Progress on mechanisms of hydroxychloroquine in the treatment of immune-related renal diseases
10.3760/cma.j.issn.1673-4408.2025.09.001
- VernacularTitle:羟氯喹治疗免疫相关肾脏疾病的机制研究进展
- Author:
Yingqi LIN
1
;
Wenyan HUANG
Author Information
1. 上海交通大学医学院附属儿童医院 上海市儿童医院肾脏风湿免疫科 200062
- Keywords:
Kidney diseases;
Hydroxychloroquine;
Immunomodulation;
Lysosomes;
Toll-like receptors
- From:
International Journal of Pediatrics
2025;52(9):577-582
- CountryChina
- Language:Chinese
-
Abstract:
Hydroxychloroquine is a classical antimalarial agent that has been widely used in the treatment of autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis due to its notable anti-inflammatory and immunomodulatory effects. In recent years，increasing attention has been paid to the therapeutic potential of hydroxychloroquine in immune-related kidney diseases，including lupus nephritis，IgA nephropathy，and renal ischemia-reperfusion injury. Although clinical studies have shown encouraging results，the underlying mechanisms of hydroxychloroquine remain incompletely understood. Emerging evidence suggests that hydroxychloroquine may exert renal protective effects through multiple immunoregulatory pathways. These include inhibition of lysosomal acidification and autophagy，modulation of innate immune signaling via Toll-like receptors，suppression of NLRP3 inflammasome activation，and reduction of NADPH oxidase activity and oxidative stress. Moreover，hydroxychloroquine can downregulate the production of pro-inflammatory cytokines such as IL-6，tumor necrosis factor-alpha（TNF-α），and interferon-α（IFN-α），contributing to a reduction in renal inflammation. Additional mechanisms involve the modulation of the Th17/Treg cell balance and the inhibition of neutrophil extracellular trap formation，which further supports its role in modulating immune responses，attenuating renal inflammation，and preserving kidney function. This article provides a concise review of the mechanisms of hydroxychloroquine in immune-related renal diseases.
