Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA.
Pediatr Nephrol. 2021 Sep;36(9):2607-2614. doi: 10.1007/s00467-020-04812-z. Epub 2020 Nov 13.
The selectivity of the glomerular filter is established by physical, chemical, and signaling interplay among its three core constituents: glomerular endothelial cells, the glomerular basement membrane, and podocytes. Functional impairment or injury of any of these three components can lead to proteinuria. Podocytes are injured in many forms of human and experimental glomerular disease, including minimal change disease, focal segmental glomerulosclerosis, and diabetes mellitus. One of the earliest signs of podocyte injury is loss of their distinct structure, which is driven by dysregulated dynamics of the actin cytoskeleton. The status of the actin cytoskeleton in podocytes depends on a set of actin binding proteins, nucleators and inhibitors of actin polymerization, and regulatory GTPases. Mutations that alter protein function in each category have been implicated in glomerular diseases in humans and animal models. In addition, a growing body of studies suggest that pharmacological modifications of the actin cytoskeleton have the potential to become novel therapeutics for podocyte-dependent chronic kidney diseases. This review presents an overview of the essential proteins that establish actin cytoskeleton in podocytes and studies demonstrating the feasibility of drugging actin cytoskeleton in kidney diseases.
肾小球滤过膜的选择性是由其三个核心成分——肾小球内皮细胞、肾小球基底膜和足细胞之间的物理、化学和信号相互作用所决定的。这三个成分中的任何一个功能受损或损伤都可能导致蛋白尿。在许多形式的人类和实验性肾小球疾病中,包括微小病变性肾病、局灶节段性肾小球硬化和糖尿病,足细胞都会受到损伤。足细胞损伤的最早迹象之一是其独特结构的丧失,这是由肌动蛋白细胞骨架的失调动力学驱动的。足细胞中肌动蛋白细胞骨架的状态取决于一组肌动蛋白结合蛋白、肌动蛋白聚合的成核因子和抑制剂,以及调节 GTPase。改变这些类别中蛋白质功能的突变已被牵连到人类和动物模型中的肾小球疾病中。此外,越来越多的研究表明,肌动蛋白细胞骨架的药理学修饰有可能成为治疗依赖于足细胞的慢性肾脏病的新型疗法。本文综述了在足细胞中建立肌动蛋白细胞骨架的基本蛋白,并介绍了在肾脏病中对肌动蛋白细胞骨架进行药物治疗的可行性研究。