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Renal biopsy-driven molecular target identification in glomerular disease

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Abstract

Chronic kidney disease has severe impacts on the patient and represents a major burden to the health care systems worldwide. Despite an increased knowledge of pathophysiological processes involved in kidney diseases, the progress in defining novel treatment strategies has been limited. One reason is the descriptive disease categorization used in nephrology based on clinical findings or histopathological categories irrespective of potential different molecular disease mechanisms. To accelerate progress toward a targeted treatment, a definition of human disease extending from phenotypic disease classification to mechanism-based disease definitions is needed. In recent years, we have witnessed a major transition in biomedical research from a single gene research to an information rich and collaborative science. Tissue-based analysis in renal disease allows to link structure to molecular function. In our review, we introduce the concept of precision medicine in nephrology, describe several large cohort studies established for molecular analysis of kidney diseases, and highlight examples of renal biopsy-driven target identification by integrative systems biology approaches. Furthermore, we give an outlook on how the new disease definitions can be used for patient stratification in clinical trial design. Finally, we introduce the concept of an informational commons of renal precision medicine for joint analyses of large-scale data sets in renal failure.

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Acknowledgements

This work has been supported by the Else-Kröner-Fresenius Foundation and the European Consortium for High-Throughput Research in Rare Kidney Diseases (EURenOmics; European Union FP 7:305608).

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Authors and Affiliations

  1. Nephrological Center, Medical Clinic and Policlinic IV, University of Munich, Munich, Germany

    Maja T. Lindenmeyer

  2. Department of Medicine, University of Michigan, Ann Arbor, MI, USA

    Matthias Kretzler

  3. Internal Medicine - Nephrology, University of Michigan, 1150 W. Medical Center Dr. 1560 MSRB II, Ann Arbor, MI, 48109-5676, USA

    Matthias Kretzler

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  1. Maja T. Lindenmeyer
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  2. Matthias Kretzler
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Correspondence to Matthias Kretzler.

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This article is part of the special issue on Functional Anatomy of the Kidney in Health and Disease in Pflügers Archiv—European Journal of Physiology.

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Lindenmeyer, M.T., Kretzler, M. Renal biopsy-driven molecular target identification in glomerular disease. Pflugers Arch - Eur J Physiol 469, 1021–1028 (2017). https://doi.org/10.1007/s00424-017-2006-y

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  • DOI: https://doi.org/10.1007/s00424-017-2006-y

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