Cellular Plasticity in Kidney Injury and Repair

In an advance online publication in Nature Reviews Nephrology, Monica Chang-Panesso, MD, and Benjamin Humphreys, MD, PhD, Chief, Division of Nephrology, present an in-depth review of recent advances in the role of cellular plasticity in kidney regeneration and repair after injury.

naturereviewWhile it was once thought that mature, adult cells remained terminally differentiated, it is now known that such cells possess “cellular plasticity” – the ability of a cell to transform into a different cell type. Under certain physiological/pathological circumstances, mature cells can dedifferentiate, in which they revert to a more primitive, stem-like form of the cell, or transdifferentiate, in which they directly transform from one differentiated cell type into another differentiated cell type.
Acute kidney injury (AKI) is a serious, prevalent condition that is a major cause of morbidity and mortality in hospitalized individuals. Therapies for treatment of AKI and prevention of its progression to CKD are scarce. Understanding the mechanisms and pathways of kidney regeneration after injury is essential in order to develop new treatments for AKI.

Key points of the review are:

  • Originally described in in vitro conditions, cellular plasticity is now a recognized feature in vivo, particularly as part of the regenerative response to injury of a tissue.
  • Epithelial dedifferentiation occurs after kidney injury, and is considered to be a limited form of cellular plasticity.
  • There is no evidence that a cell from one tubule segment can differentiate into a cell from another segment.
  • The potential existence of a fixed population of epithelial progenitors vs the existence of cells with universal dedifferentiation capacity is still controversial.
  • The molecular pathways underlying epithelial cell plasticity are likely different from developmental pathways, and must be understood in order to identify novel therapeutic targets.

Read the full review here.