Podocytes as a Direct Target of Drugs Used in Idiopathic Nephrotic Syndrome

Podocytes are terminally differentiated glomerular epithelial cells that are responsible for maintaining the structure and function of the glomerular filtration barrier in the kidney. Injury to podocytes can directly result in nephrotic syndrome, and thus these cells represent a promising target for renal protection. Immunosuppressive agents such as glucocorticoids and calcineurin inhibitors remain the primary treatments for nephrotic syndrome despite the lack of a complete understanding of their mechanisms of action. Increasing evidence suggests that these drugs may exert direct beneficial effects on podocytes themselves, suggesting that efficacy of these drugs in nephrotic syndrome may not be explained by their conventional anti-inflammatory or immunosuppressive actions but instead by a direct modulation of podocyte biology and signalling.