Role of glomerular mechanical strain in the pathogenesis of diabetic nephropathy.

Glomerular rigidity limits the glomerular expansion and mesangial cell (MC) stretch induced by variations in intracapillary pressure. In tissue culture, MC stretch stimulates synthesis of extracellular matrix components (ECM). Therefore, altered glomerular rigidity in diabetes may influence ECM accumulation by modulating the glomerular distention and MC stretch associated with glomerular hypertension. An ambient of high glucose concentration per se also enhances MC formation of ECM, possibly altering the cellular response to mechanical stretch. In this study, compliance was measured in isolated perfused glomeruli from streptozotocin-injected rats at four days (4d-D), five weeks (5w-D) and six months (6m-D) after induction of diabetes. In addition, collagen metabolism induced by stretch was investigated in MC cultured in 8 and 35 mM glucose concentrations. Glomerular compliance was normal in 5w-D rats and moderately increased in 4d-D (16%) and 6m-D animals (14%). As compared to static cultures. MC stretch increased total collagen synthesis (8 mM, 50%; 35 mM, 27%) and catabolism. However, while the fraction of newly formed collagen being catabolized increased in 8 mM-stretched cultures, in 35 mM-stretched it was unchanged. This resulted in marked increase in the net collagen accumulated in the incubation medium (4 vs. 24%) and cell layer 5 vs. 15%) only in the latter. In diabetes, the largely unaltered glomerular stiffness renders hypertension-induced MC stretch unopposed. More importantly, the accumulation of ECM caused by any degree of mechanical strain is greatly aggravated in a milieu of high glucose concentration.