Contrast ultrasound and targeted microbubbles: diagnostic and therapeutic applications in progressive diabetic nephropathy.
Diabetic nephropathy remains one of the most common causes for end-stage renal disease worldwide. Although therapies aimed at optimizing glycemic control and systemic blood pressure have benefit, the reduction in progressive nephropathy remains modest at best. Thus, research continues to focus on newer therapies to address the unmet needs for additional renal protective strategies. The ability to noninvasively image the molecular and cellular processes that underlie diabetic nephropathy would be useful in risk stratifying patients with diabetes, and more importantly would aid in the evaluation of novel therapies to prevent and treat nephropathy. In addition, the development of ultrasound technologies that allow targeted gene delivery using high-power ultrasound and DNA-bearing microbubbles may have applicability for gene therapy to prevent diabetic nephropathy. This review highlights contrast-enhanced ultrasound imaging techniques for the evaluation of renal pathologies, including perfusion and molecular imaging techniques, and ultrasound-mediated gene delivery for therapeutic applications in diabetic nephropathy, that have potential for translation to clinical practice.
Division of Cardiology, Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. leong-poih@smh.ca
Howard
H
Leong-Poi
D000818:Animals; D003287:Contrast Media / Q000627:therapeutic use; D003928:Diabetic Nephropathies / Q000000981:diagnostic imaging / Q000628:therapy; D018014:Gene Transfer Techniques; D015316:Genetic Therapy; D006801:Humans; D045423:Microbubbles / Q000627:therapeutic use; D057054:Molecular Imaging / Q000379:methods; D014463:Ultrasonography / Q000379:methods
D003287:Contrast Media