臨床検査57巻6号

2013年06月発行

今月の特集1 尿バイオマーカー

尿中ポドカリキシンによる病態解析

著者： 原正則¹

所属機関： ¹新潟県立吉田病院小児科

ページ範囲：P.610 - P.616

■急性腎障害（AKI），慢性腎臓病（CKD）対策上，治療指標となるような有用な尿バイオマーカーの開発が望まれている．

■たこ足細胞（Podo）は特異な形態をとり，高度に機能が分化しており，非常に増殖しにくいなどの生物学的な特性を有している．

■Podo障害が糸球体硬化に深く関与している．

■尿中Podo検査，尿中ポドカリキシン（PCX）定量検査はPodo障害を評価する有用な検査法である．

参考文献

1）Mundel P, Kriz W：Structure and function of podocytes: an update. Anat Embryol.　192：385-397，1995

2）Mundel P, Shankland SJ：Podocyte biology and response to injury. J Am Soc Nephrol　13：3005-3015，2002

3）Kriz W：Progressive renal failure--inability of podocytes to replicate and the consequences for development of glomerulosclerosis. Nephrol Dial Transplant　11：1738-1742，1996

4）Kerjaschki D, Sharkey DJ, Farquhar MG：Identification and characterization of podocalyxin--the major sialoprotein of the renal glomerular epithelial cell. J Cell Biol　98：1591-1596，1984

5）Kershaw DB, Beck SG, Wharram BL, et al：Molecular cloning and characterization of human podocalyxin-like protein. Orthologous relationship to rabbit PCLP1 and rat podocalyxin. J Biol Chem　272：15708-15714，1997

6）Kim YH, Goyal M, Kurnit D, et al：Podocyte depletion and glomerulosclerosis have a direct relationship in the PAN-treated rat. Kidney Int　60：957-968，2001

7）Shirato I, Hosser H, Kimura K, et al：The development of focal segmental glomerulosclerosis in masugi nephritis is based on progressive podocyte damage. Virchows Arch　429：255-273，1996

8）Pagtalunan ME, Miller PL, Jumping-Eagle S, et al：Podocyte loss and progressive glomerular injury in type II diabetes. J Clin Invest　99：342-348，1997

9）Steffes MW, Schmidt D, McCrery R, et al：International Diabetic Nephropathy Study Group: Glomerular cell number in normal subjects and in type 1 diabetic patients. Kidney Int　59：2104-2113，2001

10）Lemley KV, Lafayette RA, Safai M, et al：Podocytopenia and disease severity in IgA nephropathy. Kidney Int　61：1475-1485，2002

11）Kriz W, Gretz N, Lemley KV：Progression of glomerular diseases: is the podocyte the culprit? Kidney Int　54：687-697，1998

12）Kriz W：Podocyte is the major culprit accounting for the progression of chronic renal disease. Microsc Res Tech　57：189-195，2002

13）Kriz W：Progressive renal failure--inability of podocytes to replicate and the consequences for development of glomerulosclerosis. Nephrol Dial Transplant　11：1738-1742，1996

14）Kriz W, Kretzler M, Nagata M, et al：A frequent pathway to glomerulosclerosis: deterioration of tuft architecture-podocyte damage-segmental sclerosis. Kidney Blood Press Res　19：245-253，1996

15）Kihara I, Yatoita E, Kawasaki K, et al：Limitations of podocyte adaptation for glomerular injury in puromycin aminonucleoside nephrosis. Pathol Int　45：625-634，1995

16）Schiffer M, Bitzer M, Roberts IS, et al：Apoptosis in podocytes induced by TGF-beta and Smad7. J Clin Invest　108：807-816，2001

17）Ding G, Reddy K, Kapasi AA, et al：Angiotensin II induces apoptosis in rat glomerular epithelial cells. Am J Physiol Renal Physiol　283：173-180，2002

18）Sanwal V, Pandya M, Bhaskaran M, et al：Puromycin aminonucleoside induces glomerular epithelial cell apoptosis. Exp Mol Pathol　70：54-64，2001

19）Vogelmann SU, Nelson WJ, Myers BD, et al：Urinary excretion of viable podocytes in health and renal disease. Am J Physiol Renal Physiol　285：40-48，2003

20）Hara M, Yamamoto T, Yanagihara T, et al：Urinary excretion of podocalyxin indicates glomerular epithelial cell injuries in glomerulonephritis. Nephron　69：397-403，1995

21）Hara M, Yanagihara T, Takada T, et al：Urinary excretion of podocytes reflects disease activity in children with glomerulonephritis. Am J Nephrol　18：35-41，1998

22）Hara M, Yanagihara T, Kihara I, et al：Apical cell membranes are shed into urine from injured podocytes: a novel phenomenon of podocyte injury. J Am Soc Nephrol　16：408-416，2005

23）Hara M, Yamamoto T, Yanagihara T, et al：Urinary excretion of podocalyxin indicates glomerular epithelial cell injuries in glomerulonephritis Nephron　69：397-403，1995

24）Hara M, Yanagihara T, Takada T, et al：Urinary excretion of podocytes reflects disease activity in children with glomerulonephritis. Am J Nephrol　18：35-41，1998

25）Hara M, Yanagihara T, Kihara I：Cumulative excretion of urinary podocytes reflects disease progression in IgA nephropathy and Schönlein-Henoch purpura nephritis. Clin J Am Soc Nephrol　2：231-238，2007

26）Nakamura T, Ushiyama C, Suzuki S, et al：Urinary excretion of podocytes in patients with diabetic nephropathy. Nephrol Dial Transplant　15：1379-1383，2000

27）Hara M, Yamagata K, Tomino Y, et al：Urinary podocalyxin is an early marker for podocyte injury in patients with diabetes: establishment of a highly sensitive ELISA to detect urinary podocalyxin. Diabetologia　55：2913-2919，2012