先天性心疾患の変異が腎障害に関連(Congenital heart disease mutation linked to kidney damage)

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2025-11-07 デューク大学(Duke)

デューク大学生体医工学科のサミラ・ムサ教授らは、先天性心疾患(CHD)の原因となるSMAD2遺伝子変異が、腎臓発達異常と損傷も引き起こすことを発見した。ヒトiPS細胞にこの変異を導入し腎臓オルガノイドを作成、腎臓オンチップモデルで解析した結果、変異により細胞配列が乱れ、ろ過機能を担うポドサイトの形成不全と接続障害が確認された。これは腎障害が胎児期のごく初期に生じることを示す初の実験的証拠である。研究はCHD患者への早期腎機能スクリーニングの必要性を強調し、個別化治療や再生医療応用への道を開く。成果はNature Biomedical Engineering誌に掲載。

<関連情報>

人工多能性幹細胞モデルを用いた解析により、先天性心疾患に関連するSMAD2変異における有足細胞形成の変化が明らかになった Engineered human induced pluripotent stem cell models reveal altered podocytogenesis in congenital heart disease-associated SMAD2 mutations

Rohan Bhattacharya,Tarsha Ward,Titilola D. Kalejaiye,Alekshyander Mishra,Sophia M. Leeman,Hamidreza Arzaghi,Jonathan G. Seidman,Christine E. Seidman &Samira Musah
Nature Biomedical Engineering  Published:03 November 2025
DOI:https://doi.org/10.1038/s41551-025-01543-0

先天性心疾患の変異が腎障害に関連(Congenital heart disease mutation linked to kidney damage)

Abstract

Clinical observations of patients with congenital heart disease carrying SMAD2 genetic variants revealed correlations with multi-organ impairments at the developmental and functional levels. Many patients with congenital heart disease present with glomerulosclerosis, periglomerular fibrosis and albuminuria. It remains largely unknown whether SMAD2 variants associated with congenital heart disease can directly alter kidney cell fate, tissue patterning and organ-level function. Here we investigate the role of pathogenic SMAD2 variants in podocytogenesis, nephrogenic cell lineage specification and glomerular filtration barrier function using a combination of CRISPR-based disease modelling, stem cell and microfluidic organ-on-a-chip technologies. We show that the abrogation of SMAD2 results in altered patterning of the mesoderm and intermediate mesoderm cell lineages, which give rise to nearly all kidney cell types. Following further differentiation of intermediate mesoderm cells, the mutant podocytes failed to develop arborizations and interdigitations. A reconstituted glomerulus-on-a-chip system showed substantial albumin leakage, as observed in glomerulopathies. This study implicates chronic heart disease-associated SMAD2 mutations in kidney tissue malformation that might inform targeted regenerative therapies.

医療・健康
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