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Li C, Szeto CC. Urinary podocyte markers in diabetic kidney disease. Kidney Res Clin Pract 2024; 43:274-286. [PMID: 38325865 PMCID: PMC11181047 DOI: 10.23876/j.krcp.23.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/30/2023] [Accepted: 10/30/2023] [Indexed: 02/09/2024] Open
Abstract
Podocytes are involved in maintaining kidney function and are a major focus of research on diabetic kidney disease (DKD). Urinary biomarkers derived from podocyte fragments and molecules have been proposed for the diagnosis and monitoring of DKD. Various methods have been used to detect intact podocytes and podocyte-derived microvesicles in urine, including centrifugation, visualization, and molecular quantification. Quantification of podocyte-specific protein targets and messenger RNA levels can be performed by Western blotting or enzyme-linked immunosorbent assay and quantitative polymerase chain reaction, respectively. At present, many of these techniques are expensive and labor-intensive, all limiting their widespread use in routine clinical tests. While the potential of urinary podocyte markers for monitoring and risk stratification of DKD has been explored, systematic studies and external validation are lacking in the current literature. Standardization and automation of laboratory methods should be a priority for future research, and the added value of these methods to routine clinical tests should be defined.
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Affiliation(s)
- Chuanlei Li
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Cheuk-Chun Szeto
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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Zeng L, Ng JKC, Fung WWS, Chan GCK, Chow KM, Szeto CC. Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease. BMC Nephrol 2024; 25:32. [PMID: 38267859 PMCID: PMC10807208 DOI: 10.1186/s12882-024-03471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Diabetic kidney diseases (DKD) is a the most common cause of end-stage kidney disease (ESKD) around the world. Previous studies suggest that urinary podocyte stress biomarker, e.g. podocin:nephrin mRNA ratio, is a surrogate marker of podocyte injury in non-diabetic kidney diseases. METHOD We studied 118 patients with biopsy-proved DKD and 13 non-diabetic controls. Their urinary mRNA levels of nephrin, podocin, and aquaporin-2 (AQP2) were quantified. Renal events, defined as death, dialysis, or 40% reduction in glomerular filtration rate, were determined at 12 months. RESULTS Urinary podocin:nephrin mRNA ratio of DKD was significantly higher than the control group (p = 0.0019), while urinary nephrin:AQP2 or podocin:AQP2 ratios were not different between groups. In DKD, urinary podocin:nephrin mRNA ratio correlated with the severity of tubulointerstitial fibrosis (r = 0.254, p = 0.006). and was associated with the renal event-free survival in 12 months (unadjusted hazard ratio [HR], 1.523; 95% confidence interval [CI] 1.157-2.006; p = 0.003). After adjusting for clinical and pathological factors, urinary podocin:nephrin mRNA ratio have a trend to predict renal event-free survival (adjusted HR, 1.327; 95%CI 0.980-1.797; p = 0.067), but the result did not reach statistical significance. CONCLUSION Urinary podocin:nephrin mRNA ratio has a marginal prognostic value in biopsy-proven DKD. Further validation is required for DKD patients without kidney biopsy.
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Affiliation(s)
- Lingfeng Zeng
- Department of General Medicine, The Xiangya Second Hospital of Central South University, Changsha, China
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Randwick, Australia
| | - Jack Kit-Chung Ng
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Randwick, Australia
- Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Winston Wing-Shing Fung
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Randwick, Australia
| | - Gordon Chun-Kau Chan
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Randwick, Australia
| | - Kai-Ming Chow
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Randwick, Australia
| | - Cheuk-Chun Szeto
- Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Randwick, Australia.
- Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
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Mesfine BB, Vojisavljevic D, Kapoor R, Watson D, Kandasamy Y, Rudd D. Urinary nephrin-a potential marker of early glomerular injury: a systematic review and meta-analysis. J Nephrol 2024; 37:39-51. [PMID: 36808610 PMCID: PMC10920435 DOI: 10.1007/s40620-023-01585-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 01/13/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Both early recognition of glomerular injury and diagnosis of renal injury remain important problems in clinical settings, and current diagnostic biomarkers have limitations. The aim of this review was to determine the diagnostic accuracy of urinary nephrin for detecting early glomerular injury. METHODS A search was conducted through electronic databases for all relevant studies published until January 31, 2022. The methodological quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Pooled sensitivity, specificity, and other estimates of diagnostic accuracy were determined using a random effect model. The Summary Receiver Operating Characteristics (SROC) was used to pool the data and to estimate the area under the curve (AUC). RESULTS The meta-analysis included 15 studies involving 1587 participants. Overall, the pooled sensitivity of urinary nephrin for detecting glomerular injury was 0.86 (95% CI 0.83-0.89) and specificity was 0.73 (95% CI 0.70-0.76). The AUC-SROC to summarise the diagnostic accuracy was 0.90. As a predictor of preeclampsia, urinary nephrin showed a sensitivity of 0.78 (95% CI 0.71-0.84) and specificity of 0.79 (95% CI 0.75-0.82), and as a predictor of nephropathy the sensitivity was 0.90 (95% CI 0.87-0.93), and specificity was 0.62 (95% CI 0.56-0.67). A subgroup analysis using ELISA as a method of diagnosis showed a sensitivity of 0.89 (95% CI 0.86-0.92), and a specificity of 0.72 (95% CI 0.69-0.75). CONCLUSION Urinary nephrin may be a promising marker for the detection of early glomerular injury. ELISA assays appear to provide reasonable sensitivity and specificity. Once translated into clinical practice, urinary nephrin could provide an important addition to a panel of novel markers to help in the detection of acute and chronic renal injury.
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Affiliation(s)
- Belete Biadgo Mesfine
- College of Public Health, Medical and Veterinary Science, James Cook University, 1 James Cook Drive, Douglas, Townsville, QLD, 4811, Australia
- College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia
| | - Danica Vojisavljevic
- College of Public Health, Medical and Veterinary Science, James Cook University, 1 James Cook Drive, Douglas, Townsville, QLD, 4811, Australia
| | - Ranjna Kapoor
- College of Public Health, Medical and Veterinary Science, James Cook University, 1 James Cook Drive, Douglas, Townsville, QLD, 4811, Australia
| | - David Watson
- Maternal Fetal Medicine Unit and Department of Obstetrics and Gynaecology, Townsville University Hospital, Townsville, Australia
| | - Yogavijayan Kandasamy
- College of Public Health, Medical and Veterinary Science, James Cook University, 1 James Cook Drive, Douglas, Townsville, QLD, 4811, Australia
- Townsville University Hospital, 100 Angus Smith Dr, Douglas, QLD, 4814, Australia
| | - Donna Rudd
- College of Public Health, Medical and Veterinary Science, James Cook University, 1 James Cook Drive, Douglas, Townsville, QLD, 4811, Australia.
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Ganesh V, M M, GK VG, Gangannagari VK. Linking adiponectin expression and kidney dysfunction among Indian patients with and without diabetic nephropathy. Bioinformation 2022; 18:876-883. [PMID: 37654826 PMCID: PMC10465784 DOI: 10.6026/97320630018876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 09/02/2023] Open
Abstract
Diabetic kidney disease is a common cause of end stage renal disease has a high incidence rate in population with type 2 diabetes mellitus patients. Adiponectin is an adipocytokine shown to strive anti-diabetic, anti-oxidative as well as anti-inflammatory. The present study aimed to determine the serum adiponectin levels in type 2 diabetes mellitus and explore its association with nephropathy. This cross sectional study recruited 90 type 2 diabetes mellitus patients with (n = 60) and without nephropathy (n = 30). Additionally 30 age, gender, and body mass index matched healthy controls were included. Enzyme linked immunosorbent assay method were used to determine adiponectin concentration. Blood sugars, glycated hemoglobin, body mass index all sounded to be brawny risk factors for nephropathy and microalbumin, e GFR showed a significant association with kidney disease progression in type 2 diabetes mellitus with nephropathy. Both the groups of type 2 diabetes mellitus patients had elevated adiponectin concentrations than controls. Serum adiponectin concentrations were significantly higher in type 2 diabetes mellitus without nephropathy and there was a significant association with nephropathy activity (P<0.0001**). The receiver operating characteristics curve analysis was used to examine the diagnostic performance of adiponectin for nephropathy shown a significant area under the curve 0.998 with sensitivity 100% and specificity 93.33% (P<0.0001**). Hence our study findings concluded that serum adiponectin concentrations considered for the early predictable and prognostic marker for nephropathy.
