Luo Yueming, Lu Zhaoyu, Waaga-Gasser Ana Maria, Yang Haifeng, Liu Jialing, Wu Juan, Lu Jiayan, Liu Xusheng, Zhang Lei
Nephrology Department, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
Department of Nephrology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, People's Republic of China.
Cancer Manag Res. 2020 Oct 7;12:9679-9689. doi: 10.2147/CMAR.S268402. eCollection 2020.
Clinical studies have indicated a relationship between diabetic nephropathy (DN) and the incidence and prevalence of renal cell carcinoma (RCC). However, the mechanism linking diabetic nephropathy and renal cell carcinoma has not yet to be identified.
In this study, a total of 42 male Sprague Dawley (SD) rats were randomly assigned to a DN group (n=35) and a control group (n=7). All animals in the DN group were unilaterally nephrectomized and treated with streptozotocin with the development of blood glucose levels >16.7mmol/L and dominant proteinuria and were compared to controls without such changes. Histopathologic alterations in the kidneys were examined by HE staining and Ki-67 immunohistochemistry. Differentially expressed genes were identified and validated by RNA-seq and PCR.
As the results, except for two rats that failed to develop the DN model and were excluded from the analysis, 33 rats in the DN group with overt signs of DN demonstrated significantly higher food and water intake, urine production, and urine protein and urinary protein/creatinine ratio than controls. Overall, 15.2% (n=5/33) of DN animals developed RCC while none tumors were observed in the control group (n=0/7). RNA-seq analysis in these animals indicated different gene expression and calcium pathway expression in DN animals with developing tumors, when compared with animals with no obvious tumors. In addition, DN animals diagnosed with RCC showed increased expression of GLUT2 and c-met, when compared to controls and DN animals without tumors.
In conclusion, the disordered calcium metabolism, especially disturbed TRPV5 mediated Ca signal, may have been related to the development of RCC in DN rats. Further studies related to the detailed mechanism are still needed.
临床研究表明糖尿病肾病(DN)与肾细胞癌(RCC)的发病率和患病率之间存在关联。然而,糖尿病肾病与肾细胞癌之间的联系机制尚未明确。
在本研究中,总共42只雄性斯普拉格-道利(SD)大鼠被随机分为糖尿病肾病组(n = 35)和对照组(n = 7)。糖尿病肾病组的所有动物均进行单侧肾切除术,并用链脲佐菌素治疗,使其血糖水平>16.7mmol/L且出现显性蛋白尿,并与未发生此类变化的对照组进行比较。通过苏木精-伊红(HE)染色和Ki-67免疫组织化学检查肾脏的组织病理学改变。通过RNA测序(RNA-seq)和聚合酶链反应(PCR)鉴定并验证差异表达基因。
结果显示,除两只未成功建立糖尿病肾病模型的大鼠被排除在分析之外,糖尿病肾病组中33只出现明显糖尿病肾病体征的大鼠的食物和水摄入量、尿量、尿蛋白及尿蛋白/肌酐比值均显著高于对照组。总体而言,15.2%(n = 5/33)的糖尿病肾病动物发生了肾细胞癌,而对照组未观察到肿瘤(n = 0/7)。对这些动物的RNA-seq分析表明,与无明显肿瘤的动物相比,发生肿瘤的糖尿病肾病动物存在不同的基因表达和钙信号通路表达。此外,与对照组和无肿瘤的糖尿病肾病动物相比,被诊断为肾细胞癌的糖尿病肾病动物的葡萄糖转运蛋白2(GLUT2)和c-甲硫氨酸(c-met)表达增加。
总之,钙代谢紊乱,尤其是瞬时受体电位香草酸亚型5(TRPV5)介导的钙信号紊乱,可能与糖尿病肾病大鼠肾细胞癌的发生有关。仍需要进一步研究详细机制。