摘要
腹膜透析(peritoneal dialysis,PD)作为终末期肾病(end stage renal disease,ESRD)的治疗方式之一,尽管可以利用自身腹膜作为生物透析膜,从而清除慢性肾脏病(chronic kidney disease,CKD)5期患者体内代谢废物和纠正水电解质紊乱,但透析人群的年死亡率仍然很高,并且腹膜的进行性纤维化导致了腹透技术的应用周期缩短。通过对腹膜透析患者血清进行非靶向及靶向代谢组学的研究来筛选出差异代谢物,先前研究表明某些代谢物如三甲胺N-氧化物,犬尿氨酸和瓜氨酸,色氨酸代谢物5-甲氧基色氨酸(5-MTP)是检测早期CKD的最有前途的生物标志物代谢物;CA125、IL-6和纤溶酶原激活物抑制剂1(PAI-1),VEGF和、MMP2是腹膜纤维化可能的生物标志物,差异代谢物可作为生物标志物在慢性肾脏病的诊断、腹膜纤维化的发病机制以及腹膜透析患者的治疗、预后等方面有着广泛的临床应用前景。因此通过实施各种代谢组学方法来鉴定与腹膜透析相关的代谢物和代谢途径,然后将这些知识与功能和机制生物学研究相结合,对于慢性肾脏病患者的诊疗有着积极意义,代谢组学研究有望发现与疾病过程相关的途径。
Peritoneal Dialysis is one of the treatments for end-stage renal disease(ESRD).Although the peritoneum can be used as a biodialysis membrane to remove metabolic waste,the annual mortality rate in peritoneal dialytic patients is still high,and the progressive fibrosis of the peritoneum has shortened the application cycle of peritoneal dialysis.Through non-targeted and targeted metabonomics studies on the serum of peritoneal dialysis patients,we could find the differential metabolites of patients with adequate peritoneal dialysis and inadequate peritoneal dialysis.Previous studies have shown that certain metabolite such as trimethylamine N-oxide,canine Urine and citrulline,tryptophan metabolite 5-methoxytryptophan(5-MTP)is the most promising biomarker metabolite for the detection of early CKD;CA125,IL-6 and Plasminogen Activator inhibitor 1(PAI-1),VEGF,and MMP2 are possible biomarkers of peritoneal fibrosis.Therefore,various metabolomics methods are implemented to identify metabolites and metabolic pathways related to peritoneal dialysis,and has positive significance for the diagnosis and treatment in Chronic Kidney Disease patients.Metabolomics research is expected to discover pathways related to the disease process.
作者
叶明君
戴勇
汤冬娥
李强
尹良红
YE Mingjun;DAI Yong;TANG Donge;LI Qiang;YIN Lianghong(Department of Nephrology,the First Affiliated Hospital of Jinan University,Jinan University,Guangzhou 510632,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2022年第1期1-6,共6页
The Journal of Practical Medicine
基金
广东省工程技术研究中心(编号:507204531040)
东莞市社会科技发展(重点)项目资助项目(编号:201950715002195)。
