Figure 162

Typical renal epithelial cell. Diagram of a typical renal epithelial cell. Sublethal injury to polarized epithelial cells leads to multiple lesions, including loss of the permeability barrier and apical-basolat-eral polarity [7-12]. To recover, cells must reestablish intercellular junctions and repolarize to form distinct apical and basolateral domains characteristic of functional renal epithelial cells. These junctions include those necessary for maintaining the permeability barrier (ie, tight junctions), maintaining cell-cell contact (ie, adherens junctions and desmosomes), and those involved in cell-cell communication (ie, gap junctions). In addition, the cell must establish and maintain contact with the basement membrane through its integrin receptors. Thus, to understand how kidney cells recover from sublethal ischemic injury it is necessary to understand how renal epithelial cells form these junctions. Furthermore, after lethal injury to tubule cells new cells may have to replace those lost during the ischemic insult, and these new cells must differentiate into epithelial cells to restore proper function to the tubules.

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