Podocyte is the major culprit accounting for the progression of chronic renal disease
Podocyte is the major culprit accounting for the progression of chronic renal disease
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DOI：
10.1002/jemt.10072
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发表时间：
2002-05-15
影响因子：
2.5
通讯作者：
Kriz, W
中科院分区：
文献类型：
--
作者：
Kriz, W
足细胞是导致慢性肾功能衰竭的肾小球疾病的发展和进展的主要罪魁祸首的概念是公认的。这个过程的基本步骤是：（1）在Bowman囊上建立丛粘连;（2）通过包含在丛粘连中的毛细血管形成滤液，该滤液被递送到Bowman间隙中，朝向肾小球;和（3）该滤液在受影响的肾单位的外部表面上扩散，导致该肾单位的变性。本综述总结了在肾小管上皮水平的肾单位-肾单位转移的错误滤过的相关性的利弊。令人惊讶的是，组织病理学清楚地表明，间质增生周围的退化肾单位往往封装的退化过程，限制它已经受到影响的肾单位。没有证据表明，这种由间质增生和基质沉积介导的疾病可能会转移到邻近的、迄今未受影响的肾单位。在“经典”FSGS的背景下，导致肾单位变性的过程似乎总是通过严重的足细胞损伤在相应的肾小球中单独开始。(C)2002 Wiley-Liss，Inc.
The concept that the podocyte is the major culprit underlying development and progression of glomerular diseases leading to chronic renal failure is well established. The essential steps in this process are (1) the establishment of tuft adhesions to Bowman's capsule; (2) the formation by capillaries contained in a tuft adhesion of a filtrate that is delivered, instead into Bowman's space, towards the interstitium; and (3) the spreading of this filtrate on the outer aspect of the affected nephron leading to the degeneration of this nephron. The present review summarizes the pros and cons concerning the relevance of misdirected filtration for a nephron-to-nephron transfer of the disease at the level of the tubular interstitium. Surprisingly, the histopathology clearly shows that interstitial proliferation surrounding degenerating nephrons tends to encapsulate the degenerative process, confining it to the already affected nephron. No evidence is available that the disease, mediated by interstitial proliferation and matrix deposition, may jump to a neighboring, so far unaffected, nephron. It appears that the process that leads to the degeneration of a nephron in the context of "classic" FSGS always starts separately in the respective glomerulus by severe podocyte injury. (C) 2002 Wiley-Liss, Inc.