Abstract

Abnormal angiogenesis plays a major role in the development of early stage diabetic nephropathy. Vascular endothelial growth factor (VEGF) is a classical proangiogenic factor that regulates abnormal glomerular angiogenesis linked to glomerular hypertrophy in the early stage of diabetic nephropathy. Leucine-rich α-2-glycoprotein-1 (LRG1) was recently reported as a novel proangiogenic factor that is expressed in endothelial cells and promotes angiogenesis by modulating the transforming growth factor-β signaling pathway. However, the pathophysiology of LRG1 in diabetic nephropathy remains largely unknown. In the present study, we investigated intrarenal expression of the novel proangiogenic factor LRG1 in diabetic db/db mice by immunohistochemistry and a laser capture microdissection method during the development of diabetic nephropathy. We hypothesized that glomerular LRG1 expression is increased earlier than VEGF expression under conditions of pathological angiogenesis in the early stage of diabetic nephropathy. Thus, we compared glomerular expression of VEGF and LRG1 in diabetic db/db mice at 16 and 24 weeks of age. At 16 weeks, diabetic db/db mice exhibited glomerular hypertrophy with abnormal angiogenesis characterized by endothelial cell proliferation, which was concomitant with an increase in LRG1 expression of glomerular endothelial cells. However, glomerular VEGF expression was not increased at this early stage. At 24 weeks, the features of early diabetic nephropathy in db/db mice had developed further, along with further enhanced glomerular LRG1 expression. At this late stage, glomerular VEGF and fibrosis-related-gene expression was also significantly increased compared with nondiabetic db/m mice. These results suggest that LRG1 plays a pivotal role in the initial development of diabetic nephropathy by promoting abnormal angiogenesis, thereby suggesting that LRG1 is a potential preemptive therapeutic target of diabetic nephropathy.

Highlights

  • Diabetic nephropathy has become a leading cause of end stage renal disease (ESRD) worldwide [1, 2]

  • Glomerular mRNA expression levels of Vascular endothelial growth factor (VEGF) and its main receptor, vascular endothelial growth factor receptor-2 (VEGFR-2), which are key mediators of abnormal angiogenesis and glomerular hypertrophy, were not increased in db/db mice compared with db/m mice (Figures 3(b) and 3(c))

  • Our most important finding is that the increase in Leucine-rich α-2-glycoprotein-1 (LRG1) expression of glomerular endothelial cells precedes the increase in VEGF expression, which is another proangiogenic factor involved in the development of diabetic nephropathy

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Summary

Introduction

Diabetic nephropathy has become a leading cause of end stage renal disease (ESRD) worldwide [1, 2]. Despite treatment by inhibition of the renin angiotensin system and tight glycemic control, the risk of ESRD remains high. Diabetic nephropathy is diagnosed at the early stage by detection of microalbuminuria. Early prevention of diabetic nephropathy progression remains challenging. Understanding the pathogenesis of early stage diabetic nephropathy and developing methods to control its progression are important issues

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