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Accordingly we studied an in vitro model of proteinuria, and identified 231 "albumin-regulated genes" differentially expressed by primary human kidney tubular epithelial cells exposed to albumin.
In summary, we have used an in vitro model of proteinuria to identify a set of "albumin-regulated genes" in primary human renal tubular cells.
Using this strategy, we have demonstrated in an in vitro model of proteinuria that exposure of primary human renal proximal tubular epithelial cells to albumin induces the differential mRNA expression of a number of "albumin-regulated" genes, including interleukin-8 (IL-8) and the epidermal growth factor receptor (EGFR) [29].
In order to rationally filter the large volume of data derived from the microarray experiments, the following strategy was employed to select the genes that are characteristic of the renal response to proteinuria: 1 – Identification of genes differentially expressed in the in vitro model of proteinuria by SAM and Limma analysis (described below).
Finally, while we derived our list of candidate genes from an in vitro model of proteinuria, it is likely that the transcriptional response of the genes measured in the tubulo-interstitium of the kidney biopsies is not due entirely to exposure to albumin the ultrafiltrate.
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Protein overload models as well as animal models of proteinuria induced by renal injury have suggested that excessive protein reabsorption induces EMT in tubular cells [ 6, 7].
In fully adjusted models, a history of proteinuria remained an independent marker of increased infection risk for LRTI, pneumonia, and sepsis (IRRs of 1.07 [95% CI, 1.05-1.09], 1.26 [95% CI, 1.19-1.33], and 1.33 [95% CI, 1.20-1.47]).
They considered the observed relation in line with the observations made in the passive Heymann model of nephritis, where proteinuria persisted after the decline in antibody titer, also supporting a pathogenic role for PLA2R ABs: the immunological phase of MN must end before a clinical response is to be seen.
In rat model of nephropathy, paricalcitol lowered proteinuria associated with the inhibition of the RAAS [ 101].
In this way, we developed a model of so-called pure proteinuria without signs of nephrotic syndrome.
We think that our recent model of annual screening for proteinuria and CKD risk factors [ 45] combining educational message, detection and management of risk factor in general population may contribute partly to reach this first goal.
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