Endothelial dysfunction and inflammation in diabetic nephropathy

In this thesis we investigated various mechanisms by which the immune system plays a role in the development of diabetic nephropathy. In chapter 2 we describe that APOC1-tg mice develop glomerulosclerosis at 15 months of age, with increased number of glomerular macrophages. Our results suggest that apoCI may exacerbate the development of DN by increasing the inflammatory response in activated glomerular macrophages. In chapter 3 we demonstrate that sFLT-1 significantly improves kidney function, resolves diabetes-related kidney damage, and reduces endothelial cell activation and inflammation, suggesting that sFLT-1 can reduce the severity of DN by reducing glomerular inflammation and supporting cellular repair mechanisms.In chapter 4 we show that reducing endoglin levels diminished VEGF-A-induced endothelial activation by increasing pAkt and reducing pATF-2. These data suggest that targeting endoglin may have therapeutic value in patients who are at risk for developing DN.In chapter 5 we demonstrate that renal complement activation is associated with more severe classes of DN, reduced kidney function, and the presence of histological lesions.In chapter 6 we describe that transfecting APOC1-tg mice with sFlt-1 does not accelerate development of glomerulosclerosis, but lowered the number of glomerular macrophages. These data suggest that sFLT-1 treatment has an anti-inflammatory effect.Dutch Kidney Foundation; Chipsoft; Stichting Preventie Diabetes; Department of pathology, LUMCLUMC / Geneeskunde Repositoriu