A protein secreted by podocytes may play a key role in the development of nephrotic syndrome, and an acid precursor in the body may be useful in treating some forms of the condition.

A recent study of transgenic rats revealed that in some forms of nephrotic syndrome, the glomerular filter is compromised due to the overproduction of the glycoprotein angiopoietin-like-4 (Angptl4) in podocytes.

But the researchers also found that Angptl4 lacks the attachment of adequate amounts of sialic acid, a modified carbohydrate that affects the protein’s adhesive properties. Feeding the sialic acid precursor N-acetyl-D-mannosamine (ManNAc) to the rats suffering from Angptl4 overexpression increased the amount of protein-bound sialic acid, reducing proteinuria by 40%, according to a report in Nature Medicine (2011;17:117-122).

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