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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Soc+Nephrol
2015 ; 26
(5
): 1040-52
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Deficient Autophagy Results in Mitochondrial Dysfunction and FSGS
#MMPMID25406339
Kawakami T
; Gomez IG
; Ren S
; Hudkins K
; Roach A
; Alpers CE
; Shankland SJ
; D'Agati VD
; Duffield JS
J Am Soc Nephrol
2015[May]; 26
(5
): 1040-52
PMID25406339
show ga
FSGS is a heterogeneous fibrosing disease of the kidney, the cause of which
remains poorly understood. In most cases, there is no effective treatment to halt
or retard progression to renal failure. Increasing evidence points to
mitochondrial dysfunction and the generation of reactive oxygen species in the
pathogenesis of CKD. Autophagy, a major intracellular lysosomal degradation
system, performs homeostatic functions linked to metabolism and organelle
turnover. We prevented normal autophagic pathways in nephrons of mice by mutating
critical autophagy genes ATG5 or ATG7 during nephrogenesis. Mutant mice developed
mild podocyte and tubular dysfunction within 2 months, profound glomerular and
tubular changes bearing close similarity to human disease by 4 months, and organ
failure by 6 months. Ultrastructurally, podocytes and tubular cells showed
vacuolization, abnormal mitochondria, and evidence of endoplasmic reticulum
stress, features that precede the appearance of histologic or clinical disease.
Similar changes were observed in human idiopathic FSGS kidney biopsy specimens.
Biochemical analysis of podocytes and tubules of 2-month-old mutant mice revealed
elevated production of reactive oxygen species, activation of endoplasmic
reticulum stress pathways, phosphorylation of p38, and mitochondrial dysfunction.
Furthermore, cultured proximal tubule cells isolated from mutant mice showed
marked mitochondrial dysfunction and elevated mitochondrial reactive oxygen
species generation that was suppressed by a mitochondrial superoxide scavenger.
We conclude that mitochondrial dysfunction and endoplasmic reticulum stress due
to impaired autophagic organelle turnover in podocytes and tubular epithelium are
sufficient to cause many of the manifestations of FSGS in mice.