Okada Shinichi, Shikata Kenichi, Matsuda Mitsuhiro, Ogawa Daisuke, Usui Hitomi, Kido Yuichi, Nagase Ryo, Wada Jun, Shikata Yasushi, Makino Hirofumi
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
Diabetes. 2003 Oct;52(10):2586-93. doi: 10.2337/diabetes.52.10.2586.
Diabetic nephropathy is a leading cause of end-stage renal failure. Several mechanisms, including activation of protein kinase C, advanced glycation end products, and overexpression of transforming growth factor (TGF)-beta, are believed to be involved in the pathogenesis of diabetic nephropathy. However, the significance of inflammatory processes in the pathogenesis of diabetic microvascular complications is poorly understood. Accumulation of macrophages and overexpression of leukocyte adhesion molecules and chemokines are prominent in diabetic human kidney tissues. We previously demonstrated that intercellular adhesion molecule (ICAM)-1 mediates macrophage infiltration into the diabetic kidney. In the present study, to investigate the role of ICAM-1 in diabetic nephropathy, we induced diabetes in ICAM-1-deficient (ICAM-1(-/-)) mice and ICAM-1(+/+) mice with streptozotocin and examined the renal pathology over a period of 6 months. The infiltration of macrophages was markedly suppressed in diabetic ICAM-1(-/-) mice compared with that of ICAM-1(+/+) mice. Urinary albumin excretion, glomerular hypertrophy, and mesangial matrix expansion were significantly lower in diabetic ICAM-1(-/-) mice than in diabetic ICAM-1(+/+) mice. Moreover, expressions of TGF-beta and type IV collagen in glomeruli were also suppressed in diabetic ICAM-1(-/-) mice. These results suggest that ICAM-1 is critically involved in the pathogenesis of diabetic nephropathy.
糖尿病肾病是终末期肾衰竭的主要原因。包括蛋白激酶C激活、晚期糖基化终产物以及转化生长因子(TGF)-β过表达在内的多种机制被认为与糖尿病肾病的发病机制有关。然而,炎症过程在糖尿病微血管并发症发病机制中的重要性却知之甚少。巨噬细胞的积聚以及白细胞黏附分子和趋化因子的过表达在糖尿病患者肾脏组织中很突出。我们之前证明细胞间黏附分子(ICAM)-1介导巨噬细胞浸润到糖尿病肾脏中。在本研究中,为了探究ICAM-1在糖尿病肾病中的作用,我们用链脲佐菌素诱导ICAM-1缺陷(ICAM-1(-/-))小鼠和ICAM-1(+/+)小鼠患糖尿病,并在6个月的时间内检查肾脏病理。与ICAM-1(+/+)小鼠相比,糖尿病ICAM-1(-/-)小鼠中巨噬细胞的浸润明显受到抑制。糖尿病ICAM-1(-/-)小鼠的尿白蛋白排泄、肾小球肥大和系膜基质扩张明显低于糖尿病ICAM-1(+/+)小鼠。此外,糖尿病ICAM-1(-/-)小鼠肾小球中TGF-β和IV型胶原的表达也受到抑制。这些结果表明ICAM-1在糖尿病肾病的发病机制中起关键作用。