New insights into the role of podocytes in proteinuria

被引:153
作者
Patrakka, Jaakko [1 ]
Tryggvason, Karl [2 ]
机构
[1] Karolinska Univ Hosp, Dept Renal Med, Stockholm, Sweden
[2] Karolinska Inst, Dept Med Biochem & Biophys, Div Matrix Biol, Stockholm, Sweden
基金
英国医学研究理事会;
关键词
GLOMERULAR-BASEMENT-MEMBRANE; INTEGRIN-LINKED KINASE; ACTIN CYTOSKELETON; HEPARAN-SULFATE; MICE LACKING; KIDNEY; EXPRESSION; NEPHRIN; MYH9; BETA-1-INTEGRIN;
D O I
10.1038/nrneph.2009.108
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Disturbances in many different molecular pathways and interactions can lead to the same clinical end points of proteinuria and end-stage renal disease. Proteinuria is often accompanied by a cytopathological change in the glomerulus that is referred to as effacement ( retraction) of the podocyte foot processes. The molecular mechanisms that lead to proteinuria and podocyte effacement are poorly understood; therefore, targeted therapies are lacking. During the past 5 years, however, a large body of data has emerged in this field. The discovery of podocyte gene defects that underlie some hereditary proteinuric syndromes has changed our understanding of the relative contributions of components of the glomerular filter. Furthermore, pathogenic pathways activated in podocytes during proteinuria have been identified. Together, these findings pinpoint the podocyte as the most obvious candidate for therapeutic intervention. in the near future, the use of large-scale expression profiling platforms, transgenic mouse lines, and other in vivo gene delivery methods will further expand our understanding of the pathology of the glomerular filtration barrier, and perhaps reveal novel target molecules for the therapy of proteinuric kidney diseases.
引用
收藏
页码:463 / 468
页数:6
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