title: Immunotherapy for acute kidney injury.
abstract: Acute renal failure, now referred to as acute kidney injury, is a common and clinically important problem. Acute kidney injury frequently occurs as a result of acute tubular necrosis (ATN), which is often caused by a reduction in systemic blood pressure or renal blood flow (e.g., as observed in severe sepsis or during renal transplantation). The disease course in ATN is variable, including prolonged dialysis-dependence and chronic renal dysfunction, but there is currently no specific therapy for ATN. There is increasing evidence that the inflammatory response in ATN significantly contributes to disease severity and outcome. In this review, we summarize recent developments in the understanding of how the immune system responds to dying cells, and the relevance of these discoveries to ATN. In particular, NLRP3 inflammasome activation and IL-1β-mediated neutrophil recruitment are likely to play a key role and may provide novel therapeutic targets for immunotherapy in ATN.
authors.affiliation: Division of Renal Medicine, Department of Medicine, University of Cambridge, Cambridge, UK.
authors.forename: Miriam
authors.initials: M
authors.lastname: Berry
authors.forename: Menna R
authors.initials: MR
authors.lastname: Clatworthy
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002352:Carrier Proteins / Q000276:immunology; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D058847:Inflammasomes / Q000276:immunology; D053583:Interleukin-1beta / Q000276:immunology; D016030:Kidney Transplantation; D007683:Kidney Tubular Necrosis, Acute / Q000276:immunology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D000071199:NLR Family, Pyrin Domain-Containing 3 Protein; D020556:Neutrophil Infiltration / Q000276:immunology; D009504:Neutrophils / Q000276:immunology / Q000473:pathology; D012079:Renal Circulation / Q000276:immunology; D018805:Sepsis / Q000276:immunology / Q000473:pathology / Q000628:therapy; D014184:Transplantation, Homologous
chemical_list: D002352:Carrier Proteins; C508585:IL1B protein, human; D058847:Inflammasomes; D053583:Interleukin-1beta; D000071199:NLR Family, Pyrin Domain-Containing 3 Protein; C453881:NLRP3 protein, human