Nephrol Dial Transplant (1999) 14: 2827-2829
© 1999 European Renal Association-European Dialysis and Transplant Association
Hypothesis
GLUT1 and TGF-ß: the link between hyperglycaemia and diabetic nephropathy
1 Division of Nephrology, Department of Medicine, Virginia Commonwealth University/Medical College of Virginia and McGuire VAMC, Richmond, 2 Renal-Electrolyte and Hypertension Division, Department of Medicine, and the Penn Center for the Molecular Studies of Kidney Diseases, University of Pennsylvania, Philadelphia, USA
Correspondence and offprint requests to: Fuad N. Ziyadeh, MD, Renal-Electrolyte & Hypertension Division, University of Pennsylvania, 415 Curie Boulevard, 700 Clinical Research Building, Philadelphia, PA 19104-6144, USA.
Abstract
Recent experimental work implicates transforming growth factor-ß (TGF-ß) as an aetiologic mediator of diabetic nephropathy and the ubiquitous glucose transporter GLUT1 as an important permissive factor for the tissue injury caused by hyperglycaemia. High ambient glucose increases GLUT1 expression and glucose transport activity when compared with physiologic glucose concentrations. Treatment of rat mesangial cells with TGF-ß up-regulates GLUT1 mRNA and protein levels and significantly increases glucose uptake. Addition of neutralizing anti-TGF-ß antibody prevents the stimulatory effects of high glucose on GLUT1 expression. Cultured rat mesangial cells transduced with the human GLUT1 gene and thus overexpressing the GLUT1 protein show marked increase in glucose uptake and the synthesis of extracellular matrix molecules, even when grown in normal ambient glucose concentrations. Thus, TGF-ß and GLUT1, two proteins that are up-regulated in glomerular mesangial cells in a hyperglycaemic milieu, can influence the expression of one another. It is therefore fair to conclude that, with successful interruption of the TGF-ß–GLUT1 axis, the beneficial effects of strict glucose control on the development of diabetic nephropathy could likely be augmented.
Keywords: diabetic nephropathy; fibrosis; GLUT1; hyperglycaemia, TGF-ß
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