Podocytes appear abnormal with degenerated or fused (effacement) pedicels (foot process
) resting on the irregular thickened basal lamina of capillaries.
Neuromyelitis optica (NMO) immunoglobulin G (IgG), is directed against aquaporin-4 (AQP4) which is present in the Astrocytic Foot process
. Sensitivity and specificity of NMO IgG for NMO is 91% and 100% respectively.
It is reported that relapse or worsening of NS in idiopathic membranous nephropathy can occur even though the glomerular immune deposits have been eradicated , and nephrotic range proteinuria in patients with membranous LN was better correlated with the degree of foot process
effacement than the degree of immune complex deposition, pointing to it as manifestation of concomitant podocyte dysfunction .
The mean of the foot process
width (WFP) was calculated as follows :
Soda et al., "Inhibition of podocyte FAK protects against proteinuria and foot process
effacement," Journal of the American Society of Nephrology, vol.
Podocyte injuries were confirmed by the increase in desmin expression in podocytes and by slit membrane abnormalities, including decreased podocin expression and augmented foot process
effacement assessed by transmission electron microscopy.
Experiments showed that the activation of this pathway may be involved in ADR-induced podocyte foot process
effacement, disruption of the slit diaphragm, and consequent albuminuria .
This is important since inhibition of FAK activation or their deletion in podocytes has been found to protect against proteinuria and foot process
effacement induced by glomerular injury .
However, the fusion of podocytes' foot process
was rare and the damage of GBM was modified in the Islets group (Figure-1.
In podocytes, uPAR is one of the pathways capable of activating [alpha]v[[beta].sub.3] integrin promoting cell motility and activation of small GTPases, such as Cdc42 and Rac1, which can lead to podocyte contraction, shifting from a stationary to motile phenotype and leading to foot process
effacement and proteinuria (Figure 1) .
Electron microscopy showed extensive diffuse foot process
effacement, and subepithelial electron dense deposits (Fig.
Most characteristically, podocytes can undergo a process termed effacement, where the normal cellular architecture of the foot process
is altered and results in flattening and spreading of the foot process
along the GBM and disruption of the slit diaphragm.