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"Kidneys" Том 7, №1, 2018

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Focal segmental glomerulosclerosis: genetic analysis and target therapy

Authors: Мельник А.А.
Специализированный медицинский центр «Оптима-фарм», г. Киев, Украина

Categories: Nephrology

Sections: Specialist manual

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Summary

При фокально-сегментарному гломерулосклерозі (ФСГС) відбувається початкове пошкодження подоцитів. Генетичні дослідження людини за останні кілька років показали, що ФСГС — це насамперед подоцитопатія з більш ніж 20 мутованими генами, що беруть участь у патогенезі даного захворювання. Нефрин (ген NPHS1) разом із подоцином (ген NPHS2) є основними білками щілинної діафрагми подоцитів. Аутосомно-рецесивні мутації NPHS1 та NPHS2 пов’язані з більш тяжким станом пацієнтів, що проявляється ранньою протеїнурією і термінальною нирковою недостатністю, ніж аутосомно-домінуючі мутації INF2, TRPC6 і ACTN4. Для ініціального лікування ФСГС Kidney Disease Improving Global Outcomes 2012 р. рекомендує використовувати кортикостероїдну й імуносупресивну терапію.

При фокально-сегментарном гломерулосклерозе (ФСГС) происходит исходное повреждение подоцитов. Генетические исследования человека за последние несколько лет показали, что ФСГС — это прежде всего подоцитопатия с более чем 20 мутированными генами, участвующими в патогенезе данного заболевания. Нефрин (ген NPHS1) вместе с подоцином (ген NPHS2) являются основными белками щелевой диафрагмы подоцитов. Аутосомно-рецессивные мутации NPHS1, NPHS2 связаны с более тяжелым состоянием пациентов, что проявляется ранней протеинурией и терминальной почечной недостаточностью, чем аутосомно-доминирующие мутации INF2, TRPC6 и ACTN4. Для инициального лечения ФСГС Kidney Disease Improving Global Outcomes 2012 г. рекомендует использовать кортикостероидную и иммуносупрессивную терапию.

With focal segmental glomerulosclerosis (FSGS) is associated with initial damage of podocytes. Human genetic studies over the last few years have shown that FSGS is primarily a podocytopathia with more than 20 mutated genes involved in the pathogenesis of this disease. Nephrin (NPHS1 gene) together with the podocine (NPHS2 gene) are the main proteins of podocyts slit diaphragm. Autosomal-recessive mutations of NPHS1, NPHS2 are associated with more severe condition of patients, which is manifested by early proteinuria and end-stage renal disease compared with autosomal-dominant mutations of INF2, TRPC6 and ACTN4. For initial treatment of FSGS, Kidney Disease Improving Global Outcomes (KDIGO) 2012 recommends the use of corticosteroid and immunosuppressive therapy.


Keywords

фокально-сегментарний гломерулосклероз; подоцити; мутації білків; лікування

фокально-сегментарный гломерулосклероз; подоциты; мутации белков; лечение

focal segmental glomerulosclerosis; podocytes; protein mutations; treatment


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Date: 2018.08.27
Categories: Nephrology
Sections: Specialist manual
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Authors: Бельмер С.В., Малкоч А.В. Российский государственный медицинский университет, г. Москва
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Categories: Family medicine/Therapy, Medicine of emergency
Sections: Specialist manual

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