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How immunosuppressive drugs may directly target podocytes in glomerular diseases

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Abstract

Podocytes are the direct target of immunologic injury in many immune-mediated glomerular diseases, leading to proteinuria and subsequent kidney failure. Immunosuppressive agents such as steroids, calcineurin inhibitors, and rituximab are the commonly used treatment strategies in this context for their immunotherapeutic or anti-inflammatory properties. However, in recent years, studies have demonstrated that immunosuppressive agents can have a direct effect on podocytes, introducing the concept of the non-immunologic mechanism of kidney protection by immunomodulators. In this review, we focus on the mechanisms by which these agents may directly target the podocyte independent of their systemic effects and examine their clinical significance.

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Authors and Affiliations

  1. Department of Transplantation Renal Unit, Careggi University Hospital, 50139, Florence, Italy

    Maurizio Salvadori

  2. Department of Medicine, Division of Nephrology, Santa Maria Annunziata Hospital, Via Antella, 58, 50012 Ponte a Niccheri, Bagno a Ripoli, Florence, Italy

    Aris Tsalouchos

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  1. Maurizio Salvadori
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Salvadori, M., Tsalouchos, A. How immunosuppressive drugs may directly target podocytes in glomerular diseases. Pediatr Nephrol 37, 1431–1441 (2022). https://doi.org/10.1007/s00467-021-05196-4

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