Transcriptional regulation of podocyte disease

The podocyte is a highly specialized visceral epithelial cell that forms the outermost layer of the glomerular capillary loop and plays a critical role in the maintenance of the glomerular filtration barrier. Several transcriptional factors regulate the podocyte function under normal and disease conditions. In this review, the role of Wilms tumor 1 (WT1), LIM homeobox transcription factor 1, beta (Lmx1b), pod1, pax-2, kreisler, nuclear factor-kappa B (NF-kappaB), smad7, and zinc fingers and homeoboxes (ZHX) proteins in the development of podocyte disease is outlined. The regulation of several important podocyte genes, including transcriptional factors, by ZHX proteins, their predominant non-nuclear localization in the normal in vivo podocyte, and changes in ZHX expression related to the development of minimal change disease and focal and segmental glomerulosclerosis are discussed. Finally, some future therapeutic strategies for glomerular disease are proposed.