Rubio-Guerra AF, Vargas-Robles H, Rodríguez-López L, Suárez-Cuenca JA, Escalante-Acosta BA

Language: Spanish
References: 17
Page: 235-239
PDF size: 487.24 Kb.

ABSTRACT

Background: Several cytokines and growing factors have been implicated in the pathophysiology of diabetic renal damage, as the transforming growth factor-beta1 (TGF-β1), which plays a key role in the development of diabetic nephropathy because TGF-β1 favors glomerular hypertrophy, extracellular matrix expansion and glomerulosclerosis.
Objective: To evaluate the relationship between the levels of TGF-β1 and the degree of albuminuria in normotensive type-2 diabetic patients.
Patients and method: A prospective study was done with 30 normotensive type-2 diabetic patients in whom TGF-β1 was measured by ELISA. Additionally, 24 h urinary albumin excretion was measured, the levels of TGF-β1 and albuminuria were correlated with the Spearman correlation coefficient.
Results: We found a significant correlation (r = 0.5, p < 0.001) between TGF-β1 levels and 24 h urinary albumin excretion. We also found that those patients with TGF-β1 values higher than 41 ng/mL had an increased probability to present more than 100 mg of 24 h urinary albumin excretion.
Conclusion: Our results suggest that TGF-β1 may be a marker, and potentially a therapeutic target, for nephropathy in normotensive type-2 diabetic patients.

REFERENCES

1. Craig KJ, Donovan K, Munnery M, Owens DR, et al. Identification and management of diabetic nephropathy in the diabetes clinic. Diabetes Care 2003;26:1806-1811.

2. Gruden G, Perin PC, Camussi G. Insight on the pathogenesis of diabetic nephropathy from the study of podocyte and mesangial cell biology. Current Diabetes Rev 2005;1:27-40.

3. Dinneen SF, Gerstein HC. The association of microalbuminuria and mortality in non-insulin-dependent diabetes mellitus. A systemic overview of the literature. Arch Intern Med 1997;157:1413-1418.

4. Wright J, Vardhan A. The problem of diabetic nephropathy and practical prevention of its progression. Br J Diabetes Vasc Dis 2008;8:272-277.

5. Soldatos G, Cooper ME. Diabetic nephropathy: important pathophysiologic mechanisms. Diab Res Clin Pract 2008;82:s75-s79.

6. Navarro-González JF, Mora-Fernández C. The role of inflammatory cytokines in diabetic nephropathy. J Am Soc Nephrol 2008;19:433-442.

7. Van den Heuvel M, Batenburg WW, Danser J. Diabetic complications: a role for the prorenin-(pro) renin receptor-TGβ1 axis? Mollecular Cellular Endocrinol 2009;302:213-218.

8. Chen S, Jim B, Ziyadeh FN. Diabetic nephropathy and transforming growth factor-beta: transforming our view of glomeruloesclerosis and fibrosis build-up. Semin Nephrol 2003;23:532-543.

9. Ziyadeh FN. Mediators of diabetic renal disease: The case for TGF-β as the mayor mediator. J Am Soc Nephrol 2004;15:S55-S57.

10. Stehouwer CD, Gall MA, Twisk JW, Knudsen E, et al. Increased urinary albumin excretion, endothelial dysfunction, and chronic low-grade inflammation in type 2 diabetes progressive, interrelated, and independently associated with risk of death. Diabetes 2002;51:1157-1165.

11. Rubio AF. Nefropatía diabética. En: Castro MG, Liceaga G. Temas de Medicina Interna. México: Alfil, 2010;151-163.

12. Rubio AF, Vargas H, Lozano JJ, Escalante BA. Correlation between circulating adhesion molecules levels and albuminuria in type 2 diabetic hypertensive patients. Kydney Blood Press Res 2009;32:106-109.

13. Ziyadeh FN. Different roles for TGF β-1 and VEGF in the pathogenesis of the cardinal features of diabetic nephropathy. Diab Res Clin Pract 2008;82:38-41.

14. Benigni A. Add-on anti-TGF β antibody to ACE inhibitor arrest progressive diabetic nephropathy in the rat. J Am Soc Nephrol 2003;14:1816-1824.

15. Hills CE, Squires PE. TGF-beta1-induced epithelial-tomesenchymal transition and therapeutic intervention in diabetic nephropathy. Am J Nephrol 2010;31:68-74.

16. Rubio-Guerra AF, Vargas-Robles H, Vargas-Ayala G, Rodríguez-Lopez L, et al. Trandolapril-verapamil y TGF β-1. Revista de la ALAD 2012;2:304-309.

17. Rubio AF, Arceo A, Vargas G, Rodríguez L. The effect of trandolapril and its fixed-dose combination with verapamil on proteinuria in normotensive adults with type 2 diabetes. Diabetes Care 2004;27:1688-1691.