Since the advent of modern medicine, the function of the immune system in disease and recovery has been a central focus for researchers around the world. One of the most significant areas within this realm is the study of acute kidney injury (AKI), a systemic condition defined by the sudden loss of renal functionality and buildup of nitrogen wastes in the body. Among the various causes of AKI, ischemic AKI stands out as the predominant form, where the kidneys suffer from restricted blood flow, leading to tissue damage and impaired organ performance. A comprehensive review of this phenomenon sheds light on the intricacies of the immune system’s involvement in both exacerbating and ameliorating the condition, with potential therapeutic implications. This article delves into the study presented in the Current Protein & Peptide Science journal, offering an in-depth examination of the immune responses in ischemic AKI, with hopes to further illuminate the path towards targeted treatments.
Background
Published on September 30, 2019, in the journal Current Protein & Peptide Science, a review article titled “Immune Cells in Ischemic Acute Kidney Injury” encompasses a zoomed-in view of the tangled web involving immune cells within the context of ischemic AKI. The authors, led by Zheng Long L et al. from the Department of Urology and the Shanghai Key Laboratory of Organ Transplantation at Fudan University, provide an insightful narrative, linking the innate and adaptive arms of the immune system to both the pathogenesis and recovery phase of ischemic AKI.
Ischemic Acute Kidney Injury: An Overview
Ischemia, or the lack of adequate blood supply to tissues, leads to acute renal function impairment when it comes to the kidneys. Resulting from conditions like hemorrhage, shock, or thrombosis, ischemic AKI triggers a cascade of biological responses. Tissues release damage-associated molecular patterns (DAMPs) and hypoxia-inducible factors (HIFs), while endothelial dysfunction and the overexpression of adhesion molecules pave the way for an inflammatory onslaught. This environment is ripe for the recruitment of various immune cell types, culminating in a cycle of injury and eventual repair.
Immune Cells at the Heart of AKI
Neutrophils, dendritic cells, macrophages, and lymphocytes are key immune players within the ischemic AKI scenario. They not only contribute to the amplification of renal injury through mechanisms like oxidative burst and cytokine production but also partake in repair processes post-ischemia reperfusion injury (IRI). Each type of immune cell has a dual role—both as a villain and a savior in the narrative of kidney injury.
The Immune Pathways in Ischemic AKI
Prompted by the release of DAMPs and HIFs, the complement system and toll-like receptors (TLRs) get activated, orchestrating an immune response marked by the influx of immune cells to the damaged site. Chemokines and cytokines form a chemical siren that calls in these cells, while adhesion molecules provide a sticky surface for them to adhere and transmigrate into the tissue. This leads to a localized inflammation, which, if uncontrolled, can exacerbate the injury.
Potential for Targeted Interventions
The review by Zheng Long L et al. emphasizes the possibility of targeting these specific immune pathways and responses to remediate the effects of ischemic AKI. In-depth recognition of subpopulations within immune cells that drive recovery could open avenues for novel therapeutic interventions. By modulating the activities of these immune cells, such treatments could ameliorate inflammation and support tissue repair, altering the prognosis of AKI.
The DOI of this insightful review is 10.2174/1389203720666190507102529, providing a direct path to the research for those keen to explore the niche of immune responses within AKI.
Keywords
1. Ischemic acute kidney injury
2. Immune cells AKI
3. AKI treatment research
4. Renal dysfunction inflammation
5. Adaptive immunity AKI
References
1. Zheng Long L, Gao Wenjun W, Hu Chao C, Yang Cheng C, Rong Ruiming R. (2019). Immune Cells in Ischemic Acute Kidney Injury. Current Protein & Peptide Science, 20(8), 770–776. DOI: 10.2174/1389203720666190507102529
2. Bonventre JV, Yang L. (2011). Cellular pathophysiology of ischemic acute kidney injury. The Journal of Clinical Investigation, 121(11), 4210-4221. DOI: 10.1172/JCI45161
3. Ysebaert DK, De Greef KE, Vercauteren SR, et al. (2000). Identification and kinetics of leukocytes after severe ischaemia/reperfusion renal injury. Nephrology Dialysis Transplantation, 15(10), 1562-1574. DOI: 10.1093/ndt/15.10.1562
4. Jang HR, Rabb H. (2009). The immune response in ischemic acute kidney injury. Nephron Clinical Practice, 112(4), c235-42. DOI: 10.1159/000228905
5. Ko GJ, Jang HR, Huang Y, et al. (2019). The role of innate immunity in sepsis and potential therapeutic targets. Molecular Medicine, 25(1), 58. DOI: 10.1186/s10020-019-0113-1
The exploration of the interplay between the immune system and ischemic AKI highlights the subtlety of the body’s internal mechanisms and their significance in health and disease. The work of Zheng Long L and colleagues acts not only as a map of these intricate pathways but also as a beacon, guiding future research efforts towards the development of more effective treatments for one of the most common and perilous renal conditions.