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2015 ; 34
(2
): 69-75
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Nonimmunologic targets of immunosuppressive agents in podocytes
#MMPMID26484025
Yoo TH
; Fornoni A
Kidney Res Clin Pract
2015[Jun]; 34
(2
): 69-75
PMID26484025
show ga
Proteinuria is a characteristic finding in glomerular diseases and is closely
associated with renal outcomes. In addition, therapeutic interventions that
reduce proteinuria improve renal prognosis. Accumulating evidence has
demonstrated that podocytes act as key modulators of glomerular injury and
proteinuria. The podocyte, or glomerular visceral epithelial cell, is a highly
specialized and differentiated cell that forms interdigitated foot processes with
neighboring podocytes, which are bridged together by an extracellular structure
known as the "slit diaphragm" (SD). The SD acts as a size- and charge-selective
barrier to plasma protein. Derangement of SD structure or loss of SD-associated
protein results in podocyte injury and proteinuria. During the past decades,
several immune-modulating agents have been used for the treatment of glomerular
diseases and for the reduction of proteinuria. Interestingly, recent studies have
demonstrated that immunosuppressive agents can have a direct effect on the
SD-associated proteins and stabilize actin cytoskeleton in podocyte and have
therefore introduced the concept of nonimmunologic mechanism of renoprotection by
immunomodulators. This review focuses on the evidence that immuno-modulating
agents directly target podocytes.