【摘要】 肾脏纤维化是慢性肾脏病进展至终末期肾病的关键病理过程，其特征表现为细胞外基质过度沉积，导致肾脏组织结构破坏与功能丧失。支链氨基酸(BCAA)作为必需氨基酸，在维持蛋白质动态平衡、能量代谢调控及细胞信号转导等机制中发挥重要作用，其代谢紊乱可通过多种机制导致疾病发生发展。研究显示，BCAA代谢紊乱通过炎症与氧化应激、代谢重编程与能量障碍、上皮-间充质转化及肠道菌群失调等机制参与肾脏纤维化的进程。本文从BCAA代谢紊乱及其在肾脏纤维化中的作用两方面系统综述BCAA代谢紊乱与肾脏纤维化的关系，探讨通过调控BCAA稳态或其下游通路延缓肾脏纤维化的临床应用价值。更多还原

【Abstract】 Renal fibrosis is a critical pathological process in the progression of chronic kidney disease to end-stage renal disease, characterized by excessive deposition of extracellular matrix, leading to structural destruction and functional loss of the kidney. As a class of essential amino acids, branched-chain amino acid(BCAA) is critical for maintaining protein homeostasis, modulating energy metabolism, and regulating cellular signaling pathways. Dysregulation of BCAA metabolism can contribute to disease pathogenesis through multiple mechanisms. Emerging evidence suggests that BCAA metabolic dysregulation participates in renal fibrosis progression via mechanisms such as inflammation and oxidative stress, metabolic reprogramming and energy dysfunction, epithelial-mesenchymal transition, and gut microbiota dysbiosis. This article systematically reviews the relationship between BCAA metabolic dysregulation and renal fibrosis from two perspectives: the dysregulation of BCAA metabolism and its mechanistic roles in renal fibrosis pathogenesis. Furthermore, we discuss the clinical potential of modulating BCAA homeostasis or intervening in downstream signaling pathways to attenuate renal fibrosis progression.更多还原