Wiggins R C
Nephrology Division, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109-0676, USA.
Kidney Int. 2007 Jun;71(12):1205-14. doi: 10.1038/sj.ki.5002222. Epub 2007 Apr 4.
Glomerular diseases encompass a broad array of clinicopathologically defined syndromes which together account for 90% of end-stage kidney disease costing $20 billion per annum to treat in the United States alone. Recent insights have defined the central role of the podocyte as both the regulator of glomerular development as well as the determinant of progression to glomerulosclerosis. We can now place all glomerular diseases within this spectrum of podocytopathies with predictable outcomes based on podocyte biology impacted by temporal, genetic, and environmental cues. This simplified construct is particularly useful to rationalize clinical effort toward podocyte preservation and prevention of progression as well as to focus basic research effort on understanding podocyte biology and for clinical research toward development of practical monitoring strategies for podocyte injury, dysfunction, and loss.
肾小球疾病涵盖了一系列临床病理定义的综合征，仅在美国，这些疾病就占终末期肾病的90%，每年治疗费用高达200亿美元。最近的研究见解明确了足细胞的核心作用，它既是肾小球发育的调节因子，也是进展为肾小球硬化的决定因素。基于受时间、遗传和环境因素影响的足细胞生物学特性，我们现在可以将所有肾小球疾病归为足细胞病范畴，并预测其结果。这种简化的架构对于合理安排旨在保护足细胞和预防疾病进展的临床工作尤为有用，同时也有助于将基础研究工作聚焦于理解足细胞生物学，以及开展临床研究以开发针对足细胞损伤、功能障碍和丢失的实用监测策略。
