Figure 7.

Proposed mechanism of how periostin mediates renal damage. Proinflammatory transcription factors, with the major factor being NFκΒ, induce expression of periostin, which activates integrin-β3, inducing integrin downstream signaling and leading to cell motility, survival, and podocyte foot process effacement. In parallel, periostin promotes the tissue expression of several chemokines (MCP-1, RANTES, VCAM-1, and CSF-1) and profibrotic molecules (COL1, COL3, and TGF-β1), inducing inflammatory cell infiltration and matrix stabilization, and podocyte damage further amplifies these effects, causing a vicious circle.