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Transplantation. 2019 Aug 19. doi: 10.1097/TP.0000000000002930. [Epub ahead of print]

Further Evidence that the Soluble Urokinase Plasminogen Activator Receptor Does Not Directly Injure Mice or Human Podocytes.

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Department of Pharmaceutical Chemistry, University of California, San Francisco, California 94143, United States.
University of California, San Francisco, Kidney Transplant Service, CA 94143-0780, United States.
AbbVie, Renal Discovery, 1 North Waukegan Road North Chicago, IL 60064.
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA 94143, USA.
Division of Transplant Surgery, University of California San Francisco, San Francisco, CA, USA.



The role of the soluble urokinase receptor (suPAR) in focal segmental glomerulosclerosis (FSGS) as the circulating factor or as a predictor of recurrence after transplantation remains controversial. Previously published studies in mice and isolated podocytes produced conflicting results on the effect of suPAR on podocyte injury, effacement of foot processes and proteinuria. These discordant results were in part due to diverse experimental designs and different strains of mice. The aim of our study was to determine the reasons for the inconsistencies of the previous studies results with suPAR by using uniform methods and studies in different strains of mice.


We utilized a primary culture of human podocytes and two mouse models, the wild type (WT) and the uPAR KO (uPAR-/-), in an attempt to resolve the reported conflicting results.


In both wild-type and uPAR-/- mouse models, injection of recombinant uPAR, even at a high dose (100 μ g), did not induce proteinuria, effacement of podocytes or disruption of the cytoskeleton. Injection of suPAR resulted in its deposition exclusively in the glomerular endothelial cells and not in the podocytes of WT mice, and was not detected at the uPAR KO mice. Kidneys from patients with recurrent FSGS had negative immunostaining for uPAR.We also evaluated the effect of recombinant uPAR on primary culture of human podocytes. uPAR did not result in podocytes damage.


suPAR by itself is not the cause for direct podocyte injury, in vitro or in vivo These findings suggest a more complex and still poorly understood role of suPAR in FSGS.

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