Glomerular albumin permeability as an in vitro model for characterizing the mechanism of focal glomerulosclerosis and predicting post-transplant recurrence.
The putative mechanisms of proteinuria in idiopathic focal glomerulosclerosis and of its post-transplant recurrence are discussed. It is proposed that a balance between circulating factors with permeability activity on glomeruli and putative inhibitors play a key role. The characterization of inductors is currently in progress; most inhibitors appear to be apolipoproteins (mainly apoJ and apo E) but we cannot exclude other substances. The goal is now to evaluate the concentration of both inducers and inhibitors of glomerular permeability in vivo. Permeability activity in plasma of patients with FSGS with and without recurrence of the disease may be evaluated by an in vitro functional essay with isolated glomeruli. Published data on permeability activity evaluated with this method in different proteinuric states gave, however, controversial results and this test cannot be readily considered of clear clinical utility. Only the definitive characterization and quantification in vivo of the different molecules that play a role in FSGS may furnish adequate answer.
Ghiggeri
Gian Marco
GM
Unit of Nephrology, G. Gaslini Children's Hospital, 16148 Genoa, Italy. labnefro@ospedale-gaslini.ge.it
Artero
Mary
M
Carraro
Michele
M
Candiano
Giovanni
G
Musante
Luca
L
Bruschi
Maurizio
M
Zennaro
Cristina
C
Ginevri
Fabrizio
F
Caridi
Gianluca
G
Faccini
Luigi
L
Perfumo
Francesco
F
Gusmano
Rosanna
R
D000419:Albuminuria / Q000378:metabolism / Q000628:therapy; D005920:Glomerular Mesangium / Q000378:metabolism* / Q000473:pathology; D005923:Glomerulosclerosis, Focal Segmental / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D066298:In Vitro Techniques; D016030:Kidney Transplantation; D008954:Models, Biological; D010539:Permeability; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy*; D012008:Recurrence