IgA肾病(IgA nephropathy, IgAN)是多机制共同参与免疫介导的肾小球疾病,也是世界上最常见的原发性肾小球疾病,其病因及病理机制尚不明确,亦无特异性疗法,是国内外临床亟需解决的难题。现代医学研究表明IgA肾病与“肺–肠”轴和黏膜免疫关系密切,通过干预“肺–肠”轴传导对肾脏病产生调控作用,或可成为治疗IgA肾病的新靶点。且传统药物对IgA肾病的治疗经过多年发展已展现出其显著疗效及副作用小的优势。本文就目前“肺–肠”轴与黏膜免疫在IgAN发病机制中作用的研究进展进行归纳探讨,以期为未来从“肺–肠”轴与黏膜免疫角度寻找IgAN新的治疗靶点提供思路及为研究拓宽思路。IgA nephropathy (IgAN) is an immune-mediated glomerular disease that involves multiple mechanisms and is the most common primary glomerular disease in the world. The etiology and pathogenesis of IgA nephropathy are still unclear, and there is no specific therapy for IgA nephropathy, so it is a problem that needs to be solved urgently for both domestic and foreign clinics. Modern medical research has shown that IgA nephropathy is closely related to the “lung-intestinal” axis and mucosal immunity, and that interfering with the “lung-intestinal” conduction has a regulatory effect on renal disease, which may become a new target for the treatment of IgA nephropathy. Moreover, after years of development, traditional medicines for IgA nephropathy have demonstrated their remarkable efficacy and low side effects. In this paper, we summarize and discuss the current research progress on the role of lung-intestinal axis and mucosal immunity in the pathogenesis of IgAN, with a view to providing ideas and broadening the mindset for future research on finding new therapeutic targets for IgAN from the perspective of lung-intestinal axis and mucosal immunity.
慢性肾脏病是世界公认的重大卫生问题,近些年肠–肾轴理论的提出受到国内外学者的广泛关注,揭示了肠道微生态环境与慢性肾脏病之间的关系,为慢性肾脏病的治疗提供了新思路、新理念,本文通过肠–肾轴理论与古方清脾饮相结合以及在总结导师金丽霞教授的临床经验以及临床验案的基础上,为临床治疗CKD提供一种可行性的治疗理念和思路。Chronic Kidney Disease (CKD) is a major health problem recognized worldwide. In recent years, the theory of intestinal-kidney axis has attracted extensive attention from scholars at home and abroad, revealing the relationship between the intestinal micro-ecological environment and CKD, and providing new ideas and concepts for the treatment of CKD. In this paper, the theory of intestinal-kidney axis is combined with the ancient formula of decoction for clearing the spleen, and on the basis of the summarized clinical experience of the supervisor, Prof. Jin Lixia, as well as the clinical cases, a feasible treatment concept and ideas for the clinical treatment of CKD are provided.
