促肾上腺皮质激素治疗肾性蛋白尿的研究

促肾上腺皮质激素(ACTH)是脑垂体前叶分泌的神经内分泌多肽。它是体内下丘脑-垂体-肾上腺轴和黑素皮质素系统的重要组成部分。ACTH具有促进肾上腺皮质激素分泌和皮质增生、降低血脂、刺激胰岛素分泌、调节免疫和神经系统功能等作用,曾被广泛用于治疗小儿肾病综合征(NS)。近来越来越多的临床证据显示,ACTH能够有效缓解难治性NS患者蛋白尿,但迄今大多是单中心非随机临床研究。ACTH疗效可能与其促进糖皮质激素分泌、降低血脂、调节免疫、保护足细胞以及调节胆碱能抗炎通路有关,但迄今尚不明确;需要综合多种研究手段进一步研究阐述。

Role of adrenocorticotropin therapy in proteinuric nephropathies

Despite the advances in immunosuppression and blockade of the renin-angiotensin-aldosterone cascade,the refractory nephrotic syndrome remains to be a therapeutic challenge.Adrenocorticotropin(ACTH),a pituitary neuroimmunoendocine polypeptide,was widely used about half century ago as an effective therapy for childhood nephrotic syndrome but has since largely been replaced by less costly,orally administered synthetic glucocorticoids.In addition to controlling steroidogenesis as a component of the hypothalamic...