environmental pollutant is associated with renal injury in DN http://dx.doi.org/10.1016/j.hkjn.2015.08.014. 0064. Hyperphosphatemia and Tubulointerstitial Injury ...
Diabetic Nephropathy
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from week 12 to week 20 on db/db mice and in cultured mouse tubular epithelial cells (mTECs) under high AGE conditions. Results: lncRNA_5318 was highly upregulated in db/db mice that developed renal fibrosis with impaired renal function. Upregulation of lncRNA_5318 was tightly associated with upregulation of renal TGF-b1 and massive activation of Smad3 on the diabetic kidney, which was further confirmed in mTECs stimulated with AGE. ChiP assay demonstrated a Smad3 binding site on lncRNA_5318 promoter. Knockdown of Smad3 from mTECs blocked AGE-induced lncRNA_5318, revealing a Smad3-dependent mechanism in regulating lncRNA_5318 expression. Moreover, knockdown of lncRNA_5318 was able to inhibit AGEs-induced Smad3-dependent fibrosis. Importantly, Treatment in db/db mice with shRNA lncRNA_5318 showed a protective effect on diabetic kidney injury by inhibiting an increase in urinary albumin excretion and renal fibrosis including collagen I and collagen IV expression over week12-20 on db/db mice. Conclusion: lncRNA_5318 is a Smad3-dependent lncRNA that functions to promote Smad3 dependent renal fibrosis under diabetic conditions. Blockade of lncRNA_5318 may represent a novel therapy for DN.
remain unclear. The present study was designed to explore the role of GPR124 in podocytes in DN. Methods: Diabetes was induced by tail-vein injection of streptozotocin (STZ) in podocyte-specific deletion of GPR124 mice. Glomerular function was assessed by measuring proteinuria, and podocyte morphology was evaluated by transmission electron microscopy (TEM). Results: We found that GPR124 was down-regulated in the kidney from diabetic mice, db/db mice, and in kidney biopsies from diabetic patients. In cultured podocytes, high-glucose (HG) significantly decreased GPR124 expression in podocytes. Overexpression of GPR124 ameliorated HG-reduced the expressions of ZO-1 and nephrin in podocytes. Furthermore, Co-IP results revealed that GPR124 directly binds to ZO-1 in WT mice. HG or and gene silencing of GPR124 can reduce ZO-1 expression in podocyte. Consistently, podocyte-specific deletion of GPR124 exacerbated renal injury as evidenced by high albuminuria and foot process effacement in mice. Conclusion: Our study for the first time demonstrates that GPR124 is an essential factor for podocyte adhesion to glomerular basement membrane (GBM). A better understanding of the biological activities of GPR124 in the kidney may open new therapeutic avenues for the treatment of glomerular diseases.
http://dx.doi.org/10.1016/j.hkjn.2015.08.010 http://dx.doi.org/10.1016/j.hkjn.2015.08.012 0041 Deletion of Smad3 Prevents Renal Fibrosis and Inflammation in Type 2 Diabetes 1,2
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B. H. Xu , Y. K. You , S. F. Sun , X. R. Huang , H. F. Liu , R. C. W. Ma , H. Y. Lan1 1 Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, CUHK-Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong, China 2 Institute of Nephrology, Guangdong Medical College, Zhanjiang, China Objective: Transforming growth factor (TGF)-b/Smad3 signaling is highly activated in the diabetic kidney in patients with type-2 diabetes. However, the precise role of Smad3 in the pathogenesis of type-2 diabetic nephropathy remains largely unclear, which was investigated in this study by specifically deleting Smad3 from db/db mice. Methods: Smad3 knockout (KO)-db/db mice were generated by crossing the db/m mouse to the Sma3+/ mouse. This cross-breeding resulted in five groups of mice: Smad3 / db/db, Smad3+/+ db/db, Smad3+/ db/db, Smad3+/+db/m, and Smad3 / db/m mice. Groups of 8 mice were scarified at weeks 8, 20, and 32 and effect of deleting Smad3 gene on levels of fasting blood glucose, renal function, histological injury, and molecular pathology were examined. Results: Compared to Smad3+/+db/m and Smad3 / db/m mice that exhibited normal levels of blood glucose and urinary albumin excretion over the 32-week time course, Smad3+/+ db/db, Smad3+/ db/db developed progressive higher levels of fasting blood glucose (15e40 mmol/L) with significant diabetic kidney injury including increased microalbuminuria and deposition of collagen I, IV. In contrast, deletion of Smad3 from db/db mice (Smad3 / db/db) prevented an increase in blood glucose over the 32-week time course and protected against the development of diabetic kidney injury with normal renal function and histology without evidence for renal fibrosis and inflammation. In addition, Smad3 deficiency also prevented renal inflammation by inactivating NF-kB/ signaling and therefore blunting upregulation of TNF-a, MCP-1, and macrophage infiltration. Conclusion: Deletion of Smad3 prevents the development of type-2 diabetic nephropathy. This novel finding strongly suggests that targeting Smad3 may be a novel and effective therapy for type-2 diabetic complications clinically.
