Glomerular endothelial cells versus podocytes as the cellular target in diabetic nephropathy.

Abstract:

:It usually takes several years (in some cases, decades) for predisposed individuals to move from the onset of type 1 or type 2 diabetes to the development of microalbuminuria, the first sign of diabetic nephropathy. This long, complication-free, period represents the best possible moment to start a successful preventive strategy (primary prevention) aimed to avoid or at least to postpone the increase of albumin excretion rate. Prevention is based on understanding and counteracting the initial mechanisms leading to the development of the disease and unfortunately, in case of diabetic nephropathy, most of them remain unclear. Little is also known about which, among endothelial cells and podocytes, represent the first glomerular target of the complication. Selective damage of the endothelium or of the podocyte results, as a common consequence, in an increase of albumin excretion rate. Albuminuria by itself cannot therefore be of help to solve the case. Endothelium and podocytes are involved in a continuous cross-talk and by studying the impact of diabetes on this "communication" process it should be possible to obtain some information regarding the weak component of the glomerular filter. Finally, the careful investigation of the mechanisms leading to the development podocyturia, a recently identified glomerular dysfunction associated to the pathogenesis of diabetic nephropathy, could contribute to shed some more light on the very early stages of this complication.

journal_name

Acta Diabetol

journal_title

Acta diabetologica

authors

Maestroni S,Zerbini G

doi

10.1007/s00592-018-1211-2

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

1105-1111

issue

11

eissn

0940-5429

issn

1432-5233

pii

10.1007/s00592-018-1211-2

journal_volume

55

pub_type

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