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International Journal of Nephrology
Volume 2012, Article ID 937623, 6 pages
http://dx.doi.org/10.1155/2012/937623
Review Article

An Overview of Molecular Mechanism of Nephrotic Syndrome

1Pathology Laboratory, Department of Biological Sciences, Federal University of Triângulo Mineiro, 38025-180 Uberaba, MG, Brazil
2Immunology Laboratory, Department of Biological Sciences, Federal University of Triângulo Mineiro, 38025-180 Uberaba, MG, Brazil
3Technical Health School of UFPB, Federal University of Paraíba, 58051-900 João Pessoa, PA, Brazil

Received 8 May 2012; Revised 20 June 2012; Accepted 20 June 2012

Academic Editor: Omran Bakoush

Copyright © 2012 Juliana Reis Machado et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Podocytopathies (minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS)) together with membranous nephropathy are the main causes of nephrotic syndrome. Some changes on the expression of nephrin, podocin, TGF-β, and slit diaphragm components as well as transcription factors and transmembrane proteins have been demonstrated in podocytopathies. Considering the pathogenesis of proteinuria, some elucidations have been directed towards the involvement of epithelial-mesenchymal transition. Moreover, the usefulness of some markers such as TGF-β1, nephrin, synaptopodin, dystroglycans, and malondialdehyde have been determined in the differentiation between MCD and FSGS. Experimental models and human samples indicated an essential role of autoantibodies in membranous glomerulonephritis, kidney damage, and proteinuria events. Megalin and phospholipase-A2-receptor have been described as antigens responsible for the formation of the subepithelial immune complexes and renal disease occurrence. In addition, the complement system seems to play a key role in basal membrane damage and in the development of proteinuria in membranous nephropathy. This paper focuses on the common molecular changes involved in the development of nephrotic proteinuria.