0057 MiR302a-3p Modulates Renal Epithelial-Mesenchymal Transition in DKD by Targeting ZEB1 W. T. Tang, L. Z. Zheng, R. Y. Yan, J. Y. Yang, J. N. Ning, L. P. Peng, Q. Z. Zhou, L. C. Chen Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China Objective: Recent study found that miRNAs are involved in diabetic kidney disease (DKD). The objective of this study is to determine the role of miR302a-3p in the process of renal epithelial-mesenchymal transition (EMT) in DKD. Methods: The levels of miR302a-3p in the plasma of DKD patients were detected by realtime PCR and then the relationship of miR302a-3p and UAE or eGFR were analyzed. Secondly, miR302a-3p expression was determined in HK-2 cells treated with high glucose for different time. And then miR302a-3p mimics and inhibitor were transfected to HK-2 cells following exposure to high glucose and low glucose respectively. The expressions of ZO-1, vimentin and ZEB-1 were determined by realtime PCR and western blot. Results: The expression of circulating miR-302a-3p was significantly increased in the diabetes mellitus (DM) group (n Z 22) compare with control (healthy persons, n Z 30) and then decreased in the early stage of diabetic nephropathy (DNE) group (n Z 20). Furthermore, its expression in clinical diabetic nephropathy (DNC) group (n Z 18) was decreased significantly compared with DM group. Circulating miR-302a-3p had negative relevance with UAE in DNE group (r Z 0.649, P Z 0.002) and DNC group (r Z -0.681, P Z 0.006;); Circulating miR302a-3p had positive relevance with eGFR in DNC group (r Z 0.486, P Z 0.041). In vitro, miR-302a-3p expression in HG group increased at 6 h and aescended to the highest level at 12 h and then gradually decreased from 24 h to 72 h. More interesting, ZEB1 protein expression had an opposite change which gradually decreased from 6 h to 24 h and then gradually increased from 48 h to 72 h. Moreover, overexpression of miR-302a-3p suppressed expression of ZEB1 in the post-transcriptional level and reversed high glucose-mediated downregulation of E-cadherin and upregulation of vimentin. Meanwhile, loss of miR-302a-3p expression can lead to EMT of HK-2 cells just as high glucose stimulation. Conclusion: miR-302a-3p may play a protective role by targeting ZEB1 in renal epithelial- mesenchymal transition in DKD.
http://dx.doi.org/10.1016/j.hkjn.2015.08.011 http://dx.doi.org/10.1016/j.hkjn.2015.08.013 0056 Gene Deficiency of GPR124 Exacerbates Podocyte Injury in Diabetic Nephropathy Xiaojie Wang, Yiqi Duan, Fan Yi Shandong university school of medicine, Jinan, China Objective: GPR124 is a very recently identified G protein-coupled receptor (GPCR), which has a large ectodomain and belongs to the adhesion GPCR subfamily. GPR124 is crucial for the growth of solid tumors and also important for angiogenesis. However, the functional role of GPR124 in the kidney and the contribution of GPR124 to the pathogenesis of diabetic nephropathy (DN)
0063 Perfluorooctane Sulfonate (PFOS) Promotes Renal Injury Under Diabetic Condition In Vitro Arthur C. K. Chung Partner State Key Laboratory of Environmental and Biological Analysis, Kowloon Tong, Kowloon, Hong Kong Diabetic nephropathy (DN) is the leading cause of end stage renal disease. TGF-beta signaling plays an important role in DN but how persistent organic
S4 pollutants (POP) affects renal injury has not been elucidated. Perfluorooctane sulfonate (PFOS) is an emerging POP in China. PFOS is readily absorbed after oral exposure and accumulates primarily in the serum, kidney, and liver. Toxicological studies on animals indicate its potential developmental, reproductive and systematic effect. PFOS can activate peroxisome proliferator-activated receptor alpha (PPARalpha) and may act via PPARalpha to produce some of their effects. In this study, we examined whether PFOS enhanced renal injury in vitro under diabetic condition. Our results demonstrated that the presence of PFOS was able to enhance the expression of fibrotic markers and enhanced oxidative stress in renal tubular epithelial cells under diabetic condition. PFOS also promoted the apoptosis of the renal tubular epithelial cells. This study demonstrated that presence of PFOS promoted renal injury in vitro under diabetic condition, suggesting that an environmental pollutant is associated with renal injury in DN
Diabetic Nephropathy predict long-term renal outcome is uncertain, particularly in the Type 2 diabetic nephropathy (DN). Methods: A total of 501 patients (The National Clinical Research Center of Kidney Diseases, 2003e2011) were recruited in prospective cohort study. Follow-up was 5-year. Renal outcome was defined by eGFRcrecys < 15 ml/min per 1.73 m2 or renal replacement therapy. Results: The distributions of standardized serum cystatin C with eGFRcre and eGFRcre-cys are shown in Figure 1. Kaplan-Meier curves showed significantly increased renal end points with higher quartile of cystatin C (p < 0.001) and lower eGFRcre-cys (p < 0.001). The highest AUROCs was eGFRcre-cys in predicting the renal endpoint compared with eGFRcre or eGFRcys. The best cutoff value for predicting the renal endpoint was 29.28% decline in the 24month, which value showed 79.6% sensitivity and 82.6% specificity. Cox regression models with restricted cubic splines were shows a change of 30% in eGFRcre-cys was associated with adjusted HRs for ESRD of 27.92 (95%CI, 3.95e197.48) over 2-year.
