[Urinary excretion of proinflammatory cytokines and transforming growth factor beta at early stages of diabetic nephropathy].
OBJECTIVE
To examine correlations between urine excretion of proinflammatory cytokines, transforming growth factor beta (TGF-b) and changes in renal structure and function, quality of glycemia control in patients with type 1 diabetes mellitus.


METHODS
Urinary excretion of interleukine 1-beta (IL-1b), monocytic chemoattractive protein-1 (MCP-1), RANTES and TGF-b was measured with enzyme immunoassay in 57 patients including 22 patients with normal albuminuria, 23--with microalbuminuria, 12--with macroalbuminuria. Creatinine clearance was subnormal in 8 patients with macroalbuminuria. The control group consisted of 10 healthy persons. Morphological examination of renal biopsies was performed in 8 patients with normoalbuminuria and 10 patients with microalbuminuria.


RESULTS
Patients with normoalbuminuria had excretion of MCP-1 significantly higher than in controls. Microalbuminuria patients showed high excretion of IL-1b, MCP-1 and TGF-b. Excretion of IL-1b, MCP-1, RANTES and TGF-b in patients with macroalbuminuria was higher than in controls and other groups of patients. Excretion of cytokines and TGFb correlated inversely with glomerular filtration rate and hemoglobin level. Positive correlations were detected between excretion of IL-1b, MCP-1, TGFb and glycated hemoglobin A(1c). In patients with normo- and microalbuminuria cytokine and TGFb excretion correlated with thickness of glomerular and glomerular basal membrane. CD68-positive macrophages were detected in the intersticium of 1 patient with normoalbuminuria and 6 patients with microalbuminuria.


CONCLUSIONS
Urinary excretion of proinflammatory cytokines and TGF-b was elevated in patients with DM-1 having micro- and macroalbuminuria suggesting participation of inflammation in development of diabetic nephropathy.
Bondar'
I A
IA
Klimontov
V V
VV
Nadeev
A P
AP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology / Q000473:pathology / Q000652:urine; D015703:Antigens, CD / Q000276:immunology; D015214:Antigens, Differentiation, Myelomonocytic / Q000276:immunology; D015415:Biomarkers / Q000652:urine; D018932:Chemokine CCL2 / Q000652:urine*; D018946:Chemokine CCL5 / Q000652:urine*; D003930:Diabetic Retinopathy / Q000150:complications / Q000503:physiopathology / Q000652:urine*; D005260:Female; D005500:Follow-Up Studies; D050533:Glomerular Basement Membrane / Q000473:pathology; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007249:Inflammation / Q000473:pathology / Q000652:urine; D053583:Interleukin-1beta / Q000652:urine*; D008264:Macrophages / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D016212:Transforming Growth Factor beta / Q000652:urine*; D000097382:CD68 Molecule
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D018932:Chemokine CCL2; D018946:Chemokine CCL5; D053583:Interleukin-1beta; D016212:Transforming Growth Factor beta; C067980:CD68 antigen, human; D000097382:CD68 Molecule