The effect of ramipril therapy on cytokines and parameters of incipient diabetic nephropathy in patients with type 1 diabetes mellitus.
We compared the levels of transforming growth factor beta1 (TGF-beta1), vascular endothelial growth factor (VEGF) and other biochemical parameters in patients with type 1 diabetes mellitus with and without incipient diabetic nephropathy (iDN) and compared them with healthy control subjects. We also measured the effect of 3 and 6 months of ramipril treatment in diabetes patients with iDN. Compared with healthy controls, TGF-beta1 levels were increased in both groups of diabetes patients, whereas VEGF was only elevated in patients with iDN. Ramipril did not have a significant effect on TGF-beta1 or VEGF levels. We observed a significant decrease in microalbuminuria and cystatin C following ramipril treatment. Increased VEGF levels in patients with iDN suggest a role for this cytokine in the pathogenesis of diabetic nephropathy. Cystatin C would make a suitable marker for the screening and assessment of iDN, and for the evaluation of the therapeutic efficacy of drugs.
Janickova Zdarska
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Department of Internal Medicine, University Hospital Motol, 2nd Medical School, Charles University, Prague, Czech Republic. denisa.janickova.zdarska@email.cz
Zavadova
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Kvapil
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D000328:Adult; D000418:Albumins / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D055316:Cystatin C; D015891:Cystatins / Q000032:analysis; D016207:Cytokines / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006710:Homocysteine / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000378:metabolism; D008297:Male; D010865:Pilot Projects; D017257:Ramipril / Q000627:therapeutic use*; D053773:Transforming Growth Factor beta1 / Q000097:blood / Q000187:drug effects; D042461:Vascular Endothelial Growth Factor A / Q000097:blood / Q000187:drug effects
D000418:Albumins; D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D016207:Cytokines; D053773:Transforming Growth Factor beta1; D042461:Vascular Endothelial Growth Factor A; D006710:Homocysteine; D005340:Fibrinogen; D017257:Ramipril