Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
Kidney Int. 2010 Apr;77(8):662-8. doi: 10.1038/ki.2009.559. Epub 2010 Feb 3.
Most kidney diseases that ultimately lead to end-stage renal failure originate within the glomerulus and are associated with proteinuria. Treatment options are unspecific and offer partial cures at best because available therapies do not primarily treat glomerular cells but rather act systemically and thus cause many side effects. Most glomerulopathies directly stem from injury to podocytes, cells that have a key role in the maintenance of the glomerular filter. Thus, these cells constitute an obvious and promising target for the development of novel kidney-protective drugs. During the last decade, enormous advances have been made in the understanding of podocyte structure and function. A number of pathways that are altered during glomerular diseases may be targeted by novel small- and large-molecule drugs as well as biologicals that have been identified in nephrology and other areas of drug development. Cultured podocytes provide a valuable model for high-throughput drug screening assays. Furthermore, podocytes have been shown to possess many features that make them particularly good target cells for renal protection. This mini-review discusses some of the most recent promising data related to potential drug therapy for proteinuria and kidney disease through direct podocyte targeting.
大多数最终导致终末期肾衰竭的肾脏疾病起源于肾小球,并与蛋白尿有关。治疗选择是非特异性的,最多只能提供部分治愈,因为可用的疗法主要不是针对肾小球细胞,而是全身性作用,因此会引起许多副作用。大多数肾小球疾病直接源于足细胞的损伤,足细胞在维持肾小球滤过中起着关键作用。因此,这些细胞构成了开发新型肾脏保护药物的一个明显而有前途的靶点。在过去的十年中,人们对足细胞的结构和功能有了深入的了解。在肾小球疾病中发生改变的许多途径可以通过新型小分子和大分子药物以及在肾脏病学和药物开发的其他领域中发现的生物制剂来靶向。培养的足细胞为高通量药物筛选试验提供了有价值的模型。此外,已经表明足细胞具有许多使其成为肾脏保护特别理想的靶细胞的特征。这篇迷你综述讨论了一些与通过直接靶向足细胞治疗蛋白尿和肾脏疾病的潜在药物治疗相关的最新有希望的数据。
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