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关于自体树突状细胞疗法对糖尿病肾病(DKD)患者蛋白尿及炎症生物标志物(白细胞介素-6、白细胞介素-10、肿瘤坏死因子α)影响的开放标签临床试验

Open-Label Clinical Trial on the Impact of Autologous Dendritic Cell Therapy on Albuminuria and Inflammatory Biomarkers (Interleukin-6, Interleukin-10, Tumor Necrosis Factor α) in Diabetic Kidney Disease (DKD).

作者信息

Sitepu Enda Cindylosa, Hernowo Bhimo Aji, Chiuman Linda, Lister I Nyoman Ehrich, Putranto Terawan Agus

机构信息

Faculty of Medicine, Dentistry, and Health Science, Universitas Prima Indonesia, Medan 20118, Indonesia.

Faculty of Medicine, Universitas Pembangunan Nasional "Veteran" Jakarta, Jakarta 12450, Indonesia.

出版信息

Curr Issues Mol Biol. 2024 Dec 2;46(12):13662-13674. doi: 10.3390/cimb46120816.

DOI:10.3390/cimb46120816
PMID:39727944
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11727525/
Abstract

The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, leading to a higher incidence of diabetic kidney disease (DKD), a major risk factor for end-stage kidney disease (ESKD). This study investigates the effects of autologous dendritic cell (DC) therapy on albuminuria and inflammatory biomarkers (IL-6, IL-10, and TNF-α) in DKD patients. An open-label clinical trial was conducted with 69 DKD outpatients at the Gatot Soebroto Army Central Hospital (RSPAD GS). Each subject received a single DC injection, with evaluations of urinary albumin-creatinine ratio (UACR) and inflammatory biomarkers at baseline and 4 weeks post-intervention. UACR was measured weekly, while eGFR, IL-6, IL-10, and TNF-α levels were assessed at baseline and week 4. Results indicated a significant reduction in median UACR from 250 mg/g at baseline to 153 mg/g in week 1, with sustained lower levels over 4 weeks ( < 0.05). No significant change of eGFR was found ( = 0.478). TNF-α levels also significantly decreased from 2.16 pg/mL to 1.92 pg/mL ( = 0.03), while IL-6 ( = 0.83) and IL-10 ( = 0.11) showed no significant change. The reduction in UACR and TNF-α suggests that DC therapy may alleviate albuminuria through anti-inflammatory mechanisms primarily suppressing TNF-α. No significant change in IL-10 levels implies that the anti-inflammatory effect is not mediated by IL-10 enhancement. This study demonstrates the potential of DC therapy as adjunct therapy to reduce albuminuria in DKD patients, with further research needed to explore long-term efficacy, long-term safety, and dosing strategies.

摘要

2型糖尿病(T2DM)在全球的患病率正在上升,导致糖尿病肾病(DKD)的发病率升高,而DKD是终末期肾病(ESKD)的主要危险因素。本研究调查了自体树突状细胞(DC)疗法对DKD患者蛋白尿和炎症生物标志物(IL-6、IL-10和TNF-α)的影响。在加托·苏布罗托陆军中央医院(RSPAD GS)对69名DKD门诊患者进行了一项开放标签的临床试验。每个受试者接受一次DC注射,并在基线和干预后4周评估尿白蛋白肌酐比值(UACR)和炎症生物标志物。每周测量UACR,而在基线和第4周评估估算肾小球滤过率(eGFR)、IL-6、IL-10和TNF-α水平。结果表明,中位UACR从基线时的250 mg/g显著降至第1周的153 mg/g,并在4周内持续保持较低水平(P<0.05)。未发现eGFR有显著变化(P = 0.478)。TNF-α水平也从2.16 pg/mL显著降至1.92 pg/mL(P = 0.03),而IL-6(P = 0.83)和IL-10(P = 0.11)无显著变化。UACR和TNF-α的降低表明,DC疗法可能通过主要抑制TNF-α的抗炎机制减轻蛋白尿。IL-10水平无显著变化意味着抗炎作用不是由IL-10增强介导的。本研究证明了DC疗法作为辅助疗法降低DKD患者蛋白尿的潜力,需要进一步研究以探索其长期疗效、长期安全性和给药策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ea4/11727525/aed6446de453/cimb-46-00816-g005.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ea4/11727525/aed6446de453/cimb-46-00816-g005.jpg
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