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Review Molecular Mechanisms and Treatment Options of Nephropathic Cystinosis

Journal

TRENDS IN MOLECULAR MEDICINE
Volume 27, Issue 7, Pages 673-686

Publisher

CELL PRESS
DOI: 10.1016/j.molmed.2021.04.004

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Funding

  1. Dutch Kidney Foundation [.150KG19]

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Nephropathic cystinosis is a severe systemic disorder caused by mutations in the CTNS gene, primarily affecting the kidneys. Recent studies have shown that the loss of cystinosin leads to disrupted autophagy dynamics, accumulation of distorted mitochondria, and increased oxidative stress, resulting in abnormal proliferation and dysfunction of kidney cells.
Nephropathic cystinosis is a severe, monogenic systemic disorder that presents early in life and leads to progressive organ damage, particularly affecting the kidneys. It is caused by mutations in the CTNS gene, which encodes the lysosomal transporter cystinosin, resulting in intralysosomal accumulation of cystine. Recent studies demonstrated that the loss of cystinosin is associated with disrupted autophagy dynamics, accumulation of distorted mitochondria, and increased oxidative stress, leading to abnormal proliferation and dysfunction of kidney cells. We discuss these molecular mechanisms driving nephropathic cystinosis. Further, we consider how unravelling molecular mechanisms supports the identification and development of new strategies for cystinosis by the use of small molecules, biologicals, and genetic rescue of the disease in vitro and in vivo.

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