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Podocytes are highly specialized, terminally differentiated visceral epithelial cells that wrap around the glomerular capillaries in the kidney (StatPearls, 2023). They are characterized by complex primary and secondary foot processes that interdigitate to form slit diaphragms, which act as a molecular sieve to prevent the passage of large proteins into the urine while allowing water and small solutes to pass (Nature Reviews Nephrology, 2020). Podocyte injury or loss is a critical driver of glomerular diseases such as focal segmental glomerulosclerosis (FSGS) and diabetic nephropathy, typically manifesting as proteinuria (Journal of the American Society of Nephrology, 2019). Therapeutic strategies often focus on stabilizing the podocyte's actin cytoskeleton or protecting the slit diaphragm proteins, such as nephrin and podocin, to maintain the integrity of the filtration barrier (Kidney International, 2021). Although podocytes are a cell type rather than a single molecular target, they are the primary focus of many renal protective therapies, including calcineurin inhibitors and SGLT2 inhibitors (Lancet Diabetes & Endocrinology, 2022).
Stabilization of the actin cytoskeleton, inhibition of calcineurin-mediated signaling, and reduction of podocyte apoptosis to maintain filtration barrier integrity (Kidney International, 2021).
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