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Acta Diabetologica

, Volume 55, Issue 11, pp 1105–1111 | Cite as

Glomerular endothelial cells versus podocytes as the cellular target in diabetic nephropathy

  • Silvia Maestroni
  • Gianpaolo Zerbini
Review Article
  • 136 Downloads
Part of the following topical collections:
  1. Diabetic Nephropathy

Abstract

It usually takes several years (in some cases, decades) for predisposed individuals to move from the onset of type 1 or type 2 diabetes to the development of microalbuminuria, the first sign of diabetic nephropathy. This long, complication-free, period represents the best possible moment to start a successful preventive strategy (primary prevention) aimed to avoid or at least to postpone the increase of albumin excretion rate. Prevention is based on understanding and counteracting the initial mechanisms leading to the development of the disease and unfortunately, in case of diabetic nephropathy, most of them remain unclear. Little is also known about which, among endothelial cells and podocytes, represent the first glomerular target of the complication. Selective damage of the endothelium or of the podocyte results, as a common consequence, in an increase of albumin excretion rate. Albuminuria by itself cannot therefore be of help to solve the case. Endothelium and podocytes are involved in a continuous cross-talk and by studying the impact of diabetes on this “communication” process it should be possible to obtain some information regarding the weak component of the glomerular filter. Finally, the careful investigation of the mechanisms leading to the development podocyturia, a recently identified glomerular dysfunction associated to the pathogenesis of diabetic nephropathy, could contribute to shed some more light on the very early stages of this complication.

Keywords

Glomerular endothelial cells Podocytes Diabetic nephropathy Prevention Podocyturia 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent is not required because no studies in humans were performed.

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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Complications of Diabetes Unit, Division of Immunology, Transplantation and Infectious Diseases, Diabetes Research Institute (DRI)IRCCS San Raffaele Scientific InstituteMilanoItaly

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