4.2 Review

Collapsing glomerulopathy: unraveling varied pathogeneses

Journal

CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION
Volume 32, Issue 3, Pages 213-222

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MNH.0000000000000873

Keywords

collapsing glomerulopathy; digital spatial profiling; endothelial cell; podocyte

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Collapsing glomerulopathy is a condition characterized by nephrotic syndrome and rapid loss of kidney function. It is associated with various clinical and genetic conditions, and its underlying mechanisms are being explored through animal models and patient studies.
Purpose of reviewCollapsing glomerulopathy presents clinically with nephrotic syndrome and rapid progressive loss of kidney function. Animal models and patient studies have uncovered numerous clinical and genetic conditions associated with collapsing glomerulopathy, as well as putative mechanisms, which will be reviewed here.Recent findingsCollapsing glomerulopathy is classified pathologically as a variant of focal and segmental glomerulosclerosis (FSGS). As such, most research efforts have focused on the causative role of podocyte injury in driving the disease. However, studies have also shown that injury to the glomerular endothelium or interruption of the podocyte-glomerular endothelial cell signaling axis can also cause collapsing glomerulopathy. Furthermore, emerging technologies are now enabling exploration of diverse molecular pathways that can precipitate collapsing glomerulopathy using biopsies from patients with the disease.Since its original description in the 1980s, collapsing glomerulopathy has been the subject of intense study, and these efforts have uncovered numerous insights into potential disease mechanisms. Newer technologies will enable profiling of the intra-patient and inter-patient variability in collapsing glomerulopathy mechanisms directly in patient biopsies, which will improve the diagnosis and classification of collapsing glomerulopathy.

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