However, the
role of innate immunity in diabetic nephropathy (DN) has yet to be demonstrated. The aim of this study was to investigate the expression of toll-like receptors (TLR) and its ligands in human kidney tissue of DN. Methods: We studied 12 type 2 DN patients with renal biopsy, and 12 patients with nephrectomy for renal cancer served as controls. Clinical characteristics were recorded, and intrarenal expression of TLRs (TLR2 and TLR4) and its ligands (heat shock protein70, HSP70 and MYD88) was examined by immunohistochemistry. Results: The intrarenal expression of TLR2 was markedly decreased in glomerulus of the DN group (1.30 ± 0.21%/mm2 vs. 28.50 ± 3.45%/mm2, P < 0.01), whereas its expression was increased in the tubulointerstitum (16.55 ± 0.75%/mm2 vs. 8.93 ± 0.62%/mm2, P < 0.05), and this trend was accompanied by MYD88 expression (Glomerulus:
1.76 ± 0.60%/mm2 Crizotinib Pexidartinib manufacturer vs. 90.92 ± 10.69%/mm2; tubulointerstitum: 24.48 ± 2.38%/mm2 vs. 16.15 ± 1.12%/mm2, P < 0.01, respectively). In contrast, TLR4 immunoreactivity was significantly increased in the glomerulus of DN group (45.65 ± 3.08%/mm2 vs. 31.61 ± 1.32%/mm2, P < 0.01) but not in the tubulointerstitum. HSP70 expression, a TLR ligand, was significantly increased in the DN group compared with the Con group (Glomerulus: 91.40 ± 13.88%/mm2 vs. 50.91 ± 4.07%/mm2; tubulointerstitum: 19.27 ± 1.23%/mm2 vs. 9.25 ± 0.74%/mm2, P < 0.01, respectively). Correlation Tyrosine-protein kinase BLK analysis revealed that TLRs expression was correlated with the proteinuria and the eGFR. Conclusion: These findings suggest that an alteration in TLRs and its ligands expression is closely associated with diabetic renal injury, and that innate immunity may be one of important
players in type 2 DN. FUJITA TAKAYUKI1, WATANABE HIDETSUNA WATANABE2, HEMMI SEIICHIRO1, YABUKI MINAKO1, FUKE YOSHINOBU1, SATOMURA ATAUSHI3, SOMA MASAYOSHI1,4 1Department of Nephrology, Hypertension and Endocrinology, Nihon University School of Medicine; 2Department of Internal Medicine, Sakuboukai Tokiwadaigeka Hospital, Tokyo, Japan; 3Department of Laboratory Medicine, Nihon University School of Medicine, Tokyo, Japan; 4Department of General Medicine, Nihon University School of Medicine, Tokyo, Japan Introduction: Glomerular endothelial injury is commonly encountered in diabetic nephropathy, as in type 2 diabetes mellitus (T2DM). Microalbuminuria is associated with endothelial cell dysfunction, and is a significant risk factor for cardiovascular mortality in diabetes. This study was undertaken to study the effect of sitagliptin, a dipeptidyl peptidase-4 (DPP4) inhibitor, on microalbuminuria as a mechanism of improving glomerular endothelial injury in patients with T2DM. Methods: Sitagliptin, a DPP4 inhibitor, was administered to twenty patients with T2DM, 50 mg/day, for 8 weeks.