Vascular endothelial growth factor and diabetic nephropathy |
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Authors: | Sheldon Chen Fuad N Ziyadeh |
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Affiliation: | (1) Department of Internal Medicine, American University of Beirut, P.O. Box 11-0236, Riad El-Solh 1107, 2020 Beirut, Lebanon |
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Abstract: | The field of vascular endothelial growth factor (VEGF) has recently witnessed a surge of research into its role in diabetic
kidney disease. Based on its credentials as a potent inducer of vasopermeability and angiogenesis, podocyte-derived VEGF is
believed to participate in the glomerular capillary hyperpermeability of macromolecules that potentially underlies the pathogenesis
of diabetic albuminuria. The evidence for VEGF’s role is relatively straightforward in animal models of diabetes, establishing
that VEGF is upregulated in the diabetic kidney, that VEGF alone reproduces some aspects of diabetic glomerulopathy, and that
antagonism of VEGF attenuates diabetic albuminuria and other associated features of the podocytopathy. However, the promise
shown in the animal studies has not carried over as convincingly into the realm of human studies, as some investigators find
a negative or no relationship between VEGF and diabetic nephropathy, whereas others find a positive correlation between the
two. If VEGF does play a role in diabetic renal disease, its observed effects and known mechanisms seem to point squarely
at the podocyte as a central target of the maladaptive VEGF overactivity. |
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