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Affiliation(s)
- Veluri Ganesh
- Department of Biochemistry, Aarupadai Veedu Medical College & Hospital, Vinayaka Mission's Research Foundation (Deemed to be University), Salem- 636308, Tamilnadu, India
| | - Murugan M
- Department of Biochemistry, Aarupadai Veedu Medical College & Hospital, Vinayaka Mission's Research Foundation (Deemed to be University), Salem- 636308, Tamilnadu, India
| | - Veerabhadra Goud GK
- Department of Biochemistry, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair - 744104, Andaman and Nicobar Islands, India
| | - Vijay Kumar Gangannagari
- Department of Microbiology, Akash Institute of Medical Sciences and Research Centre, Bangalore - 562110, Karnataka, India
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Exfoliated Kidney Cells from Urine for Early Diagnosis and Prognostication of CKD: The Way of the Future? Int J Mol Sci 2022; 23:ijms23147610. [PMID: 35886957 PMCID: PMC9324667 DOI: 10.3390/ijms23147610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Chronic kidney disease (CKD) is a global health issue, affecting more than 10% of the worldwide population. The current approach for formal diagnosis and prognostication of CKD typically relies on non-invasive serum and urine biomarkers such as serum creatinine and albuminuria. However, histological evidence of tubulointerstitial fibrosis is the 'gold standard' marker of the likelihood of disease progression. The development of novel biomedical technologies to evaluate exfoliated kidney cells from urine for non-invasive diagnosis and prognostication of CKD presents opportunities to avoid kidney biopsy for the purpose of prognostication. Efforts to apply these technologies more widely in clinical practice are encouraged, given their potential as a cost-effective approach, and no risk of post-biopsy complications such as bleeding, pain and hospitalization. The identification of biomarkers in exfoliated kidney cells from urine via western blotting, enzyme-linked immunosorbent assay (ELISA), immunofluorescence techniques, measurement of cell and protein-specific messenger ribonucleic acid (mRNA)/micro-RNA and other techniques have been reported. Recent innovations such as multispectral autofluorescence imaging and single-cell RNA sequencing (scRNA-seq) have brought additional dimensions to the clinical application of exfoliated kidney cells from urine. In this review, we discuss the current evidence regarding the utility of exfoliated proximal tubule cells (PTC), podocytes, mesangial cells, extracellular vesicles and stem/progenitor cells as surrogate markers for the early diagnosis and prognostication of CKD. Future directions for development within this research area are also identified.
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Mizdrak M, Kumrić M, Kurir TT, Božić J. Emerging Biomarkers for Early Detection of Chronic Kidney Disease. J Pers Med 2022; 12:jpm12040548. [PMID: 35455664 PMCID: PMC9025702 DOI: 10.3390/jpm12040548] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 12/14/2022] Open
Abstract
Chronic kidney disease (CKD) is a major and serious global health problem that leads to kidney damage as well as multiple systemic diseases. Early diagnosis and treatment are two major measures to prevent further deterioration of kidney function and to delay adverse outcomes. However, the paucity of early, predictive and noninvasive biomarkers has undermined our ability to promptly detect and treat this common clinical condition which affects more than 10% of the population worldwide. Despite all limitations, kidney function is still measured by serum creatinine, cystatin C, and albuminuria, as well as estimating glomerular filtration rate using different equations. This review aims to provide comprehensive insight into diagnostic methods available for early detection of CKD. In the review, we discuss the following topics: (i) markers of glomerular injury; (ii) markers of tubulointerstitial injury; (iii) the role of omics; (iv) the role of microbiota; (v) and finally, the role of microRNA in the early detection of CKD. Despite all novel findings, none of these biomarkers have met the criteria of an ideal early marker. Since the central role in CKD progression is the proximal tubule (PT), most data from the literature have analyzed biomarkers of PT injury, such as KIM-1 (kidney injury molecule-1), NGAL (neutrophil gelatinase-associated lipocalin), and L-FABP (liver fatty acid-binding protein).
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Affiliation(s)
- Maja Mizdrak
- Department of Nephrology and Hemodialysis, University Hospital of Split, 21000 Split, Croatia;
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.); (T.T.K.)
| | - Marko Kumrić
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.); (T.T.K.)
| | - Tina Tičinović Kurir
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.); (T.T.K.)
- Department of Endocrinology, Diabetes and Metabolic Disorders, University Hospital of Split, 21000 Split, Croatia
| | - Joško Božić
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.); (T.T.K.)
