Abstract
BackgroundDiabetic nephropathy (DN) is associated with high risk of cardiovascular disease and mortality. Exosomal microRNAs (miRNAs) regulate gene expression in a variety of tissues and play important roles in the pathology of various diseases. We hypothesized that the exosomal miRNA profile would differ between DN patients and patients without nephropathy.MethodsWe prospectively enrolled 74 participants, including healthy volunteers (HVs), diabetic patients without nephropathy, and those with DN. The serum exosomal miRNA profiles of participants were examined using RNA sequencing.ResultsThe expression levels of 107 miRNAs differed between HVs and patients without DN, whereas the expression levels of 95 miRNAs differed between HVs and patients with DN. Among these miRNAs, we found 7 miRNAs (miR-1246, miR-642a-3p, let-7c-5p, miR-1255b-5p, let-7i-3p, miR-5010-5p, miR-150-3p) that were uniquely up-regulated in DN patients compared to HVs, and miR-4449 that was highly expressed in DN patients compared to patients without DN. A pathway analysis revealed that these eight miRNAs are likely involved in MAPK signaling, integrin function in angiogenesis, and regulation of the AP-1 transcription factor. Moreover, they were all significantly correlated with the degree of albuminuria.ConclusionsPatients with DN have a different serum exosomal miRNA profile compared to HVs. These miRNAs may be promising candidates for the diagnosis and treatment of DN and cardiovascular disease.
Highlights
Diabetic nephropathy (DN) is associated with high risk of cardiovascular disease and mortality
Diabetic patients with an estimated glomerular filtration rate < 60 mL/min/1.73 m2 were not included in the study, because we focused on early DN
We found that the miRNA let-7c-5p was significantly up-regulated in patients with DN when compared to healthy volunteer (HV)
Summary
Diabetic nephropathy (DN) is associated with high risk of cardiovascular disease and mortality. Obtaining kidney tissues through a renal biopsy is highly invasive and these tissues sample are not readily available Another important consideration is that DN is a kidney-specific disease, and a consequence of the systemic complications of DM. MiRNAs in EVs may have high chance to provide signatures reminiscent of their cell origin and are protected from the activity of extracellular RNases [13]. These exosome-enclosed miRNAs most likely function in intercellular communication and they could play a role in the pathology of various diseases [14,15,16]. Because of the inherent limitations in this technique unidentified miRNAs are often not detected [18]
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