Abstract
Acute kidney injury (AKI) has impacted a heavy burden on global healthcare system with a high morbidity and mortality in both hospitalized and critically ill patients. However, there are still some shortcomings in clinical approaches for the disease to date, appealing for an earlier recognition and specific intervention to improve long-term outcomes. In the past decades, owing to the predictable base-pairing rule and highly modifiable characteristics, nucleic acids have already become significant biomaterials for nanostructure and nanodevice fabrication, which is known as nucleic acid nanotechnology. In particular, its excellent programmability and biocompatibility have further promoted its intersection with medical challenges. Lately, there have been an influx of research connecting nucleic acid nanotechnology with the clinical needs for renal diseases, especially AKI. In this review, we begin with the diagnostics of AKI based on nucleic acid nanotechnology with a highlight on aptamer- and probe-functionalized detection. Then, recently developed nanoscale nucleic acid therapeutics towards AKI will be fully elucidated. Furthermore, the strengths and limitations will be summarized, envisioning a wiser and wider application of nucleic acid nanotechnology in the future of AKI.
Highlights
Acute kidney injury (AKI) is a clinical syndrome characterized by an abrupted decline in renal function due to miscellaneous factors, such as rapid volume depletion, acute infection, nephrotoxic medicines and so on, leading to a retention of nitrogen wastes and creatinine accompanied by electrolyte disturbances and acid-base imbalance [1,2].AKI occurs in more than 50% of patients in intensive care unit (ICU) while mortality reaches 10~20% even in non-ICU hospitalized patients suffering AKI, spawning huge significance to its early identification and medical intervention [3,4]
They screened out 33 proteins elevated in the serum of AKI-D patients who died in the first 8 days compared with those who survived over 8 days, among which fibroblast growth factor-23 (FGF23), tissue plasminogen activator, and soluble urokinase plasminogen activator receptor were strongly associated with a higher mortality
Nucleic acid nanotechnology harnessed for diagnostics and therapeutics in AKI is mainly discussed, in which the specific binding ability, diverse range of targets and easy incorporation into various biochemical platforms contribute to novel methods for AKI
Summary
Acute kidney injury (AKI) is a clinical syndrome characterized by an abrupted decline in renal function due to miscellaneous factors, such as rapid volume depletion, acute infection, nephrotoxic medicines and so on, leading to a retention of nitrogen wastes and creatinine accompanied by electrolyte disturbances and acid-base imbalance [1,2]. The concept of nucleic acid nanotechnology has further blossomed in the field of biomedical science, smart drug delivery systemsdiagnosis and molecular recognition recognition tools including [10,11]. Schematic diagram of how nucleic acid nanotechnology plays part in the diagnostic and Figure. Schematic diagram of how nucleic acid nanotechnology plays a part in a the diagnostic and therapeutic of of acute kidney injury (AKI). In AKI diagnostics, aptamers, DNA nanostructherapeuticstrategies strategies acute kidney injury. In AKI therapeutics, oxidative stress, ferroptosis, molecules and nucleic acids. We mainly introduce nucleic acid nanotechnology-based diagnostics targeting AKIrelated proteins, small molecules and nucleic acids, on their detection performance and how aptamers or nucleic acid probes are incorporated into various methodologies facilitating AKI diagnosis. Non-aptamer/probe aided diagnostic methods indirectly implying AKI and modified DNA-mediated AKI proteomic discoveries are discussed in the following paragraphs (Table 1)
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