血管內皮生長因子的表現量與腎臟疾病的關連性

The Role of Vascular Endothelial Growth Factor in Renal Diseases

陳甫安(Fu-An Chen) ； 徐大爲(Ta-Wei Hsu) ； 王緯書(Wei-Shu Wang)

《內科學誌》 21卷5期 (2010/10) Pp. 337-343

https://doi.org/10.6314/JIMT.2010.21(5).05

摘要

血管內皮生長因子(Vascular endothelial growth factor, VEGF)在血管生長、血管通透性的維持，以及血管內皮細胞壽命的延長上扮演了不可或缺的角色。腎臟內也有VEGF，主要存在於腎絲球足細胞和腎小管細胞；適量的VEGF有助於維持腎臟生理的恆定，過多或過少都會造成腎臟疾病。VEGF已被證實和許多腎臟疾病有所關聯，目前研究最深入的是糖尿病腎病變。VEGF會因爲高血糖的環境而增加表現，但由於其下游的一氧化氮在糖尿病患身上會被抑制，增加的VEGF反而對病患的腎臟產生了負面的影響；然而，利用VEGF抑制劑來治療糖尿病腎病變，截至目前爲止尚未有定論。而在其他腎臟疾病方面，VEGF對於急性腎衰竭、腎膈增生型腎炎的作用是正面的，對腎移植病變的作用的則是負面的。隨著VEGF拮抗劑在許多腫瘤及血管相關疾病的應用逐漸廣泛，VEGF在腎臟疾病的角色也越來越受到關注，但有關其詳細的病理機轉以及實際臨床的應用，還有待更多後續的研究。

關鍵字

血管內皮生長因子 ； 腎臟疾病

並列摘要

Vascular endothelial growth factor (VEGF) is crucial for vascular growth, maintenance of vascular permeability and prolongation of the survival of endothelial cell. VEGF is expressed in the kidney, especially in glomerular podocytes and tubular cells. Adequate amount of VEGF is essential to maintain normal renal physiology. Excessive or defective expression of VEGF may cause renal disease. VEGF is involved in the pathophysiology of several renal diseases, and the most studied is diabetic nephropathy. Hyperglycemia may increase VEGF expression, however, nitric oxide, the downstream mediator of VEGF, is inhibited in diabetes. Thus, the excessive VEGF may play a detrimental role in the diabetic nephropathy. However, the role of VEGF inhibitor in the treatment of diabetic nephropathy remains elusive. In other renal disease, VEGF contributes to the restoration in acute renal failure and mesangioproliferative glomerulonephritis but is deleterious in chronic allograft nephropathy. Currently, the significance of VEGF and polymorphism of the VEGF gene in renal diseases attract more and more attention, but efforts should be made to elucidate the detailed mechanism in the pathophysiology to facilitate the clinical application of VEGF pathway in renal diseases.

並列關鍵字

Vascular endothelial growth factor, VEGF ； Renal disease