Proteinuria: From Molecular to Clinical Applications in Glomerulonephritis
1D'Amico Foundation for Renal Diseases Research, Via Cherubini 6, 20100 Milan, Italy
2Department of Nephrology, Lund University, Lund, Sweden
3Section of Nephrology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
Proteinuria: From Molecular to Clinical Applications in Glomerulonephritis
Description
Primary Glomerulonephritis (GN) is still one of the main causes of progression to end-stage renal disease (ESRD) and contributes to the elevated costs for renal replacement therapies. The aetiology of the various types of GN is still largely unknown, and genetic, molecular, and cellular factors responsible of renal lesions are different between them. Proteinuria, besides being a marker of damage, is toxic to the kidney since it is associated with the development of tubule-interstitial damage and fibrosis; moreover, it is the main predictor of functional outcome and progression. Analysis of composition of proteinuria showed that some high-molecular-weight (HMW) proteins (IgG, IgM, α2-macroglobulin) and some low-molecular-weight (LMW) proteins (α1-microglobulins, β2-microglobulin) predict functional outcome better than proteinuria per day, but outcome prediction and therapy responsiveness should be improved. Recent analysis of urinary proteome identified patterns specific for some types of GN suggesting the possibility in the near future to diagnose GN without renal biopsy and improve outcome prediction and therapy responsiveness. The main goals of future research on urinary excretion of proteins, polypeptides, and proinflammatory and profibrotic molecules may be to improve assessment of mechanisms of renal damage; assess disease severity and activity; identify more powerful predictors of functional outcome and therapy responsiveness in individual patients; and evaluate the power of urinary proteome to assess diagnosis and predict outcomes and responsiveness to treatments. We invite investigators to contribute original research articles as well as review articles that stimulate the continuing efforts to understand the mechanisms of renal damage in GN and contribute to development of strategies to contrast progression. Potential topics include, but are not limited to:
- Recent advances in mechanisms of proteinuria
- Recent advances in proteomic analysis
- Urinary molecular markers of renal damage and disease activity
- Proteinuric patterns with predictive value of functional outcome
- Urinary predictors of therapy responsiveness
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