By Jong Hoon Park, Curie Ahn (eds.)
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Acute kidney harm is outlined as an abrupt switch in serum creatinine and/or urine output, and a majority of sufferers admitted to the ICU have a few proof of the disease. regrettably, remedy for this advanced syndrome is as but missing and figuring out is restricted. An interdisciplinary panel of specialists has contributed to this quantity, illuminating the various basic and intricate elements of the disease starting from pathophysiology to therapy, from rising biomarkers to genetic polymorphisms.
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2015; Gregory et al. 2006). In addition, pro-inflammatory cytokines are up-regulated in PKD. It was reported that an increased concentration of TNF-α induces inflammation and proliferation (Li et al. 2008; Ta et al. 2013). TGFβ, MMPs, and TIMPs trigger fibrosis, especially TGF-β, which is involved in fibrosis as an inflammatory cytokine. MMPs and TIMPs induce the re-structuring of cell formations and the accumulation of collagen and fibroblasts. An increase in the abundance of cytokines and growth factors can lead to the development of inflammation and fibrosis.
NF-kB is a transcription factor that is involved in cell survival and the immune response. In canonical NF-kB signaling, when NF-kB is stimulated by factors such as TNF-α, IL-2, or lymphocytes, activated IKK complex phosphorylates IkB proteins, leading to polyubiquitination. Ubiquitinated IkB is degraded by the proteasome, freeing the p50/p65 NF-kB dimer to translocate to the nucleus and activate gene transcription (Skaug et al. 2009; Gilmore 2006; Jost and Ruland 2007). NF-kB regulates pro-inflammatory cytokines including TNF-α, IL-1α, CCL3, CCL4, and MCP1 (Tak and Firestein 2001).
However, inflammation and fibrosis alone are not able to generate PKD, which also requires hyper-proliferation to occur in the kidneys. Following an increase in cell proliferation, the abundance of certain cells and cytokines is elevated. Macrophage and cytokines secreted by macrophages accumulate in cysts and urine (Swenson-Fields et al. 2013; Zheng et al. 2003; Cowley et al. 2001; Chen et al. 2015; Gregory et al. 2006). In addition, pro-inflammatory cytokines are up-regulated in PKD. It was reported that an increased concentration of TNF-α induces inflammation and proliferation (Li et al.