RAGE drives the development of glomerulosclerosis and implicates podocyte activation in the pathogenesis of diabetic nephropathy

Thoralf M. Wendt, Nozomu Tanji, Jiancheng Guo, Thomas R. Kislinger, Wu Qu, Yan Lu, Loredana G. Bucciarelli, Ling Ling Rong, Bernhard Moser, Glen S. Markowitz, Gunther Stein, Angelika Bierhaus, Birgit Liliensiek, Bernd Arnold, Peter P. Nawroth, David Stern, Vivette D. D'Agati, Ann Marie Schmidt

Research output: Contribution to journalArticle

459 Citations (Scopus)

Abstract

Diabetic nephropathy ensues from events involving earliest changes in the glomeruli and podocytes, followed by accumulation of extracellular matrix in the mesangium. Postulated mechanisms include roles for vascular endothelial growth factor (VEGF), produced by podocytes and contributing to enhanced excretion of urinary albumin and recruitment/activation of inflammatory cells, and transforming growth factor-β (TGF-β), elicited largely from mesangial cells and driving production of extracellular matrix. RAGE, a receptor for advanced glycation endproducts (AGEs) and S100/calgranulins, displays enhanced expression in podocytes of genetically diabetic db/db mice by age 13 weeks. RAGE-bearing podocytes express high levels of VEGF by this time, in parallel with enhanced recruitment of mononuclear phagocytes to the glomeruli; events prevented by blockade of RAGE. By age 27 weeks, soluble RAGE-treated db/db mice displayed diminished albuminuria and glomerulosclerosis, and improved renal function. Diabetic homozygous RAGE null mice failed to develop significantly increased mesangial matrix expansion or thickening of the glomerular basement membrane. We propose that activation of RAGE contributes to expression of VEGF and enhanced attraction/activation of inflammatory cells in the diabetic glomerulus, thereby setting the stage for mesangial activation and TGF-β production; processes which converge to cause albuminuria and glomerulosclerosis.

Original languageEnglish (US)
Pages (from-to)1123-1137
Number of pages15
JournalAmerican Journal of Pathology
Volume162
Issue number4
DOIs
StatePublished - Apr 1 2003
Externally publishedYes

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Podocytes
Diabetic Nephropathies
Vascular Endothelial Growth Factor A
Albuminuria
Transforming Growth Factors
Extracellular Matrix
Leukocyte L1 Antigen Complex
Glomerular Basement Membrane
Mesangial Cells
Phagocytes
Albumins
Kidney

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

RAGE drives the development of glomerulosclerosis and implicates podocyte activation in the pathogenesis of diabetic nephropathy. / Wendt, Thoralf M.; Tanji, Nozomu; Guo, Jiancheng; Kislinger, Thomas R.; Qu, Wu; Lu, Yan; Bucciarelli, Loredana G.; Ling Rong, Ling; Moser, Bernhard; Markowitz, Glen S.; Stein, Gunther; Bierhaus, Angelika; Liliensiek, Birgit; Arnold, Bernd; Nawroth, Peter P.; Stern, David; D'Agati, Vivette D.; Schmidt, Ann Marie.

In: American Journal of Pathology, Vol. 162, No. 4, 01.04.2003, p. 1123-1137.

Research output: Contribution to journalArticle

Wendt, TM, Tanji, N, Guo, J, Kislinger, TR, Qu, W, Lu, Y, Bucciarelli, LG, Ling Rong, L, Moser, B, Markowitz, GS, Stein, G, Bierhaus, A, Liliensiek, B, Arnold, B, Nawroth, PP, Stern, D, D'Agati, VD & Schmidt, AM 2003, 'RAGE drives the development of glomerulosclerosis and implicates podocyte activation in the pathogenesis of diabetic nephropathy', American Journal of Pathology, vol. 162, no. 4, pp. 1123-1137. https://doi.org/10.1016/S0002-9440(10)63909-0
Wendt, Thoralf M. ; Tanji, Nozomu ; Guo, Jiancheng ; Kislinger, Thomas R. ; Qu, Wu ; Lu, Yan ; Bucciarelli, Loredana G. ; Ling Rong, Ling ; Moser, Bernhard ; Markowitz, Glen S. ; Stein, Gunther ; Bierhaus, Angelika ; Liliensiek, Birgit ; Arnold, Bernd ; Nawroth, Peter P. ; Stern, David ; D'Agati, Vivette D. ; Schmidt, Ann Marie. / RAGE drives the development of glomerulosclerosis and implicates podocyte activation in the pathogenesis of diabetic nephropathy. In: American Journal of Pathology. 2003 ; Vol. 162, No. 4. pp. 1123-1137.
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