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Originally published online as doi:10.2353/ajpath.2009.080789 on April 9, 2009

Published online before print April 9, 2009
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(American Journal of Pathology. 2009;174:1675-1682.)
© 2009 American Society for Investigative Pathology
DOI: 10.2353/ajpath.2009.080789

Genetic Podocyte Lineage Reveals Progressive Podocytopenia with Parietal Cell Hyperplasia in a Murine Model of Cellular/Collapsing Focal Segmental Glomerulosclerosis

Taisei Suzuki*, Taiji Matsusaka{dagger}{ddagger}, Makiko Nakayama*, Takako Asano§, Teruo Watanabe*, Iekuni Ichikawa{ddagger} and Michio Nagata*

From the Department of Pathology,* Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan; the Department of Pediatrics,{dagger} Vanderbilt University School of Medicine, Nashville, Tennessee; the Institute of Medical Science and Department of Medicine{ddagger} and the Department of Bioethics, Tokai University Medical School, Isehara, Kanagawa, Japan; and the Department of Pediatrics,§ National Defense Medical College, Saitama, Japan

Focal segmental glomerulosclerosis (FSGS) is a progressive renal disease, and the glomerular visceral cell hyperplasia typically observed in cellular/collapsing FSGS is an important pathological factor in disease progression. However, the cellular features that promote FSGS currently remain obscure. To determine both the origin and phenotypic alterations in hyperplastic cells in cellular/collapsing FSGS, the present study used a previously described FSGS model in p21-deficient mice with visceral cell hyperplasia and identified the podocyte lineage by genetic tagging. The p21-deficient mice with nephropathy showed significantly higher urinary protein levels, extracapillary hyperplastic indices on day 5, and glomerular sclerosis indices on day 14 than wild-type controls. X-gal staining and immunohistochemistry for podocyte and parietal epithelial cell (PEC) markers revealed progressive podocytopenia with capillary collapse accompanied by PEC hyperplasia leading to FSGS. In our investigation, non-tagged cells expressed neither WT1 nor nestin. Ki-67, a proliferation marker, was rarely associated with podocytes but was expressed at high levels in PECs. Both terminal deoxynucleotidyl transferase dUTP nick-end labeling staining and electron microscopy failed to show evidence of significant podocyte apoptosis on days 5 and 14. These findings suggest that extensive podocyte loss and simultaneous PEC hyperplasia is an actual pathology that may contribute to the progression of cellular/collapsing FSGS in this mouse model. Additionally, this is the first study to demonstrate the regulatory role of p21 in the PEC cell cycle.




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