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Pediatric Nephrology

, Volume 28, Issue 7, pp 1041–1048 | Cite as

Serum suPAR in patients with FSGS: trash or treasure?

  • Rutger J. H. MaasEmail author
  • Jeroen K. J. Deegens
  • Jack F. M. Wetzels
Review

Abstract

The urokinase-type plasminogen activator receptor (uPAR) has important functions in cell migration. uPAR can be shed from the cell membrane resulting in soluble uPAR (suPAR). Further cleavage gives rise to shorter fragments with largely unknown functions. Recent studies have demonstrated that both overexpression of uPAR on podocytes and the administration of suPAR cause proteinuria in mice. The common pathogenic mechanism involves the activation of podocyte β3-integrin. Increased activation of β3-integrin is also observed in patients with focal and segmental glomerulosclerosis (FSGS). These observations form the basis for the hypothesis that suPAR may be the circulating factor causing FSGS. A recent study fosters this idea by demonstrating increased suPAR levels in the serum of patients with FSGS and reporting an association with recurrence after transplantation and response to plasmapheresis. However, this study was heavily biased, and subsequent studies have given conflicting results. Although the experimental work is very suggestive, at present there is no proof that any known human suPAR fragment causes FSGS in humans. We therefore suggest that the measurement of suPAR using currently available assays has absolutely no value at the present time in decision-making in routine clinical practice.

Keywords

Focal segmental glomerulosclerosis Nephrotic syndrome Transplantation Recurrence Urokinase receptor Integrin 

Supplementary material

467_2013_2452_MOESM1_ESM.doc (64 kb)
ESM 1 (DOC 64.5 kb)

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Copyright information

© IPNA 2013

Authors and Affiliations

  • Rutger J. H. Maas
    • 1
    Email author
  • Jeroen K. J. Deegens
    • 1
  • Jack F. M. Wetzels
    • 1
  1. 1.Department of Nephrology 464Radboud University Nijmegen Medical CenterNijmegenThe Netherlands

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