期刊
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
卷 15, 期 12, 页码 1818-1828出版社
AMER SOC NEPHROLOGY
DOI: 10.2215/CJN.11440919
关键词
glomerular filtration barrier; glomerular basement membrane; podocyte; endothelium; focal segmental glomerulosclerosis; Kidney Genomics Series
资金
- University ofManchester
- Wellcome Trust [202860/Z/16/Z]
- Kidney ResearchUK
- MedicalResearchCouncil
- Shire
- charity Kidneys for Life
- Wellcome Trust [202860/Z/16/Z] Funding Source: Wellcome Trust
The glomerular filtration barrier is a highly specialized capillary wall comprising fenestrated endothelial cells, podocytes, and an intervening basement membrane. In glomerular disease, this barrier loses functional integrity, allowing the passage of macromolecules and cells, and there are associated changes in both cell morphology and the extracellular matrix. Over the past 3 decades, there has been a transformation in our understanding about glomerular disease, fueled by genetic discovery, and this is leading to exciting advances in our knowledge about glomerular biology and pathophysiology. In current clinical practice, a genetic diagnosis already has important implications for management, ranging from estimating the risk of disease recurrence post-transplant to the life-changing advances in the treatment of atypical hemolytic uremic syndrome. Improving our understanding about the mechanistic basis of glomerular disease is required for more effective and personalized therapy options. In this review, we describe genotype and phenotype correlations for genetic disorders of the glomerular filtration barrier, with a particular emphasis on how these gene defects cluster by both their ontology and patterns of glomerular pathology.
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