Role of inflammation in diabetic nephropathy

Alessia Fornoni, Adeel Ijaz, Thor Tejada, Oliver Lenz

Research output: Contribution to journalArticle

127 Citations (Scopus)

Abstract

Diabetic nephropathy (DN) is the leading cause of end stage renal disease (ESRD). Although the pathogenesis of DN is multi-factorial, local inflammatory stress may result from both the metabolic and hemodynamic derangements observed in DN. Inflammatory markers such as Interleukin-18 and Tumor Necrosis Factor (TNF)-α are increased in the serum of patients with diabetes and DN. This occurs at a very early stage of disease, and correlates with the degree of albuminuria. Recent data suggest that standard-pharmacologic interventions for DN, such as angiotensin converting enzyme inhibitors, angiotensin receptor blockers and aldosterone antagonists, may have anti-inflammatory properties that are independent of their hemodynamic effect. Although inflammation is traditionally thought of as a process resulting in macrophage infiltration, current scientific progress has lead to the novel idea that even cells distant from the blood stream, such as podocytes, can produce cytokines and can express molecules that are part of the co-stimulatory pathway. A strong translational research effort is currently aimed at defining the role of such molecules in cells other than lymphocytes and macrophages. Experimental animal models have recently provided evidence that some acute phase markers of inflammation such as intracellular cell adhesion molecule-1 (ICAM-1), TNF-alpha and Monocytes Chemoattractant Protein-1 (MCP-1) may have a causative role in the development of DN. Here, we review the current evidence supporting the role of inflammation in the early phases of clinical and experimental DN. A complete understanding of inflammatory pathways activated in DN may lead to the discovery of earlier and more reliable markers of DN than albuminuria and the identification of novel therapeutic targets.

Original languageEnglish
Pages (from-to)10-17
Number of pages8
JournalCurrent Diabetes Reviews
Volume4
Issue number1
DOIs
StatePublished - Feb 1 2008

Fingerprint

Diabetic Nephropathies
Inflammation
Albuminuria
Angiotensin Receptor Antagonists
Tumor Necrosis Factor-alpha
Hemodynamics
Macrophages
Mineralocorticoid Receptor Antagonists
Podocytes
Interleukin-18
Translational Medical Research
Chemokine CCL2
Cell Adhesion Molecules
Angiotensin-Converting Enzyme Inhibitors
Chronic Kidney Failure
Blood Cells
Anti-Inflammatory Agents
Animal Models
Lymphocytes
Cytokines

Keywords

  • Cytokines
  • Diabetic nephropathy
  • Inflammation
  • Insulin-resistance
  • Stress activated protein kinase

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Role of inflammation in diabetic nephropathy. / Fornoni, Alessia; Ijaz, Adeel; Tejada, Thor; Lenz, Oliver.

In: Current Diabetes Reviews, Vol. 4, No. 1, 01.02.2008, p. 10-17.

Research output: Contribution to journalArticle

Fornoni, Alessia ; Ijaz, Adeel ; Tejada, Thor ; Lenz, Oliver. / Role of inflammation in diabetic nephropathy. In: Current Diabetes Reviews. 2008 ; Vol. 4, No. 1. pp. 10-17.
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