IMR Press / FBE / Volume 4 / Issue 3 / DOI: 10.2741/E441

Frontiers in Bioscience-Elite (FBE) is published by IMR Press from Volume 13 Issue 2 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Review

Obesity-related glomerulopathy and podocyte injury: a mini review

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1 Department of Internal Medicine, University of Pisa, Italy
2 Department of Physiology and Pharmacology, University of Toledo, USA
3 Department of Reproduction and Ageing, University of Pisa, Italy

*Author to whom correspondence should be addressed.

Academic Editor: Angelo Carpi

Front. Biosci. (Elite Ed) 2012, 4(3), 1058–1070; https://doi.org/10.2741/E441
Published: 1 January 2012
(This article belongs to the Special Issue Advances in bone disease pathophisiology and management)
Abstract

Obesity-related glomerulopathy (ORG) is morphologically defined as focal segmental glomerulosclerosis and glomerulomegaly. Podocyte hypertrophy and reduced density are related to proteinuria which in a portion of patients is in the nephrotic range and evolvs towards renal failure. This article reviews the pathogenetic mechanisms of podocyte injury or dysfunction and lists new possible antiproteinuric strategies based on pharmaceutical targeting of the reported pathogenetic mechanisms. The pathogenetic mechnisms discussed include: renin angiotensin system, plasminogen activation inhibitor-1 (PAI-1), lipid metabolism, adiponectin, macrophages and proinflammatory cytokines, oxidative stress. The proposed antiproteinuric strategies include: AT2 receptor blockers; adipokine complement C19 TNF-related protein-1 blocker; selective PAI-1 inhibitor; farnesoid x receptor activation; increase of circulating adiponectin; selective antiinflammatory drugs; more potent antioxidants (Heme oxigenase, NOX4 inhibitors). However, because ORG is a rare disease, the need for a long term pharmaceutical approach in obese proteinuric patients should be carefully evaluated and limited to the cases with progressive loss of renal function.

Keywords
Obesity-Related Glomerulopathy
Podocyte Injury
Proteinuria Podocytes
Review
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