缺血预处理在肾移植缺血再灌注中的研究进展

Research Progress of Ischemic Preconditioning with Ischemia Reperfusion Injury of Renal Transplantation

摘要: 器官获取与移植不可避免面对缺血再灌注损伤，引起细胞内环境改变、炎症反应、活性氧聚集等，影响移植物功能延迟恢复及远期移植器官结局。尽管现阶段有较多研究改善缺血再灌注损伤，使得器官移植1年存活率有所提高，但近年来移植物的长期存活率并没有显著改变。从Murry等人在1986年发现缺血预处理(IPC)对器官移植的潜在益处后，在心脏保护方面取得显著成绩，其他证据表明在肾移植中也有明显效果。缺血预处理通过激活短暂非致死性缺氧环境，体液通讯、神经元刺激、循环免疫细胞的系统修饰和低氧诱导基因的激活保护机体免受更长时间的潜在致死性缺血。本文主要介绍缺血预处理的相关机制。

Abstract: Organ acquisition and transplantation inevitably face ischemia-reperfusion injury, causing intra-cellular environment changes, inflammatory response, reactive oxygen species accumulation, etc., affecting the delayed recovery of graft function and long-term outcomes of transplanted organs. Although there are many studies at present to improve the 1-year survival rate of organ transplan-tation after ischemia reperfusion injury, the long-term survival rate of grafts has not changed sig-nificantly in recent years. Since the discovery by Murry et al. in 1986 of the potential benefits of is-chaemic preconditioning (IPC) for organ transplantation with significant results in cardio protection, and other evidence has shown that it also has significant effects in kidney transplantation, ischemic preconditioning protects the organism from potentially lethal ischemia of longer duration by acti-vating a transient nonlethal hypoxic environment, humoral communication, neuronal stimulation, systemic modification of circulating immune cells, and activation of hypoxia inducible genes. This review focuses on the mechanisms involved in ischemic preconditioning.