摘要
急性肾损伤(AKI)和慢性肾病(CKD)是一个日益严重的公共卫生问题。目前缺乏检测AKI、早期CKD和改善肾外并发症的灵敏生物标志物。Klotho蛋白,主要检测于肾脏,调节肾脏健康,并作为成纤维细胞生长因子23 (FGF-23)信号通路的辅助受体。它现在正以其显著的多向性行为而被人们熟知,例如:抗氧化、抗衰老、抗凋亡、肾保护作用、促进血管生成和血管化、抑制纤维形成和干细胞保存的细胞保护作用。最新的临床研究表明,肾脏损害是肾Klotho(一种抗衰老基因名)缺乏的一种永久性状态。在AKI中,血浆和/或尿液中的Klotho水平可能会作为肾脏实质损伤的初始生物标志物。在CKD中,Klotho水平也可能是早期疾病的指标,并预测进展速度。早期使用ELISA技术的研究揭示了血浆Klotho、eGFR、血清肌酸和血尿素氮(BUN)水平之间的相关性。因此,通过多种机制预防Klotho水平的下降,可以延缓CKD的进展,改善肾功能。大量数据表明Klotho可作为一种治疗CKD患者的个体化方案。在研究可溶性Klotho作为不同类型和严重肾脏疾病患者的生物标志物的作用方面,还需要大量的研究,这将在我们的综述中重点讨论。
关键词: AKI,生物标志物,CKD
Current Molecular Medicine
Title:Implications of Klotho Protein for Managing Kidney Disease - an Emerging Role in Therapeutics and Molecular Medicine
Volume: 21 Issue: 6
关键词: AKI,生物标志物,CKD
摘要: Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) are a growing public health problem. There is a paucity of sensitive biomarkers to detect AKI, early CKD, and ameliorate extra-renal complications. Klotho protein, detected mainly in the kidneys, regulates renal health and functions as a co-receptor for fibroblast growth factor 23 (FGF-23) signaling. It is now coming to be known for its extreme pleiotropic actions. These include cytoprotection via anti-oxidation, anti-senescence, anti-apoptosis, renoprotective effects, promotion of angiogenesis and vascularisation, inhibition of fibrogenesis, and stem cell preservation. Emerging clinical studies suggest kidney damage to be a perpetual state of renal Klotho deficiency. In AKI, Klotho levels in plasma and/or urine possibly will serve as an initial biomarker for kidney parenchymal injury. In CKD, Klotho levels may also be an indicator of early disease as well as predict the rate of progression. Earlier studies using ELISA as a technique reveal a correlation between plasma Klotho, eGFR, serum creatine, and Blood Urea Nitrogen (BUN) levels. Thereby preventing the decline of Klotho levels by various mechanisms can retard CKD advancement and improve renal function. Substantial data indicate Klotho can be therapeutically included as an individualized regimen for managing CKD patients. Considerable research is required in investigating the role of soluble Klotho as a biomarker in patients with different types and severity of kidney diseases, which will be highlighted in our review.
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Cite this article as:
Implications of Klotho Protein for Managing Kidney Disease - an Emerging Role in Therapeutics and Molecular Medicine, Current Molecular Medicine 2021; 21 (6) . https://dx.doi.org/10.2174/1566524020666201120143313
DOI https://dx.doi.org/10.2174/1566524020666201120143313 |
Print ISSN 1566-5240 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5666 |
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