NDT Advance Access originally published online on July 27, 2004
Nephrology Dialysis Transplantation 2004 19(10):2505-2512; doi:10.1093/ndt/gfh207
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Nephrol Dial Transplant Vol. 19 No. 10 © ERA-EDTA 2004; all rights reserved
Original Article
NF-
B activation and overexpression of regulated genes in human diabetic nephropathy
1 Division of Nephrology, School of Medicine, Universidad Austral, Valdivia, Chile and 2 Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
Correspondence and offprint requests to: Sergio Mezzano, MD, Department of Nephrology, School of Medicine, Universidad Austral Bueras 1003 2 P, PO Box 8-D, Valdivia, Chile. Email: smezzano{at}uach.cl
Background. Nuclear factor-
B (NF-
B) regulates genes involved in renal disease progression, such as the chemokines monocyte chemoattractant protein-1 (MCP-1) and RANTES. NF-
B is activated in experimental models of renal injury, and in vitro studies also suggest that proteinuria and angiotensin II could be important NF-
B activators. It has been proposed that locally produced MCP-1 may be involved in the development of diabetic nephropathy (DN). We examined the hypothesis that NF-
B could be an indicator of renal damage progression in DN.
Methods. Biopsy specimens from 11 patients with type 2 diabeties and overt nephropathy were studied by southwestern histochemistry for the in situ detection of activated NF-
B. In addition, by immunohistochemistry and/or in situ hybridization, we studied the expression of MCP-1 and RANTES, whose genes are regulated by NF-
B.
Results. NF-
B was detected mainly in cortical tubular epithelial cells and, to a lesser extent, in some glomerular and interstitial cells. A strong upregulation of MCP-1 and RANTES was observed in all the cases, mainly in tubular cells, and there was a strong correlation between the expression of these chemokines and NF-
B activation in the same cells, as observed in serial sections (r = 0.7; P = 0.01). In addition, the tubular expression of these chemokines was correlated mainly with the magnitude of the proteinuria (P = 0.002) and with interstitial cell infiltration (P<0.05).
Conclusions. The activation of NF-
B and the transcription of certain pro-inflammatory chemokines in tubular epithelial cells are markers of progressive DN. Proteinuria might be one of the main factors inducing the observed pro-inflammatory phenotype.
Keywords: diabetic nephropathy; MCP-1; NF-
B; RANTES; renal disease progression
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