Expression of synaptopodin and GLEPP1 as markers of steroid responsiveness in primary focal segmental glomerulosclerosis

Makoto Hirakawa, Kazuhiko Tsuruya, Hideki Yotsueda, Masanori Tokumoto, Hirofumi Ikeda, Ritsuko Katafuchi, Satoru Fujimi, Hideki Hirakata, Mitsuo Iida

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15 Citations (Scopus)


The crucial involvement of podocyte failure in the development of hereditary focal segmental glomerulosclerosis (FSGS) indicates that specific podocyte proteins are closely related to podocyte function and biology. We hypothesized that podocyte failure, reflected by alteration of these proteins, leads not only to FSGS but also to resistance to steroid therapy. We investigated the association between expression of synaptopodin and glomerular epithelial protein 1 (GLEPP1) and response to corticosteroid therapy in primary FSGS. The subjects of this retrospective study were 17 adult patients with primary FSGS with nephrotic syndrome (NS) seen at Fukuoka Red Cross Hospital between 1979 and 2001. They were divided into two groups according to the response to steroid therapy at 6 months: responders (n = 10) and non-responders (persistence of nephrotic-range proteinuria, n = 7). Expression levels of synaptopodin and GLEPP1 were examined immunohistochemically using image analysis software. Low expression levels of both proteins were associated with poor steroid responsiveness in FSGS. The average gray values for synaptopodin and GLEPP1 expression in responders vs. non-responders were 9.0 ± 0.7 (mean ± S.E.M.) vs. 6.3 ± 0.9 (P = 0.04) and 9.6 ± 1.2 vs. 6.0 ± 1.0 (P = 0.04), respectively. The percentages of glomerular area staining for synaptopodin and GLEPP1 in responders vs. non-responders were 15.4 ± 2.7% vs. 8.1 ± 1.2% (P = 0.045) and 11.9 ± 1.6% vs. 6.0 ± 1.3% (P = 0.02), respectively. Synaptopodin expression correlated with the severity of proteinuria and with GLEPP1 expression. Reduced expression of both synaptopodin and GLEPP1 is associated with poor response to steroid therapy in primary FSGS.

Original languageEnglish
Pages (from-to)757-763
Number of pages7
JournalLife Sciences
Issue number8
Publication statusPublished - Jul 17 2006
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • General Pharmacology, Toxicology and Pharmaceutics
  • General Biochemistry,Genetics and Molecular Biology


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