Departments of Internal Medicine and Molecular and Integrative Physiology, and The Jared Grantham Kidney Institute, University of Kansas Medical Center, Kansas City, KS, USA.
Adv Exp Med Biol. 2019;1132:99-112. doi: 10.1007/978-981-13-6657-4_11.
Periostin is a matricellular protein that is expressed in several tissues during embryonic development; however, its expression in adults is mostly restricted to collagen-rich connective tissues. Periostin is expressed only briefly during kidney development, but it is not normally detected in the adult kidney. Recent evidence has revealed that periostin is aberrantly expressed in several forms of chronic kidney disease (CKD), and that its expression correlates with the degree of interstitial fibrosis and the decline in renal function. Polycystic kidney disease (PKD), a genetic disorder, is characterized by the formation of numerous fluid-filled cysts in the kidneys. Periostin is secreted by the cyst epithelial cells and accumulates within the extracellular matrix adjacent to the cysts. In PKD mice, periostin overexpression accelerates cyst growth and contributes to structural changes in the kidneys, including interstitial fibrosis. Recent evidence suggests that periostin is a tissue repair molecule; however, its role in repair following acute kidney injury has not been investigated. It is thought that persistent expression of this protein in CKD contributes importantly to tubulointerstitial fibrosis and the progressive decline in renal function. Future studies to define the diverse actions of periostin during kidney injury may lead to effective therapies to slow PKD progression and possibly prevent the development of CKD. This chapter reviews the current literature on the expression of periostin in PKD and other forms of CKD, mechanisms for periostin stimulated cyst growth, its potential role in extracellular matrix production and renal fibrosis, and the evidence for periostin as a novel biomarker for kidney disease.
纤调蛋白是一种基质细胞蛋白，在胚胎发育过程中在几种组织中表达；然而，其在成人中的表达大多局限于富含胶原蛋白的结缔组织。纤调蛋白在肾脏发育过程中仅短暂表达，但在成人肾脏中通常无法检测到。最近的证据表明，纤调蛋白在几种慢性肾脏病（CKD）中异常表达，其表达与间质纤维化程度和肾功能下降相关。多囊肾病（PKD）是一种遗传性疾病，其特征是肾脏中形成大量充满液体的囊肿。纤调蛋白由囊肿上皮细胞分泌，并在毗邻囊肿的细胞外基质中积累。在 PKD 小鼠中，纤调蛋白过表达加速了囊肿的生长，并导致肾脏结构发生变化，包括间质纤维化。最近的证据表明，纤调蛋白是一种组织修复分子；然而，其在急性肾损伤后的修复作用尚未得到研究。据认为，这种蛋白在 CKD 中的持续表达对肾小管间质纤维化和肾功能的进行性下降有重要贡献。进一步研究纤调蛋白在肾脏损伤过程中的多种作用，可能会为减缓 PKD 进展并预防 CKD 的发生提供有效的治疗方法。本章综述了纤调蛋白在 PKD 和其他形式的 CKD 中的表达、纤调蛋白刺激囊肿生长的机制、其在细胞外基质产生和肾脏纤维化中的潜在作用，以及纤调蛋白作为肾脏疾病新型生物标志物的证据。
