J Clin Nephrol Kidney Dis | Volume 1, Issue 1 | Review Article | Open Access

Proteins Lost and Found: Not Only a Tubular Matter

Lisa Gianesello, Monica Ceol, Giovanna Priante, Franca Anglani and Dorella Del Prete*

Department of Clinical Nephrology, University of Padua, Italy

*Correspondance to: Dorella Del Prete 

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Abstract

Proteinuria, manifested predominantly as albuminuria, has been recognized as an independent risk factor for both renal and cardiovascular disease. The loss of proteins is the hallmark of tubular and glomerular diseases and can be due to structural and/or functional alterations involving different cell types. Several studies have underlined the involvement of gene mutations in the pathogenesis of glomerulopathies and tubulopathies.
In the kidney, proximal convoluted tubular epithelial cells are the main responsible for the uptake of filtered macromolecules. Protein endocytosis needs an active receptor-mediated pathway which involves Megalin (LRP2), Cubilin, Amnionless (AMN), Disabled-2 (Dab2), the low density lipoprotein receptor adaptor protein 1 (ARH) and the Cl- /H+ antiporter ClC-5. Although the role of the tubular cells in the protein uptake is a well-known process, less is known regarding the role of glomerular cells (podocytes, mesangial, endothelial and parietal epithelial cells) in protein rescue. In the last few years, major attention has been focused on albumin handling by glomerular cells in particular by podocytes and parietal epithelial cells.
In this review we described the principal mechanisms leading to protein loss and we examined in depth the mechanisms involved in their rescue both at tubular and glomerular levels. The actual knowledge scenario supports the idea of a partnership between tubular and glomerular cells in albumin uptake, via the same way of internalization.

Keywords:

Proteins; Proteinuria ; Podocytes; Dab2; Glomerulopathies; Megalin

Citation:

Gianesello L, Ceol M, Priante G, Anglani F, Prete DD. Proteins Lost and Found: Not Only a Tubular Matter. J Clin Nephrol Kidney Dis. 2016; 1(1): 1002.

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