The link between Glut-1 and hypertension in diabetic nephropathy.
Nephropathy is a major diabetic microvascular complication; both metabolic and hemodynamic perturbations play critical roles in its occurrence and progression toward end-stage renal disease. Improvements in metabolic and blood pressure control have been shown to confer protection from this diabetic complication. In this article, we review the facilitative glucose transporter Glut-1, its regulation, and its potential role in linking metabolic and hemodynamic perturbations in the pathophysiologic processes that lead to kidney injury in diabetes. We propose that an auto-maintaining mechanism of hemodynamic perturbations and increased tissue angiotensin II may be involved in the initiation and maintenance of a loop in which transforming growth factor beta1 and Glut-1 upregulation play important roles in the pathophysiology of diabetic-induced kidney lesions. The understanding of the molecular mechanisms that link glomerular hypertension and excessive glucose metabolism may provide insight into new therapeutic strategies for the treatment of diabetic renal disease.
Gnudi
Luigi
L
Department of Diabetes and Endocrinology, Cardiovascular Division, King's College London, 5th floor Thomas Guy House, Guy's Hospital, St Thomas Street, London SE1 9RT, UK. luigi.gnudi@kcl.ac.uk
Raij
Leopoldo
L
D000818:Animals; D003928:Diabetic Nephropathies / Q000150:complications / Q000378:metabolism*; D018450:Disease Progression; D051272:Glucose Transporter Type 1 / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000378:metabolism*; D011379:Prognosis
D051272:Glucose Transporter Type 1