Mapping the path of diabetic nephropathy
One of the most severe and life-threatening complications of diabetes mellitus is diabetic nephropathy (DN). Despite research having identified genes that may contribute to susceptibility, more information is needed to better understand the risks associated with the development of DN. 'The identification of risk factors for the development of diabetic nephropathy: The PREDICTIONS Project' (Predictions) set out to discover biomarkers with good predictive value for assessing DN risk. The approach aimed at enabling the development of enhanced strategies for preventing and managing DN. Project partners approached the problem of DN as a major diabetic vascular complication through a translational research effort at the genomic, proteomic and clinical levels. In particular, work focused on identifying pathophysiologically relevant genes and biomarkers linked to DN onset, progression and response to treatment. A case-control trial was central to all efforts; it included 457 patients. Investigations aimed to re-evaluate available genetic data and study the effects of gene variants as well as the influence of advanced glycation end products (AGEs) and reactive oxygen species (ROS). Advanced AGEs are known to bring about protein modifications that can lead to DN. Samples from patients who had already undergone therapy trials were also used to examine biochemical markers. Various methodologies were used to elaborate the first comprehensive profile of diabetic nephropathy in type II diabetes. These included work on genetic, biochemical and proteomic markers as well as mechanistic models. Predictions was successful in identifying potential new biomarkers for DN and its various stages. However, more in-depth research is needed for evaluating the identified markers for significant impact on patient care.
