腹膜溶质转运的分子遗传机制研究进展  

Advances in molecular genetic mechanism of peritoneal solute transport

作　　者：林涛 陈楠[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院肾脏科,上海交通大学医学院肾脏病研究所,上海200025

出　　处：《中国血液净化》2017年第5期329-332,共4页Chinese Journal of Blood Purification

基　　金：国家自然科学基金青年项目(81300633)

摘　　要：腹膜透析(peritoneal dialysis,PD)是终末期肾脏病(End stage renal disease,ESRD)患者成熟的治疗方式之一,腹膜溶质转运功能不仅影响患者的透析充分性,也与患者预后密切相关。患者透析起始的腹膜转运功能以及进入透析后腹膜转运速率的变化均存在较大异质性。不同地区及人种的腹膜转运速率也存在显著差异。在各种因素刺激下,炎症因子及促血管生成的细胞因子产物增加,导致腹膜血管血流改变,血管新生及血管病变,最终因有效腹膜血管表面积增加而致腹膜转运率升高。近年来,部分学者采用候选基因关联分析的方法探查了白细胞介素-6(interleukin-6,IL-6),IL-10等炎症因子及内皮型一氧化氮合酶(endothelial nitric oxide synthase,ENOS),RAGE,血管内皮生长因子(vascular endothelial growth factor,VEGF),等细胞因子与腹膜溶质转运率变化的相关性。现有的研究已提示遗传机制在腹膜小分子溶质转运中的作用,但尚需在不同人群及人种中验证。这有助于了解影响腹膜转运功能的基因特点,为腹膜转运功能的研究及改善腹膜转运功能的治疗提供新思路。During peritoneal dialysis, the peritoneum is used as a dialysis membrane. Peritoneal solute transport function is closely related to adequacy of the peritoneal dialysis and prognosis of the patients. There is greater heterogeneity in the baseline peritoneal solute transport status and the changes of peritoneal solute transport rate （PSTR） after dialysis. Significant difference in PSTR is also present in different geographic re- gions and ethnic groups. In responses to various stimuli, the peritoneum produces more inflammatory cyto- kines and angiogenic factors, leading to changes of peritoneal blood flow, angiogenesis and vasculapathy. Sub- sequently transport rate for small solutes increases owing to the increase of effective peritoneal vascular sur- face. Recently, several researchers have performed the association study of PSTR （initial and longitudinal PSTR changes） with candidate genes. Polymorphisms in the candidate genes encoding inflammatory cyto- kines such as IL-6, IL-10 and TGF-[31 and encoding inflammation and angiogenesis related factors such as ENOS, RAGE and VEGF were found to be related to initial and longitudinal PSTR changes. Results of cur- rent studies have suggested the effect of genetic factors on peritoneal transport function, but the role of these factors needs to be identified in different population groups and races. Genome-wide association study may help discover new genes, contribute to further understand the genetic characteristics of peritoneal solute trans- port, and provide clues for the study of peritoneal transport function and the improvement of peritoneal trans- port function in patients.

关 键 词：腹膜溶质转运 遗传机制 

分 类 号：R459.5[医药卫生—治疗学]