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Therapeutics targeting persistent inflammation in chronic kidney disease

机译:针对慢性肾脏疾病持续发炎的治疗药物

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摘要

Systemic inflammation is a condition intrinsically linked to chronic kidney disease (CKD) and its other typical sequelae, such as acquired immune dysfunction, protein-energy wasting (PEW), and accelerated vascular aging that promote premature cardiovascular disease (CVD) and infections, the two leading causes of death in CKD patients. Inflammation is a major contributor to complications in CKD, and inflammatory markers, such as C-reactive protein and pro- and anti-inflammatory cytokines, correlate with underlying causes and consequences of the inflamed uremic phenotype, such as oxidative stress, endothelial dysfunction, CVD, PEW, and infections, and are sensitive and independent predictors of outcome in CKD. Therefore, inflammation appears to be a logical target for potential preventive and therapeutic interventions in patients with CKD. Putative anti-inflammatory therapy strategies aiming at preventing complications and improving outcomes in CKD span over several areas: (1) dealing with the source of inflammation (such as cardiovascular, gastrointestinal or periodontal disease and depression); (2) providing nonspecific immune modulatory effects by promoting healthy dietary habits and other lifestyle changes; (3) promoting increased use of recognized pharmacologic interventions that have pleiotropic effects; and, (4) introducing novel targeted anticytokine interventions. This review provides a brief update on inflammatory biomarkers and possible therapeutic approaches targeting inflammation and the uremic inflammatory milieu in patients with CKD.
机译:全身性炎症是与慢性肾脏疾病(CKD)及其其他典型后遗症固有相关的疾病,例如获得性免疫功能障碍,蛋白质能量消耗(PEW)和加速的血管衰老,这些疾病会促进早发性心血管疾病(CVD)和感染, CKD患者的两个主要死亡原因。炎症是导致CKD并发症的主要因素,炎症标志物(例如C反应蛋白和促炎和抗炎细胞因子)与尿毒症表型的潜在原因和后果(例如氧化应激,内皮功能障碍,CVD)相关,PEW和感染,是CKD结局的敏感且独立的预测因子。因此,炎症似乎是CKD患者潜在预防和治疗干预的合理目标。旨在预防CKD并发症并改善结局的推定抗炎治疗策略涵盖多个领域:(1)处理炎症的来源(例如心血管,胃肠道或牙周疾病和抑郁症); (2)通过促进健康的饮食习惯和其他生活方式的改变来提供非特异性的免疫调节作用; (3)促进更多使用具有多效性作用的公认药物干预措施; (4)引入新型靶向抗细胞因子干预药物。这篇综述简要介绍了CKD患者的炎症生物标志物和针对炎症和尿毒症炎症环境的可能治疗方法。

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