Current conceptsofthepodocyteinnephroticsyndrome

Nephrotic syndromeisadisorderoftheglomerularfiltrationbarrier,andcentralto the filtrationmechanismoftheglomerularfiltrationbarrieristhepodocyte.We are startingtobetterunderstandhowthiscell,withitsuniquearchitectural features, fulfilsitsexactfiltrationproperties.Themultiproteincomplexbetween adjacent podocytefootprocesses,theslitdiaphragm,isessentialtothecontrolof the actincytoskeletonandcellmorphology.Manyoftheproteinswithintheslit diaphragm, includingnephrin,podocin,transientreceptorpotential-6channel,and a-actinin-4, havebeenidentifiedviageneticstudiesofinheritednephrotic syndromes. Signalingfromslitdiaphragmproteinstotheactincytoskeletonis mediated viatheRhoGTPases.Thesearethoughttobeinvolvedinthecontrolof podocyte motility,whichhasbeenpostulatedasafocusofproteinuricpathways. Nephrotic syndromeiscurrentlytreatedwithimmunosuppressivetherapy,with significant adverseeffects.Thesetherapiesmayworkinnephroticsyndromedue to specificeffectsonthepodocytes.Thisreviewaimstodescribeourcurrent understanding ofthecellularpathwaysandmoleculeswithinthepodocyte relevant tonephroticsyndromeanditstreatment.Withourcurrentknowledge of thecellularbiologyofthepodocyte,thereismuchhopefortargetedtherapies for nephroticsyndromes. KCI Citation Count: 0