The dysregulated glomerular cell growth in Denys-Drash syndrome

Virchows Archiv : an International Journal of Pathology
An Hang YangBe Fun Chen

Abstract

While diffuse mesangial sclerosis is traditionally described as being the glomerulopathy of Denys-Drash syndrome (DDS), the podocyte proliferative lesions may be overlooked in these DDS cases. In the present study, an evolving process is extrapolated from a selected case of DDS that demonstrated glomerulopathy with conspicuous podocyte proliferation. The observation that podocytes express proliferation markers (Ki67, proliferating-cell nuclear antigen and topoisomerase IIalpha) in non-proliferative, mature-looking glomeruli suggests an initial pathogenic act to activate or to keep podocytes from quiescence. The subsequent proliferation of podocytes is in keeping with downregulation of WT1 and cyclin kinase inhibitors of p16 and p21. The emergence of cytokeratin-positive cells in glomeruli that show typical mesangial sclerosis implies elimination of podocytes and replacement with tubular and/or parietal epithelial cells. The final scene of evolving glomerulopathy displays apoptosis and expression of Fas-L and Bax in sclerotic mesangial lesions, which eventually end up with global sclerosis. This novel concept of DDS glomerulopathy implies complex molecular mechanisms involved in glomerular injury.

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Citations

Nov 28, 2007·Annual Review of Pathology·Christopher KwohAndrey Shaw
Aug 18, 2005·Kidney International·Jean BariétyChristian Jacquot
Oct 1, 2011·The Journal of Pathology·Eve Miller-Hodges, Peter Hohenstein
Feb 9, 2007·Neonatal Network : NN·Lori Williams Jackson
Sep 22, 2016·Kidney International·Anissa MoktefiAndre Pawlak
Oct 13, 2007·Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society·Julie PerryPaul S Thorner
Apr 4, 2008·American Journal of Physiology. Renal Physiology·Avril A MorrisonMichael R Ladomery
Oct 17, 2017·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Béla IványiCsaba Bereczki

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