Division of Nephrology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109-0676, USA.
J Cardiovasc Transl Res. 2012 Aug;5(4):491-508. doi: 10.1007/s12265-012-9382-7. Epub 2012 Jun 26.
Diabetic kidney disease (DKD) is a microvascular complication of type 1 and 2 diabetes with a devastating impact on individuals with the disease, their families, and society as a whole. DKD is the single most frequent cause of incident chronic kidney disease cases and accounts for over 40% of the population with end-stage renal disease. Contributing factors for the high prevalence are the increase in obesity and subsequent diabetes combined with an improved long-term survival with diabetes. Environment and genetic variations contribute to DKD susceptibility and progressive loss of kidney function. How the molecular mechanisms of genetic and environmental exposures interact during DKD initiation and progression is the focus of ongoing research efforts. The development of standardized, unbiased high-throughput profiling technologies of human DKD samples opens new avenues in capturing the multiple layers of DKD pathobiology. These techniques routinely interrogate analytes on a genome-wide scale generating comprehensive DKD-associated fingerprints. Linking the molecular fingerprints to deep clinical phenotypes may ultimately elucidate the intricate molecular interplay in a disease stage and subtype-specific manner. This insight will form the basis for accurate prognosis and facilitate targeted therapeutic interventions. In this review, we present ongoing efforts from large-scale data integration translating "-omics" research efforts into improved and individualized health care in DKD.
糖尿病肾病(DKD)是 1 型和 2 型糖尿病的一种微血管并发症,对患有该病的个体、他们的家庭和整个社会都有毁灭性的影响。DKD 是导致慢性肾脏病新发病例的最常见单一原因,占终末期肾病患者的 40%以上。患病率高的原因是肥胖和随后的糖尿病发病率增加,再加上糖尿病患者的长期生存率提高。环境和遗传变异促成了 DKD 的易感性和肾功能的进行性丧失。遗传和环境暴露的分子机制在 DKD 的起始和进展过程中如何相互作用,是正在进行的研究工作的重点。标准化、无偏高通量人类 DKD 样本分析技术的发展为捕捉 DKD 病理生物学的多个层面开辟了新途径。这些技术通常在全基因组范围内检测分析物,生成全面的 DKD 相关指纹图谱。将分子指纹与深入的临床表型联系起来,最终可能以疾病阶段和亚型特异性的方式阐明复杂的分子相互作用。这种洞察力将为准确的预后提供依据,并有助于有针对性的治疗干预。在这篇综述中,我们介绍了正在进行的大规模数据整合工作,将“组学”研究成果转化为改善和个体化的 DKD 医疗保健。