实验动物与比较医学 ›› 2024, Vol. 44 ›› Issue (2): 180-191.DOI: 10.12300/j.issn.1674-5817.2023.123

• 人类疾病动物模型 • 上一篇    下一篇

基于动物模型的高尿酸肾病病理及分子机制研究进展

包方奇1(), 屠海烨2, 方明笋3, 张倩3, 陈民利3()()   

  1. 1.复旦大学附属华山医院, 上海 200032
    2.浙江中医药大学药学院, 杭州 310053
    3.浙江中医药大学中医药科学院, 杭州 310053
  • 收稿日期:2023-09-01 修回日期:2023-11-24 出版日期:2024-04-25 发布日期:2024-05-09
  • 通讯作者: 陈民利(1963—),女,硕士,博士研究生导师,教授,研究方向:实验动物与比较医学。E-mail: cmli991@126.com。ORCID: 0000-0003-1911-9397
  • 作者简介:包方奇(2000—),男,复旦大学临床五年制华山班在读本科生,专业方向:临床医学。E-mail: fq15888947763@126.com
  • 基金资助:
    浙江省基础公益研究计划项目“多因素诱导高尿酸肾病大鼠模型方法的改良与评价研究”(LTGD23C040003)

Advances in Research on Pathological and Molecular Mechanism of Hyperuricemic Nephropathy Based on Animal Models

Fangqi BAO1(), Haiye TU2, Mingsun FANG3, Qian ZHANG3, Minli CHEN3()()   

  1. 1.Huashan Hospital, Fudan University, Shanghai 200032, China
    2.College of Pharmacy, Zhejiang Chinese Medical University, Hangzhou 310053, China
    3.Academy of Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
  • Received:2023-09-01 Revised:2023-11-24 Published:2024-04-25 Online:2024-05-09
  • Contact: CHEN Minli (ORCID: 0000-0003-1911-9397), E-mail: cmli991@126.com

摘要:

尿酸是人类嘌呤代谢的终产物,其过度积累会导致高尿酸血症。高尿酸血症与慢性肾病的关系密切,被认为是后者的独立危险因素,因此由高尿酸血症诱导的慢性肾病也被称为高尿酸肾病。21世纪以来,随着尿酸致病作用研究逐渐深入,以及高尿酸血症动物模型构建的发展,尿酸的致病机制逐渐被揭开,对其诱导慢性肾病的病理生理机制研究也有了重要进展,但对其病理分子机制的认识仍有很大不足。因此,新型的动物模型或造模方式或许能够给高尿酸血症及相关慢性肾病的机制研究提供更好的契机。本文从氧化应激、炎症、自噬、纤维化和肠道微生物等方面介绍高尿酸肾病病理分子机制的研究进展:氧化应激方面,尿酸在细胞内通过黄嘌呤氧化酶、烟酰胺腺嘌呤二核苷酸磷酸氧化酶、线粒体诱导氧化应激并损伤细胞;炎症方面,尿酸晶体可以激活NLRP3炎症小体并启动炎症瀑布,但关于游离尿酸的促炎作用尚存争议;自噬方面,有研究支持促进自噬可缓解尿酸诱导的炎症,也有研究支持完全相反的结论;纤维化方面,上皮间质转化是尿酸引起肾小球硬化和肾小管间质纤维化的重要机制,大量研究寻找了尿酸引起肾组织上皮间质转化的不同信号通路;肠道微生物方面,有益的菌群可通过合成短链脂肪酸、减少尿素肠肝循环、减少尿酸生成保护肾脏。本文旨在帮助人们理解高尿酸血症与慢性肾病之间的复杂关系,为进一步进行相关研究和新药研发提供参考。

关键词: 高尿酸血症, 高尿酸肾病, 病理机制, 动物模型

Abstract:

Uric acid (UA), the final product of human purine metabolism, can cause hyperuricemia (HUA) when excessively accumulated. HUA is closely linked to chronic kidney diseases (CKD) and is considered an independent risk factor. Hyperuricemic nephropathy, a form of CKD induced by HUA, has seen significant advances in understanding through research into the pathogenic roles of uric acid and the development of HUA animal models. Although progress has been made in understanding the pathophysiological mechanisms by which UA induces CKD, much remains to be learned about its pathological molecular mechanisms. New approaches in animal modeling or the selection of model animals may potentially lead to significant breakthroughs in research on hyperuricemia as well as related CKD. This paper reviews the research progress on the molecular mechanisms of hyperuricemic nephropathy, focusing on oxidative stress, inflammation, autophagy, fibrosis, and gut microbiota. Oxidative stress is induced by uric acid intracellularly through xanthine oxidase, NADPH oxidases, and mitochondria, leading to cellular damage. In terms of inflammation, uric acid crystals can activate the NLRP3 inflammasome, triggering an inflammatory cascade. The role of free uric acid as a pro-inflammatory agent, however, remains controversial. Depending on the study conducted, autophagy has been found to either alleviate or exacerbate inflammation induced by uric acid. Fibrosis, particularly through epithelial-mesenchymal transition (EMT), is a major mechanism by which uric acid causes glomerulosclerosis and tubulointerstitial fibrosis. Extensive research has explored various signaling pathways involved in uric acid-induced EMT. Beneficial gut microbiota protect the kidneys by synthesizing short-chain fatty acids, reducing urea’s enterohepatic circulation, and decreasing uric acid production. This paper aims to enhance understanding of the complex relationships between HUA and CKD, serving as a reference for further research and new drug development.

Key words: Hyperuricemia, Hyperuricemic nephropathy, Pathological mechanism, Animal model

中图分类号: