Fibrosis in diabetes complications: pathogenic mechanisms and circulating and urinary markers.
Diabetes mellitus is characterized by a lack of insulin causing elevated blood glucose, often with associated insulin resistance. Over time, especially in genetically susceptible individuals, such chronic hyperglycemia can cause tissue injury. One pathological response to tissue injury is the development of fibrosis, which involves predominant extracellular matrix (ECM) accumulation. The main factors that regulate ECM in diabetes are thought to be pro-sclerotic cytokines and protease/anti-protease systems. This review will examine the key markers and regulators of tissue fibrosis in diabetes and whether their levels in biological fluids may have clinical utility.
Ban
Camelia R
CR
Discipline of Medicine and Department of Endocrinology, The University of Sydney and Royal Prince Alfred Hospital Sydney, New South Wales, 2006, Australia.
Twigg
Stephen M
SM
D000818:Animals; D001485:Basement Membrane / Q000473:pathology; D015415:Biomarkers / Q000097:blood / Q000378:metabolism* / Q000652:urine; D009202:Cardiomyopathies / Q000378:metabolism / Q000473:pathology; D055513:Connective Tissue Growth Factor; D048909:Diabetes Complications / Q000097:blood / Q000378:metabolism* / Q000473:pathology* / Q000652:urine; D003925:Diabetic Angiopathies / Q000378:metabolism / Q000473:pathology; D003928:Diabetic Nephropathies / Q000378:metabolism / Q000473:pathology; D003930:Diabetic Retinopathy / Q000378:metabolism / Q000473:pathology; D004730:Endothelium, Vascular / Q000473:pathology; D005109:Extracellular Matrix / Q000378:metabolism / Q000473:pathology; D005234:Fatty Liver / Q000473:pathology; D005355:Fibrosis; D017127:Glycation End Products, Advanced / Q000378:metabolism; D006331:Heart Diseases / Q000378:metabolism / Q000473:pathology; D006333:Heart Failure / Q000378:metabolism / Q000473:pathology; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism / Q000473:pathology; D017874:Immediate-Early Proteins / Q000378:metabolism; D007333:Insulin Resistance; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D008103:Liver Cirrhosis / Q000378:metabolism; D045726:Metalloproteases / Q000378:metabolism; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D012084:Renin-Angiotensin System / Q000502:physiology; D016212:Transforming Growth Factor beta / Q000378:metabolism; D017539:Tunica Intima / Q000473:pathology; D015854:Up-Regulation / Q000502:physiology
D015415:Biomarkers; C526317:CCN2 protein, human; D017127:Glycation End Products, Advanced; D017874:Immediate-Early Proteins; D036341:Intercellular Signaling Peptides and Proteins; D010446:Peptide Fragments; D011347:Procollagen; D016212:Transforming Growth Factor beta; C041876:procollagen Type III-N-terminal peptide; D055513:Connective Tissue Growth Factor; D045726:Metalloproteases