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Endothelin-targeted new treatments for proteinuric and inflammatory glomerular diseases: focus on the added value to anti-renin-angiotensin system inhibition. Pediatr Nephrol 2021; 36:763-775. [PMID: 32185491 DOI: 10.1007/s00467-020-04518-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/06/2020] [Accepted: 02/21/2020] [Indexed: 12/11/2022]
Abstract
Chronic kidney disease (CKD) is the main cause of end-stage renal disease worldwide arising as a frequent complication of diabetes, obesity, and hypertension. Current therapeutic options, mainly based of inhibition of the renin-angiotensin system (RAS), provide imperfect renoprotection if started at an advanced phase of the disease, and treatments that show or even reverse the progression of CKD are needed. The endothelin (ET) system contributes to the normal renal physiology; however, robust evidence suggests a key role of ET-1 and its cognate receptors, in the progression of CKD. The effectiveness of ET receptor antagonists in ameliorating renal hemodynamics and fibrosis has been largely demonstrated in different experimental models. A significant antiproteinuric effect of ET receptor antagonists has been found in diabetic and non-diabetic CKD patients even on top of RAS blockade, and emerging evidence from ongoing clinical trials highlights their beneficial effects on a wide range of kidney disorders.
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Akihisa T, Sato M, Wakayama Y, Taneda S, Horita S, Hirose O, Makabe S, Kataoka H, Mori T, Sohara E, Uchida S, Nitta K, Mochizuki T. Glomerular Basement Membrane Protein Expression and the Diagnosis and Prognosis of Autosomal Dominant Alport Syndrome. Kidney Med 2019; 1:391-396. [PMID: 32734219 PMCID: PMC7380416 DOI: 10.1016/j.xkme.2019.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Alport syndrome is a hereditary glomerular nephritis associated with hearing loss and eye abnormalities and is classified as X-linked Alport syndrome, autosomal recessive Alport syndrome, and autosomal dominant Alport syndrome. Autosomal dominant Alport syndrome is caused by a mutation in the gene encoding type IV collagen α3 (α3[IV]); (COL4A3), or α4 (α4[IV]); (COL4A4). Autosomal dominant Alport syndrome progresses more gradually than male X-linked Alport syndrome and autosomal recessive Alport syndrome. Differentiating autosomal dominant Alport syndrome from thin basement membrane nephropathy, which shows better kidney prognosis, remains challenging. Because autosomal dominant Alport syndrome is linked to a heterozygous mutation, type IV collagen is produced by the wild-type allele, and all α(IV) chains are supposed to be normally expressed. In this study, the pathologic findings of a patient with Alport syndrome with a novel COL4A4 heterozygous nonsense mutation were investigated. We observed weaker staining of α5(IV) in the glomerular basement membrane and enhanced expressions of α2(IV), laminin, and fibronectin, which were assumed to be caused by compensatory mechanisms for lack of enough α3α4α5(IV) expression in the glomerular basement membrane. These findings may be useful not only for differentially diagnosing autosomal dominant Alport syndrome from thin basement membrane nephropathy, but also for determining the extent of progression and predicting kidney prognosis.
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Affiliation(s)
- Taro Akihisa
- Department of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masayo Sato
- Department of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshie Wakayama
- Department of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sekiko Taneda
- Division of Pathology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shigeru Horita
- Clinical Research Division for Polycystic Kidney Disease, Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo Medical and Dental University, Tokyo, Japan
| | - Orie Hirose
- Department of Pathology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shiho Makabe
- Department of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Kataoka
- Department of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.,Clinical Research Division for Polycystic Kidney Disease, Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayasu Mori
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Eisei Sohara
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinichi Uchida
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kosaku Nitta
- Department of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshio Mochizuki
- Department of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.,Clinical Research Division for Polycystic Kidney Disease, Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo Medical and Dental University, Tokyo, Japan
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Chen XP, Qin YH. [Research advances in the protective effect of all-trans retinoic acid against podocyte injury]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:719-723. [PMID: 28606243 PMCID: PMC7390304 DOI: 10.7499/j.issn.1008-8830.2017.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/18/2017] [Indexed: 06/07/2023]
Abstract
All-trans retinoic acid (ATRA) is a vitamin A derivative and plays an important role in the regulation of cell aggregation, differentiation, apoptosis, proliferation, and inflammatory response. In recent years, some progress has been made in the role of ATRA in renal diseases, especially its protective effect on podocytes. This article reviews the research advances in podocyte injury, characteristics of ATRA, podocyte differentiation and regeneration induced by ATRA, and the protective effect of ATRA against proliferation, deposition of fibers, and apoptosis.
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Affiliation(s)
- Xiu-Ping Chen
- Department of Pediatrics, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
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