Capillary rarefaction: a missing link in renal and cardiovascular disease?

IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Angiogenesis Pub Date : 2023-06-16 DOI:10.1007/s10456-023-09883-8
Floor M. E. G. Steegh, Anke A. Keijbeck, Patrick A. de Hoogt, Timo Rademakers, Alfons J. H. M. Houben, Koen D. Reesink, Coen D. A. Stehouwer, Mat J. A. P. Daemen, Carine J. Peutz-Kootstra
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Abstract

Patients with chronic kidney disease (CKD) have an increased risk for cardiovascular morbidity and mortality. Capillary rarefaction may be both one of the causes as well as a consequence of CKD and cardiovascular disease. We reviewed the published literature on human biopsy studies and conclude that renal capillary rarefaction occurs independently of the cause of renal function decline. Moreover, glomerular hypertrophy may be an early sign of generalized endothelial dysfunction, while peritubular capillary loss occurs in advanced renal disease. Recent studies with non-invasive measurements show that capillary rarefaction is detected systemically (e.g., in the skin) in individuals with albuminuria, as sign of early CKD and/or generalized endothelial dysfunction. Decreased capillary density is found in omental fat, muscle and heart biopsies of patients with advanced CKD as well as in skin, fat, muscle, brain and heart biopsies of individuals with cardiovascular risk factors. No biopsy studies have yet been performed on capillary rarefaction in individuals with early CKD. At present it is unknown whether individuals with CKD and cardiovascular disease merely share the same risk factors for capillary rarefaction, or whether there is a causal relationship between rarefaction in renal and systemic capillaries. Further studies on renal and systemic capillary rarefaction, including their temporal relationship and underlying mechanisms are needed. This review stresses the importance of preserving and maintaining capillary integrity and homeostasis in the prevention and management of renal and cardiovascular disease.

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毛细血管稀疏:肾脏和心血管疾病中缺失的一环?
慢性肾脏病(CKD)患者的心血管发病率和死亡率风险都会增加。毛细血管稀疏既可能是 CKD 和心血管疾病的原因之一,也可能是其后果。我们回顾了已发表的人体活检研究文献,得出结论认为,肾脏毛细血管稀疏的发生与肾功能衰退的原因无关。此外,肾小球肥大可能是全身内皮功能障碍的早期征兆,而肾病晚期则会出现管周毛细血管缺失。最近的无创测量研究表明,白蛋白尿患者全身(如皮肤)均可检测到毛细血管稀疏,这是早期慢性肾脏病和/或全身内皮功能障碍的标志。在晚期慢性肾脏病患者的网膜脂肪、肌肉和心脏活检中,以及在有心血管风险因素的人的皮肤、脂肪、肌肉、大脑和心脏活检中,都发现毛细血管密度降低。目前还没有对早期慢性肾脏病患者的毛细血管稀疏情况进行活检研究。目前还不清楚患有慢性肾功能衰竭和心血管疾病的人是否仅仅具有相同的毛细血管稀疏风险因素,或者肾脏和全身毛细血管稀疏之间是否存在因果关系。我们需要进一步研究肾脏和全身毛细血管稀疏,包括它们之间的时间关系和内在机制。本综述强调了在肾脏和心血管疾病的预防和治疗中保护和维持毛细血管完整性和平衡的重要性。
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来源期刊
Angiogenesis
Angiogenesis PERIPHERAL VASCULAR DISEASE-
CiteScore
21.90
自引率
8.20%
发文量
37
审稿时长
6-12 weeks
期刊介绍: Angiogenesis, a renowned international journal, seeks to publish high-quality original articles and reviews on the cellular and molecular mechanisms governing angiogenesis in both normal and pathological conditions. By serving as a primary platform for swift communication within the field of angiogenesis research, this multidisciplinary journal showcases pioneering experimental studies utilizing molecular techniques, in vitro methods, animal models, and clinical investigations into angiogenic diseases. Furthermore, Angiogenesis sheds light on cutting-edge therapeutic strategies for promoting or inhibiting angiogenesis, while also highlighting fresh markers and techniques for disease diagnosis and prognosis.
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