Department of Pediatrics, Yale University School of Medicine, 333 Cedar St., P.O. Box 208064, New Haven, CT 06520-8064, USA.
Am J Pathol. 2010 Nov;177(5):2225-33. doi: 10.2353/ajpath.2010.091146. Epub 2010 Sep 9.
The tight regulation of vascular endothelial growth factor-A (VEGF-A) signaling is required for both the development and maintenance of the glomerular filtration barrier, but the pathogenic role of excessive amounts of VEGF-A detected in multiple renal diseases remains poorly defined. We generated inducible transgenic mice that overexpress podocyte VEGF164 at any chosen stage of development. In this study, we report the phenotypes that result from podocyte VEGF164 excess during organogenesis and after birth. On doxycycline induction, podocin-rtTA:tet-O-VEGF164 mice express twofold higher kidney VEGF164 levels than single transgenic mice, localized to podocytes. Podocyte VEGF164 overexpression during organogenesis resulted in albuminuria at birth and was associated with glomerulomegaly, uniform podocyte effacement, very few and wide foot processes joined by occluding junctions, almost complete absence of slit diaphragms, and swollen endothelial cells with few fenestrae as revealed by transmission electron microscopy. Podocyte VEGF164 overexpression after birth caused massive albuminuria in 70% of 2-week-old mice, glomerulomegaly, and minimal changes on light microscopy. Transmission electron microscopy showed podocyte effacement and fusion and morphologically normal endothelial cells. Podocyte VEGF164 overexpression induced nephrin down-regulation without podocyte loss. VEGF164-induced abnormalities were reversible on removal of doxycycline and were unresponsive to methylprednisolone. Collectively, the data suggest that moderate podocyte VEGF164 overexpression during organogenesis results in congenital nephrotic syndrome, whereas VEGF164 overexpression after birth induces a steroid-resistant minimal change like-disease in mice.
血管内皮生长因子-A(VEGF-A)信号的严格调节对于肾小球滤过屏障的发育和维持都是必需的,但是在多种肾脏疾病中检测到的大量 VEGF-A 的致病作用仍然定义不清。我们生成了可诱导的转基因小鼠,可在发育的任何选定阶段过表达足细胞 VEGF164。在这项研究中,我们报告了在器官发生和出生后足细胞 VEGF164 过剩导致的表型。在强力霉素诱导下,足细胞 rtTA:tet-O-VEGF164 小鼠的肾脏 VEGF164 水平比单转基因小鼠高两倍,定位于足细胞。在器官发生期间过表达足细胞 VEGF164 会导致出生时出现白蛋白尿,并与肾小球肥大、均匀的足细胞耗竭、很少且宽的足突通过封闭连接连接、几乎完全缺乏裂孔隔膜以及肿胀的内皮细胞有关,这些变化可以通过透射电子显微镜观察到。出生后过表达足细胞 VEGF164 会导致 70%的 2 周龄小鼠出现大量白蛋白尿、肾小球肥大和光镜下的微小变化。透射电子显微镜显示足细胞耗竭和融合以及形态正常的内皮细胞。过表达足细胞 VEGF164 会导致肾素下调而没有足细胞丢失。强力霉素去除后,VEGF164 诱导的异常是可逆的,且对甲基强的松龙无反应。总的来说,这些数据表明,在器官发生期间适度过表达足细胞 VEGF164 会导致先天性肾病综合征,而出生后过表达 VEGF164 会在小鼠中诱导出一种对类固醇耐药的微小变化样疾病。