肠源性尿毒症毒素与血管钙化机制进展  

Advances in the study of gut-derived uremic toxins and vascular calcification

作　　者：何猛 戎殳 HE Meng;RONG Shu(Department of Nephrology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China)

机构地区：[1]上海交通大学医学院附属第一人民医院肾内科,上海市200080

出　　处：《中国动脉硬化杂志》2025年第1期75-84,共10页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金项目(81970636);上海市第一人民医院临床研究创新团队建设项目(CTCCR-2021B09)。

摘　　要：作为慢性肾脏病(CKD)常见的并发症,血管钙化(VC)显著增加了CKD并发心血管疾病(CVD)的发生率和死亡率。随着CKD病程进展和肾小球滤过率(GFR)的下降,某些无法有效被滤过和排出的溶质蓄积于体内形成尿毒症毒素,导致各种并发症发生并增加死亡率。肠源性尿毒症毒素(GUT)是由肠道菌群将肠道内的物质分解发酵所产生的代谢物,在CKD患者的病程和预后中具有重要的影响,并在VC的发生和发展的过程中扮演着重要角色。通过调节宿主肠道微生物群来改变尿毒症毒素水平,可以预防并治疗VC。本文将阐述几种常见的GUT包括小分子、中分子和蛋白结合的毒素等,通过调节宿主的炎症反应、氧化应激、信号通路等影响VC发生发展的具体机制,可能有助于为通过调节尿毒症毒素水平辅助治疗VC提供思路。As a common complication of chronic kidney disease(CKD),vascular calcification(VC)significantly increases the incidence of CKD-complicated cardiovascular disease(CVD)and mortality.As chronic kidney disease advances and the glomerular filtration rate(GFT)declines,certain solutes,incapable of efficient filtration and elimination,amass within the body,coalescing into uremic toxins which instigate a spectrum of complications,ultimately intensifying mortality rates.Gut-derived uremic toxins(GUT),products of intestinal flora metabolizing and fermenting intestinal substances,significantly influence the trajectory and prognosis of CKD patients,exerting a pivotal role in the genesis of VC.Manipulating uremic toxin levels by modulating the host gut microbiota emerges as a potential means to prevent and manage VC.This discourse delves into elucidating the precise mechanisms through which various commonplace GUT—encompassing small molecules,macromolecules,and protein-bound toxins—impact the evolution of VC.This impact is predominantly observed through their modulation of the host s inflammatory response,oxidative stress,and signaling pathways.These insights offer a potential avenue for the modulation of uremic toxin levels,positing a novel adjunctive therapeutic approach for managing VC.

关 键 词：尿毒症毒素 血管钙化 慢性肾脏病 肠道菌群 

分 类 号：R692.5[医药卫生—泌尿科学] R5[医药卫生—外科学]