Osteoprotegerin and kidney disease.
Vascular calcification in chronic kidney disease (CKD) patients is associated to increased mortality. Osteoprotegerin (OPG) is a soluble tumor necrosis factor (TNF) superfamily receptor that inhibits the actions of the cytokines receptor activator of nuclear factor kappa-B ligand (RANKL) and TNF-related apoptosis-inducing ligand (TRAIL) by preventing their binding to signaling receptors in the cell membrane. OPG-deficient mice display vascular calcification while OPG prevented calcification of cultured vascular smooth muscle cells and protected kidney cells from TRAIL-induced death. OPG may be a biomarker in patients with kidney disease. Circulating OPG is increased in predialysis, dialysis and transplant CKD patients and may predict vascular calcification progression and patient survival. By contrast, circulating OPG is decreased in nephrotic syndrome. In addition, free and exosome-bound urinary OPG is increased in human kidney disease. Increased urinary OPG has been associated with lupus nephritis activity. Despite the association of high OPG levels with disease, experimental functional information available suggests that OPG might be protective in kidney disease and in vascular injury in the context of uremia. Thus, tissue injury results in increased OPG, while OPG may protect from tissue injury. Recombinant OPG was safe in phase I randomized controlled trials. Further research is needed to fully define the therapeutic and biomarker potential of OPG in patients with kidney disease.
Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, Mexico.
Alejandra
A
Montañez-Barragán
Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, Mexico.
Isaias
I
Gómez-Barrera
Servicio de Nefrología, IdiPAZ, 28046, Madrid, Spain.|REDINREN, Madrid, Spain.
Maria D
MD
Sanchez-Niño
IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid and Fundación Renal Iñigo Álvarez de Toledo, 28040, Madrid, Spain.|REDINREN, Madrid, Spain.
Alvaro C
AC
Ucero
IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid and Fundación Renal Iñigo Álvarez de Toledo, 28040, Madrid, Spain. liliana.gonzalez@fjd.es.|REDINREN, Madrid, Spain. liliana.gonzalez@fjd.es.
Liliana
L
González-Espinoza
IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid and Fundación Renal Iñigo Álvarez de Toledo, 28040, Madrid, Spain. aortiz@fjd.es.|REDINREN, Madrid, Spain. aortiz@fjd.es.|Unidad de Diálisis, Fundación Jiménez Díaz, Avda. Reyes Católicos 2, 28040, Madrid, Spain. aortiz@fjd.es.
Alberto
A
Ortiz
D000818:Animals; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D009131:Muscle, Smooth, Vascular / Q000378:metabolism* / Q000473:pathology; D053244:Osteoprotegerin / Q000378:metabolism* / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D015398:Signal Transduction; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000378:metabolism; D061205:Vascular Calcification / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism*
D053244:Osteoprotegerin; D011994:Recombinant Proteins; D053221:TNF-Related Apoptosis-Inducing Ligand
Exosome; Kidney; Mortality; Osteoprotegerin; TRAIL; Vascular calcification