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2015, Number 3

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Rev Cuba Endoc 2015; 26 (3)

Mechanisms of induction of the extracellular matrix in diabetic nephropathy

Guzmán-Hernández EA, Segura-Cobos D

Language: Spanish
References: 33
Page: 278-291
PDF size: 225.69 Kb.


ABSTRACT

Diabetic nephropathy is a serious complication in diabetes mellitus. Its main and typical morphological changes are caused by the rise of the amount of the extracellulary matrix proteins. The final products of advanced glycation resulting from hyperglycemia stimulate the production of the extracellulary matrix proteins in the mesangial cells which leads to glomerulosclerosis. This article reviewed the alterations in the metabolic pathways that induce the production of factors capable of increasing the extracellulary matrix protein synthesis and their accumulation during the development of diabetic nephropathy. Elevated intracellular glucose leads to increased angiotensin II and C-kinase protein activation which, in turn, increase the number of several growth factors such as B1 transforming, vascular endothelial, connective tissue, epidermal and platelet-derived factors. All the above-mentioned causes more synthesis of renal extracellulary matrix proteins such as collagen, fibronectin, entactin and laminin which will thicken the basal membranes and will progresively extend the glomerular mesangial matrix. The matrix metalloproteins in charge of modulating the amount of proteins in the said matrix are then regulated by the tisular inhibitors of the metalloproteinases.


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