Role of nephrin in renal disease including diabetic nephropathy

被引:89
作者
Cooper, ME
Mundel, P
Boner, G
机构
[1] Univ Melbourne, Austin & Repatriat Med Ctr, Dept Med, JDRF Ctr Diabet Complicat, Heidelberg West, Australia
[2] Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA
[3] Albert Einstein Coll Med, Dept Anat & Struct Biol, Bronx, NY 10467 USA
[4] Rabin Med Ctr, Inst Hypertens & Kidney Dis, Petah Tiqwa, Israel
[5] Tel Aviv Univ, Sackler Fac Med, Dept Med, IL-69978 Tel Aviv, Israel
关键词
D O I
10.1053/snep.2002.34724
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
Nephrin, a newly described protein, has been localized to the slit membrane between adjacent podocytes of the glomerulus. Its discovery followed the demonstration of the gene NPHS1 and its mutation, resulting in the absence of the protein product, nephrin, in the congenital nephrotic syndrome of the Finnish type. The link between permutations in nephrin expression and proteinuria has been shown in animal models by using neutralizing antibodies or studying mice with inactivation of the nephrin gene. Moreover, the expression of nephrin has been shown to be reduced in various animal models of proteinuric renal disease. The relationship between changes in nephrin expression and proteinuric renal disease in humans is not fully elucidated, with a reduction in expression of this protein reported in a range of renal diseases. Diabetic nephropathy, one of the major causes of end-stage renal disease, is associated with substantial proteinuria and in experimental models with a reduction in slit pore density. In experimental models of diabetes, nephrin expression has been described as being transiently increased in the first 8 weeks of diabetes, followed in longer-term studies with reduced nephrin expression in association with increasing proteinuria. An angiotensin II-receptor blocker has been shown to prevent depletion in glomerular nephrin expression in the diabetic kidney. Human studies in both type 1 and type 2 diabetes suggest down-regulation of nephrin expression in the diabetic kidney and it has been postulated that these changes may play a role in the pathogenesis of diabetic nephropathy, specifically the development of proteinuria in this condition. Although there are other proteins involved in the structure of the epithelial podocyte and specifically the slit pore, nephrin seems to play a pivotal role in preventing passage of protein through the glomerular barrier. Furthermore, it is suggested that the antiproteinuric effects of inhibition of the renin-angiotensin system may partly relate to the effects of these agents on nephrin expression. Copyright 2002, Elsevier Science (USA). All rights reserved.
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页码:393 / 398
页数:6
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