Expression of pro-inflammatory cytokines (IL-6 & IL-18) exacerbate the risk of diabetic nephropathy in the Pakistani population.

Abstract

Diabetic nephropathy (DN) is a micro-chronic diabetic consequence induced by metabolic and hemodynamic abnormalities. Free radicals react with other critical cellular components, causing progression ofaberrant renal function. This case control study was aimed to determine the role of IL-6 and IL-18in diabetic nephropathy in Pakistani population. The study's subjects (n = 180 from Lahore, Gujranwala, and Karachi) were divided into control, diabetes mellitus(DM) and diabetic nephropathy (DN) groups. The serum concentration of IL-6 & IL-18 were determined by enzyme-linked immunosorbent assay (ELISA). The expression analysis of IL-6 & IL-18 were performed by Real Time PCR. The significant increase in serum levels of IL-6 were observed among the control, DM and DN groups (15.3 ± 24.1pg/ml, 34.7 ± 24.0pg/ml, 52.6 ± 33.2pg/ml) whereas no significant difference was observed in serum levels of IL-18. The expression analysis of IL-6 was increased by more than forty three fold in DN group (n-fold = ~43.6) as compared to DM & control whereas the expression profile of IL-18 decreased in DN group (n-fold = ~0.89). In DN group the correlation analysis revealed direct association of GFR with serum IL-6(r = 0.1114) & inverse relationship with serum IL-18(r = -0.097). In multiple regression analysis using GFR as the dependent variable, BMI and expression of IL-18 were determinants in DM subjects, but only uric acid in DN subjects. The present study implicates that increased expression of IL-6 and decreased of IL-18 was associated with development of DN in Pakistani population.