http://dx.doi.org/10.1016/j.hkjn.2015.08.014 Figure 1. The population of estimated GFRcre, GFRcys and GFRcre-cys equation. 0064 Hyperphosphatemia and Tubulointerstitial Injury in the Progression of Diabetic Nephropathy S. J. Jiang, Y. P. Pan, D. D. Q. Qiu, Y. A. An, H. C. Chen, Y. C. G. Ge, H. L. X. Xie, Z. H. L. Liu National Clinical Research Center of Kidney Diseases, Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China Objective: To evaluate the relationship between tubulointerstital injury and hyperphosphatemia in the patients with type 2 diabetes and diabetic nephropathy (T2DN), and investigate the association of hyperphosphatemia with the renal outcome, especially in the T2DN patients with eGFR60 ml/min per 1.73 m2. Methods: A total of 396 patients with T2D and biopsy-proven DN from Nanjing DN registration system who received follow-up for at least 1 year were recruited and median 5-year follow-up. Renal outcomes were defined by progression to end-stage renal disease and doubling of serum creatinine. Results: Of the participants, the baseline eGFR was 73.86 33.52 mL/min per 1.73 m2. The levels of the urinary tubulointerstitial injury markers including the NAG, RBP and NAGL were significantly difference among quintiles of serum phosphorus (P < 0.01). The participants whose eGFR90 ml/ min per 1.73 m2 had a higher rate of tubulointerstitial injury (interstitial fibrosis tubular atrophy scores of 2 and 3, P Z 0.005; interstitial inflammation scores of 1 and 2, P Z 0.035) in hyperphosphatemia (>1.45 mmol/L) group than in lower phosphorus group (1.45 mmol/L is an independent risk factor of ESRD in T2DN, especially in the patients with eGFR60 ml/min per 1.73 m2.
http://dx.doi.org/10.1016/j.hkjn.2015.08.015
0065 Prediction of Renal Outcome in Type 2 Diabetic Nephropathy by Estimating GFR from a Combination of Serum Creatinine and Cystatin C Y. P. Pan, S. J. Jiang, D. D. Q. Qiu, Y. A. An, Y. C. G. Ge, H. L. X. Xie, Z. H. L. Liu National Clinical Research Center of Kidney Diseases, Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China Objective: Serum cystatin C is an alternative to serum creatinine for estimating glomerular filtration rate (GFR), however, the utility of estimated GFR from combination of serum creatinine and cystatin C as marker to
Conclusion: eGFRcre-cys was a precision, and accuracy marker in the predicting of the renal outcome and 30% decline of eGFRcre-cys over 2 years was strongly associated with the risk of ESRD, suggesting it could be used as an alternative end point in T2DN.
http://dx.doi.org/10.1016/j.hkjn.2015.08.016
0072 Gene Expression Profile Analysis of Tangshen Formula-treated db/db Mice Hailing Zhao, Tingting Zhao, Xin Li, Ping Li Institute of Clinical Medical Science China-Japan Friendship Hospital, Chaoyang, Beijing, China Objective: Tangshen formula (TSF), as a traditional Chinese medicine, has been shown to have good clinical efficacy in diabetic nephropathy (DN) treatment. In this study, the potential molecular targets of TSF were explored in db/db mice treated with TSF. Methods: db/db mice were treated with or without TSF by gavage for 12 weeks, with db/m mice as a control. Serum glucose, 24h-albuminuria and histology were detected. Gene expression microarray was carried to detected the gene expression profile in 3 groups mice kidney tissues. Results: The results showed that treatment with TSF significantly reduced serum glucose and the excretion of urinary albumin in db/db mice, and attenuated secretion of extracellular matrix in renal glomeruli. Clustering analysis indicated the three groups could be their respective together for a class and almost 400 differentially expressed genes were identified in db/db mice and TSF-treated mice. These genes were mainly involved in
