[HTML][HTML] The podocyte's response to injury: role in proteinuria and glomerulosclerosis

SJ Shankland - Kidney international, 2006 - Elsevier
SJ Shankland
Kidney international, 2006Elsevier
The terminally differentiated podocyte, also called glomerular visceral epithelial cell, are
highly specialized cells. They function as a critical size and charge barrier to prevent
proteinuria. Podocytes are injured in diabetic and non-diabetic renal diseases. The clinical
signature of podocyte injury is proteinuria, with or without loss of renal function owing to
glomerulosclerosis. There is an exciting and expanding literature showing that hereditary,
congenital, or acquired abnormalities in the molecular anatomy of podocytes leads to …
The terminally differentiated podocyte, also called glomerular visceral epithelial cell, are highly specialized cells. They function as a critical size and charge barrier to prevent proteinuria. Podocytes are injured in diabetic and non-diabetic renal diseases. The clinical signature of podocyte injury is proteinuria, with or without loss of renal function owing to glomerulosclerosis. There is an exciting and expanding literature showing that hereditary, congenital, or acquired abnormalities in the molecular anatomy of podocytes leads to proteinuria, and at times, glomerulosclerosis. The change in podocyte shape, called effacement, is not simply a passive process following injury, but is owing to a complex interplay of proteins that comprise the molecular anatomy of the different protein domains of podocytes. These will be discussed in this review. Recent studies have also highlighted that a reduction in podocyte number directly causes proteinuria and glomerulosclerosis. This is owing to several factors, including the relative inability for these cells to proliferate, detachment, and apoptosis. The mechanisms of these events are being elucidated, and are discussed in this review. It is the hope that by delineating the events following injury to podocytes, therapies might be developed to reduce the burden of proteinuric renal diseases.
Elsevier