title: [Urinary excretion of fibrogenic and antifibrotic growth factors in type 1 diabetic patients: the interrelationship with diabetic nephropathy].
abstract: OBJECTIVE
  To assess the relation between urinary excretion of profibrotic and antifibrotic growth factors, albuminuria and glomerular fibrosis in type 1 diabetic patients.
  
  
  METHODS
  64 patients with diabetes were examined, including 25 ones with normal albumin excretion rate (AER), 30 microalbuminuric and 9 macroalbuminuric patients. Urinary excretion of type IV collagen, transforming growth factor-beta 1] (TGF-beta 1), tumor necrosis factor-alpha (TNF-alpha), fibroblast growth factor-2 (FGF-2), hepatocyte growth factor (HGF) and bone morphogenetic protein-7 (BMP-7) was determined by ELISA and compared to control (10 healthy subjects). Renal biopsy specimens were assessed in 7 patients with normal AER and in 14 microalbuminuric patients.
  
  
  RESULTS
  Type IV collagen, TGF-beta1 and TNF-alpha excretion was increased significantly in patients with micro- and macroalbuminuria as compared to control (all p<0.05). Excretion of FGF-2 was increased in macroalbuminuric patients only (p=0.003). No marked changes in excretion of antifibrotic growth factors (HGF and BMP-7) were observed. TNF-alpha and FGF-2 correlated positively with urinary type IV collagen (r=0.37 and r=0.31, respectively). The presence of glomerular fibrosis in renal biopsy specimens was associated with higher excretion of TGF-beta1, TNF-alpha and FGF-2 (all p<0.05).
  
  
  CONCLUSIONS
  The results suggest that unbalance between profibrotic and antifibrotic growth factors in the kidneys plays an important role in pathogenesis of diabetic nephropathy. Urinary TGF-beta1, TNF-alpha and FGF-2 may offer new possibilities for detection of renal fibrosis in diabetic patients.
authors.forename: I A
authors.initials: IA
authors.lastname: Bondar'
authors.forename: V V
authors.initials: VV
authors.lastname: Klimontov
authors.forename: E M
authors.initials: EM
authors.lastname: Parfent'eva
authors.forename: V V
authors.initials: VV
authors.lastname: Romanov
authors.forename: A P
authors.initials: AP
authors.lastname: Nadeev
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D024141:Collagen Type IV / Q000652:urine*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000473:pathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000209:etiology / Q000473:pathology* / Q000652:urine*; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000652:urine*; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D053773:Transforming Growth Factor beta1 / Q000652:urine*; D014409:Tumor Necrosis Factor-alpha / Q000652:urine*; D055815:Young Adult
chemical_list: D024141:Collagen Type IV; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha; D016222:Fibroblast Growth Factor 2