Kidney fibrosis is the common histological end-point of progressive, chronic kidney diseases (CKDs) regardless of the underlying etiology. The hallmark of renal fibrosis, similar to all other organs, is pathological deposition of extracellular matrix (ECM). Renal ECM is a complex network of collagens, elastin, and several glycoproteins and proteoglycans forming basal membranes and interstitial space. Several ECM functions beyond providing a scaffold and organ stability are being increasingly recognized, for example, in inflammation. ECM composition is determined by the function of each of the histological compartments of the kidney, that is, glomeruli, tubulo-interstitium, and vessels. Renal ECM is a dynamic structure undergoing remodeling, particularly during fibrosis. From a clinical perspective, ECM proteins are directly involved in several rare renal diseases and indirectly in CKD progression during renal fibrosis. ECM proteins could serve as specific non-invasive biomarkers of fibrosis and scaffolds in regenerative medicine. The gold standard and currently only specific means to measure renal fibrosis is renal biopsy, but new diagnostic approaches are appearing. Here, we discuss the localization, function, and remodeling of major renal ECM components in healthy and diseased, fibrotic kidneys and the potential use of ECM in diagnostics of renal fibrosis and in tissue engineering.

中文翻译：

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肾纤维化中的细胞外基质：不仅仅是支架。

肾脏纤维化是进行性，慢性肾脏疾病（CKD）的常见组织学终点，无论其潜在病因是什么。类似于所有其他器官，肾纤维化的标志是细胞外基质（ECM）的病理沉积。肾脏ECM是由胶原蛋白，弹性蛋白和几种糖蛋白和蛋白聚糖组成的复杂网络，形成基底膜和间隙。除提供支架和器官稳定性外，ECM的几种功能也越来越多地被认可，例如在炎症中。ECM组成取决于肾脏的每个组织学区室，即肾小球，肾小管间质和血管的功能。肾脏ECM是动态结构，尤其是在纤维化过程中，正在经历重塑。从临床角度来看，ECM蛋白直接参与几种罕见的肾脏疾病，并间接参与肾脏纤维化过程中CKD的进展。ECM蛋白可以作为再生医学中纤维化和支架的特定非侵入性生物标志物。肾活检是黄金标准，目前也是衡量肾纤维化的唯一方法，但新的诊断方法正在出现。在这里，我们讨论了健康和患病的纤维化肾脏中主要肾脏ECM成分的定位，功能和重塑，以及ECM在诊断肾脏纤维化和组织工程中的潜在用途。肾活检是黄金标准，目前也是衡量肾纤维化的唯一方法，但新的诊断方法正在出现。在这里，我们讨论了健康和患病的纤维化肾脏中主要肾脏ECM成分的定位，功能和重塑，以及ECM在诊断肾脏纤维化和组织工程中的潜在用途。肾活检是黄金标准，目前也是衡量肾纤维化的唯一方法，但新的诊断方法正在出现。在这里，我们讨论了健康和患病的纤维化肾脏中主要肾脏ECM成分的定位，功能和重塑，以及ECM在诊断肾脏纤维化和组织工程中的潜在用途。