commentaries, letters to the editor, hypothesis, case reports, epidemiology and prevention, news and views and renal biopsy teaching point. In this journal, particular emphasis is given to research, both experimental and clinical, aimed at protection/prevention of renal failure and modalities in the treatment of diabetic nephropathy. A further aim of this journal is to emphasize and strengthen the link between renal pathologists/nephropathologists and nephrologists. In addition, JRIP welcomes basic biomedical as well as pharmaceutical scientific research applied to clinical nephrology. Futuristic conceptual hypothesis that integrate various fields of acute kidney injury and renal tubular cell protection are encouraged to be submitted.
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