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Molecular Mechanisms in the Pathogenesis of Idiopathic Nephrotic Syndrome pp 221–240Cite as

Podocytes as a Direct Target of Drugs Used in Idiopathic Nephrotic Syndrome

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Abstract

Podocytes are terminally differentiated glomerular epithelial cells that are responsible for maintaining the structure and function of the glomerular filtration barrier in the kidney. Injury to podocytes can directly result in nephrotic syndrome, and thus these cells represent a promising target for renal protection. Immunosuppressive agents such as glucocorticoids and calcineurin inhibitors remain the primary treatments for nephrotic syndrome despite the lack of a complete understanding of their mechanisms of action. Increasing evidence suggests that these drugs may exert direct beneficial effects on podocytes themselves, suggesting that efficacy of these drugs in nephrotic syndrome may not be explained by their conventional anti-inflammatory or immunosuppressive actions but instead by a direct modulation of podocyte biology and signalling.

In this chapter, we will discuss the current concepts of podocytes as a direct target of drugs used in the treatment of idiopathic nephrotic syndrome and summarise the evidence for this in vitro and in vivo. These direct effects suggest that the conventional explanation for the effectiveness of the immunomodulatory therapies may be incorrect or only partially correct and that the design of novel therapies for nephrotic syndrome that target the podocyte itself could be beneficial in the future treatment of proteinuric diseases.

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Authors and Affiliations

  1. Academic Renal Unit, School of Clinical Sciences, University of Bristol, Dorothy Hodgkin Building, Whitson Street, Bristol, BS1 3NY, UK

    Lulu Jiang & Gavin I. Welsh

  2. The University of Hong Kong, Pokfulam, Hong Kong

    Peter W. Mathieson

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  1. Lulu Jiang
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  2. Peter W. Mathieson
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  3. Gavin I. Welsh
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Correspondence to Gavin I. Welsh .

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Editors and Affiliations

  1. Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Osaka, Japan

    Kazunari Kaneko

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Jiang, L., Mathieson, P.W., Welsh, G.I. (2016). Podocytes as a Direct Target of Drugs Used in Idiopathic Nephrotic Syndrome. In: Kaneko, K. (eds) Molecular Mechanisms in the Pathogenesis of Idiopathic Nephrotic Syndrome. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55270-3_13

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  • DOI: https://doi.org/10.1007/978-4-431-55270-3_13

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-55269-7

  • Online ISBN: 978-4-431-55270-3

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