- Correspondence:
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Surya M, Rajappa M, M V. Utility of Urinary Nephrin in Patients With and Without Diabetic Nephropathy and Its Correlation With Albuminuria. Cureus 2022; 13:e20102. [PMID: 34993041 PMCID: PMC8720236 DOI: 10.7759/cureus.20102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Nephrin is a podocyte-specific protein that may serve as a urinary biomarker in patients with diabetic nephropathy. The objectives of the study were to determine urinary nephrin levels in patients with and without type 2 diabetic nephropathy and to assess the correlation between urinary nephrin and albuminuria. Methods This was a cross-sectional comparative study that was carried out at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry over 18 months. Diabetic study subjects were divided into three groups-normoalbuminuria, microalbuminuria, and macroalbuminuria. Urinary albumin was detected by the dipstick method in a spot urine sample for all study subjects. In subjects with trace or no albuminuria, nephelometry was used to quantify urinary albumin levels. Urinary nephrin was estimated by the ELISA technique for all study subjects. Results Subjects in the microalbuminuria group had higher urinary nephrin levels than those in the normoalbuminuria and macroalbuminuria groups. There was a weak positive correlation between urinary albumin and nephrin levels among the study subjects (p < 0.001). Conclusion Urinary nephrin levels are increased in patients with diabetic nephropathy. There was a weak positive correlation between urinary albumin and nephrin levels among these patients.
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Affiliation(s)
- Manupati Surya
- Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Medha Rajappa
- Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Vadivelan M
- Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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Kondapi K, Kumar NL, Moorthy S, Silambanan S. A Study of Association of Urinary Nephrin with Albuminuria in Patients with Diabetic Nephropathy. Indian J Nephrol 2021; 31:142-148. [PMID: 34267436 PMCID: PMC8240926 DOI: 10.4103/ijn.ijn_305_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/13/2019] [Accepted: 12/23/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND AIMS Diabetes mellitus and its complications are associated with high mortality and morbidity. Early detection is mandatory to improve quality of life years in patients with diabetic nephropathy. Hyperglycaemia disrupts podocytes, both structurally and functionally, leading to excretion of nephrin which is present in the glomerular filtration barrier. This study was undertaken to find out whether urinary nephrin is a better indicator of podocyte injury than albuminuria in patients with diabetic nephropathy. METHODS The study included 125 type 2 diabetes mellitus patients as cases categorized into three groups, depending upon albumin excretion. Age and sex matched 45 individuals without diabetes mellitus were chosen as the control group. The study protocol was approved by Institutional Ethics committee. Microalbumin was estimated by immunoturbidometry and urinary nephrin by ELISA. ANOVA and Tukey post-hoc tests were done to compare the data between the groups. Correlation studies were done. Odds ratio for nephrin was calculated. P value less than 0.05 was considered statistically significant. The statistical analyses were performed with SPSS software version 13.0. RESULTS The urinary nephrin was found to be proportionately increased from normoalbuminuria to macroalbuminuria and it was statistically significant, with sensitivity of 92.5% and specificity of 76.7%, the cut-off value of urinary nephrin was 97.5ng/mL. CONCLUSION Albuminuria has been used as an independent predictor of diabetic nephropathy. The statistical significant difference between the groups inferred that urinary nephrin excretion increased even in the stage of normoalbuminuria. Nephrin expression and its phosphorylation get altered by hyperglycaemia, contributing to renal damage. Nephrin was found to be a sensitive marker of early kidney dysfunction in diabetic patients.
