Named for two New York virologists, the Tamm-Horsfall mucoprotein (THMP or uromodulin) was first isolated in 1950 by Igor Tamm and Frank Horsfall. Synthesized by cells of the thick ascending limb of the loop of henle, is the most abundant urinary protein in healthy mammals. That being said, it is no surprise this protein is the matrix for tubular casts, and has been shown to have roles in multiple tubular disease states.
The 616 amino acid, 90 kDa protein was first identified by Tamm and Horsfall as a potent inhibitor of viral hemoagglutination in healthy individuals. It is thought to be protective against urinary tract infections by preventing the adhesion of fimbriated E coli to tubular epithelium. The protein has also been implicated in disease states:
Myeloma Kidney/Cast Nephropathy: Filtered monoclonal light chains bind to the THMP forming obstructing tubular casts
Rhabdomyolysis: Distal tubule obstruction occurs by binding of myoglobulin
to THMP, which may be enhanced by acidic urine.
Acute Tubular Necrosis: Increased sodium concentration as a result of damage to tubular epithelial cells causes polymerization of THMP and cast formation including the sloughed tubular cells, contributing to tubular obstruction.
Nephrolithiasis: Specifically Calcium Oxalate Monohydrate stones. In an alkaline environment, THMP may prevent crystal aggregation, but in acidic urine THMP viscosity and aggregation increases, decreasing the inhibitory properties thought to prevent this stone formation.
Genetic Disorders: Medullary cystic kidney Disease type 2 and Familial Juvenile Hyperuricemic Nephropathy, (both characterized by hyperuricemia, medullary cysts, interstitial nephritis and progressive renal failure) have genetic defects located close to the human THMP gene. There is speculation that it is an alteration of the structure of THMP that accounts for these disease states.
Reference is linked above. AJKD 2003:42:4:658-676.
- ► 2019 (33)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- CLINICAL CASE 5
- Luminex Technology
- IN THE NEWS ---> CLASSIFICATION FOR DIABETIC NEPH...
- Nephrectomy or No Nephrectomy?
- CONSULT ROUNDS: ORTHOSTATIC PROTEINURIA
- TOPIC DISCUSSION Risk factors for bleeding post ki...
- New drugs for Hepatitis C
- CDC HIGH RISK DONORS
- TOPIC DISCUSSION: Peritoneal Dialysis First initia...
- CLINICAL CASE 4
- Adrenal Gland Transplantation
- IN THE NEWS --->Is BMT Nephropathy really mostly ...
- Sad News
- TOPIC DISCUSSION: Tamm Horsfall Mucoprotein
- TOPIC DISCUSSION: Re-evaluating the Role of Immuno...
- JOURNAL CLUB: DNA Methylation controls Foxp3 gene ...
- In the News: The era of epigenetics
- Sirolimus and tubular toxicity
- TOPIC DISCUSSION: FIBROTIC DISEASES
- IN THE NEWS --> IgA with ANCAs
- JOURNAL CLUB: Pirfenidone Is Renoprotective in Dia...
- IN THE NEWS- CKD and Proteinuria
- CLINICAL CASE 3
- Positive Cross Match, Desensitization
- CONSULT ROUNDS: Post Bone Marrow Transplant Thromb...
- ▼ February (25)