The mesangial cell in diabetic nephropathy

The mesangial cell plays a crucial role in the formation and maintenance of the glomerular capillary tuft and in the homeostasis of the mesangial matrix. Expansion of the mesangium, both diffuse and nodular, is a hallmark of DN. Numerous studies have shown adverse responses of the mesangial cell to injuries related to metabolic and hemodynamic effects of diabetes, including high glucose, insulin dysregulation, mechanical stress, dyslipidemia, and profibrotic growth factors. Their pivotal role in the development and progression of DN makes mesangial cells an interesting target for treatment, but this will be challenging because of the lack of specific markers.