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Affiliation(s)
- Kishore Kondapi
- Department of Biochemistry, SRMC & RI, Sri Ramachandra Institute of Higher Education Research (Deemed to be University), Porur, Chennai 600116, Chennai, Tamil Nadu, India
| | - N. Lakshmana Kumar
- Department of Biochemistry, GSL Medical College, Rajahmundry, Andhra Pradesh, India
| | - Swathi Moorthy
- Department of General Medicine, SRMC & RI, Sri Ramachandra Institute of Higher Education Research (Deemed to be University), Porur, Chennai 600116, Chennai, Tamil Nadu, India
| | - Santhi Silambanan
- Department of Biochemistry, SRMC & RI, Sri Ramachandra Institute of Higher Education Research (Deemed to be University), Porur, Chennai 600116, Chennai, Tamil Nadu, India
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Arellano-Buendía AS, Castañeda-Lara LG, Loredo-Mendoza ML, García-Arroyo FE, Rojas-Morales P, Argüello-García R, Juárez-Rojas JG, Tapia E, Pedraza-Chaverri J, Sánchez-Lozada LG, Osorio-Alonso H. Effects of Allicin on Pathophysiological Mechanisms during the Progression of Nephropathy Associated to Diabetes. Antioxidants (Basel) 2020; 9:antiox9111134. [PMID: 33203103 PMCID: PMC7697950 DOI: 10.3390/antiox9111134] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/03/2020] [Accepted: 11/13/2020] [Indexed: 02/06/2023] Open
Abstract
This study aimed to assess the impact of allicin on the course of diabetic nephropathy. Study groups included control, diabetes, and diabetes-treated rats. Allicin treatment (16 mg/kg day/p.o.) started after 1 month of diabetes onset and was administered for 30 days. In the diabetes group, the systolic blood pressure (SBP) increased, also, the oxidative stress and hypoxia in the kidney cortex were evidenced by alterations in the total antioxidant capacity as well as the expression of nuclear factor (erythroid-derived 2)-like 2/Kelch ECH associating protein 1 (Nrf2/Keap1), hypoxia-inducible factor 1-alpha (HIF-1α), vascular endothelial growth factor (VEGF), erythropoietin (Epo) and its receptor (Epo-R). Moreover, diabetes increased nephrin, and kidney injury molecule-1 (KIM-1) expression that correlated with mesangial matrix, the fibrosis index and with the expression of connective tissue growth factor (CTGF), transforming growth factor-β1 (TGF-β1), and α-smooth muscle actin (α-SMA). The insulin levels and glucose transporter protein type-4 (GLUT4) expression were decreased; otherwise, insulin receptor substrates 1 and 2 (IRS-1 and IRS-2) expression was increased. Allicin increased Nrf2 expression and decreased SBP, Keap1, HIF-1α, and VEGF expression. Concurrently, nephrin, KIM-1, the mesangial matrix, fibrosis index, and the fibrotic proteins were decreased. Additionally, allicin decreased hyperglycemia, improved insulin levels, and prevented changes in (GLUT4) and IRSs expression induced by diabetes. In conclusion, our results demonstrate that allicin has the potential to help in the treatment of diabetic nephropathy. The cellular mechanisms underlying its effects mainly rely on the regulation of antioxidant, antifibrotic, and antidiabetic mechanisms, which can contribute towards delay in the progression of renal disease.
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Affiliation(s)
- Abraham Said Arellano-Buendía
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico; (A.S.A.-B.); (L.G.C.-L.); (F.E.G.-A.); (P.R.-M.); (E.T.); (L.G.S.-L.)
| | - Luis Gerardo Castañeda-Lara
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico; (A.S.A.-B.); (L.G.C.-L.); (F.E.G.-A.); (P.R.-M.); (E.T.); (L.G.S.-L.)
| | - María L. Loredo-Mendoza
- Histopathology Laboratory, Research Subdivision, School of Medicine, Universidad Panamericana, Donatello 43, Mexico City 03910, Mexico;
| | - Fernando E. García-Arroyo
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico; (A.S.A.-B.); (L.G.C.-L.); (F.E.G.-A.); (P.R.-M.); (E.T.); (L.G.S.-L.)
| | - Pedro Rojas-Morales
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico; (A.S.A.-B.); (L.G.C.-L.); (F.E.G.-A.); (P.R.-M.); (E.T.); (L.G.S.-L.)
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico;
| | - Raúl Argüello-García
- Departamento de Genética y Biología Molecular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City 07360, Mexico;
| | - Juan G. Juárez-Rojas
- Department of Endocrinology, Instituto Nacional de Cardiología “Ignacio Chávez” México City 14080, Mexico;
| | - Edilia Tapia
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico; (A.S.A.-B.); (L.G.C.-L.); (F.E.G.-A.); (P.R.-M.); (E.T.); (L.G.S.-L.)
| | - José Pedraza-Chaverri
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico;
| | - Laura Gabriela Sánchez-Lozada
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico; (A.S.A.-B.); (L.G.C.-L.); (F.E.G.-A.); (P.R.-M.); (E.T.); (L.G.S.-L.)
| | - Horacio Osorio-Alonso
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, México City 14080, Mexico; (A.S.A.-B.); (L.G.C.-L.); (F.E.G.-A.); (P.R.-M.); (E.T.); (L.G.S.-L.)
- Correspondence: or
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