生物技术进展2026，Vol.16Issue(2)：327-337,11.DOI:10.19586/j.2095-2341.2025.0189
终末期肾病中细胞焦亡与铁死亡的机制及营养干预研究进展
Advances on Mechanisms of Pyroptosis and Ferroptosis in End-stage Renal Disease and Nutritional Interventions
摘要
Abstract
Chronic end-stage renal disease(ESRD)represents a major challenge in modern nephrology.Its progression is closely associated with programmed cell death(PCD),among which pyroptosis and ferroptosis play core regulatory roles.These PCD processes are regulated not only by genetic and pathological signals but also significantly dependent on nutritional status and met-abolic energy supply.Although studies on the"nutrition-PCD-ESRD"axis have been increasing,relevant evidence remains frag-mented and mechanistic understanding has not been unified.Accordingly,this review systematically summarized the molecular mechanisms of pyroptosis and ferroptosis in patients with ESRD and maintenance hemodialysis(MHD).Pyroptosis contributes to irreversible kidney injury through a three-stage pathway:initiation,amplification,and propagation.Ferroptosis is driven by the core axis of iron overload,antioxidant imbalance,and lipid peroxidation amplification.Both pathways are key drivers of irrevers-ible renal damage.This review further focused on the intervention effects of nutrients including zinc,vitamin D,ω-3 polyunsatu-rated fatty acids,selenium,vitamin E,L-carnitine,and dietary fiber by targeting key nodes of the above PCD pathways.It con-firmed that nutritional interventions can delay disease progression through multiple pathways,such as inhibiting inflammasome activation,restoring antioxidant defense,and regulating iron metabolism.Meanwhile,current challenges in precision nutritional therapy were identified,including high patient heterogeneity,insufficient evidence strength,and limitations of single interven-tions.Future research directions were proposed,such as establishing a PCD-signature-based precise stratification system,devel-oping multi-target synergistic intervention strategies,and strengthening supporting technologies.This review provided mechanis-tic evidence and translational ideas for nutritional intervention in ESRD/MHD patients,and offered a reference for basic research and clinical strategies.关键词
终末期肾病/程序性细胞死亡/细胞焦亡/铁死亡/尿毒症微环境/疾病修饰性营养策略Key words
ESRD/PCD/pyroptosis/ferroptosis/uremic microenvironment/disease-modifying nutritional strategies分类
生物科学引用本文复制引用
杨茜,秦伟..终末期肾病中细胞焦亡与铁死亡的机制及营养干预研究进展[J].生物技术进展,2026,16(2):327-337,11.基金项目
四川省科技计划重点研发项目(2022YFS0150). （2022YFS0150）
