title: Angiopoietins and diabetic nephropathy.
abstract: Diabetic nephropathy is the main cause of end-stage renal failure in the Western world. In diabetes, metabolic and haemodynamic perturbations disrupt the integrity of the glomerular filtration barrier, leading to ultrastructural alterations of the glomeruli, including podocyte foot process fusion and detachment, glomerular basement membrane thickening, reduced endothelial cell glycocalyx, and mesangial extracellular matrix accumulation and glomerulosclerosis, ultimately leading to albuminuria and end-stage renal disease. Many vascular growth factors, such as angiopoietins, are implicated in glomerular biology. In normal physiology angiopoietins regulate the function of the glomerular filtration barrier. When they are dysregulated, however, as they are in diabetes, they drive the cellular mechanisms that mediate diabetic glomerular pathology. Modulation of angiopoietins expression and signalling has been proposed as a tool to correct the cellular mechanisms involved in the pathophysiology of diabetic microvascular disease, such as retinopathy in humans. Future work might evaluate whether this novel therapeutic approach should be extended to diabetic kidney disease.
authors.affiliation: Unit for Metabolic Medicine, Cardiovascular Division, Faculty of Life Science & Medicine, King's College London, 3rd Floor Franklin-Wilkins Building, Waterloo Campus, Stamford Street, London, SE1 9RT, UK. luigi.gnudi@kcl.ac.uk.
authors.forename: Luigi
authors.initials: L
authors.lastname: Gnudi
mesh_terms: D000419:Albuminuria / Q000378:metabolism / Q000473:pathology; D042682:Angiopoietins / Q000378:metabolism*; D000818:Animals; D003928:Diabetic Nephropathies / Q000378:metabolism* / Q000473:pathology; D042783:Endothelial Cells / Q000378:metabolism; D006801:Humans; D007678:Kidney Glomerulus / Q000378:metabolism / Q000473:pathology
chemical_list: D042682:Angiopoietins
keywords: Albuminuria; Angiopoietin; Diabetes; Endothelial cells; Glomerulus; Review