Pathophysiology of glomerular and tubulointerstitial kidney diseases: proteomic approach

Introduction: Kidney diseases are the biggest health problem nowadays. Endemic nephropathy (EN) is a chronic tubulointerstitial kidney disease, undetectable at the beginning and with slow development to terminal renal failure. The real cause of the disease is still not known. Although the importance of inheritance is underlined, the effects of environmental factors (aristolochic acid, a mycotoxin) and the presence of disorders of the immune system are more likely to be involved in disease pathway. Aim: We aimed to establish qualitative and quantitative differences of proteins in urine of patients with the endemic nephropathy, diabetic nephropathy, acute prerenal kidney injury, and their importance in the diagnostics. The acute and chronic effects of aristolochic acid 1 and ochratoxin A on tubulocytes are important for establishing the mechanisms of kidney damage and the potential biomarkers. Methods: Proteomic technology was used, and the results were confirmed by Western blot, dot blot, immunofluoroscence and immunohistochemisry analyses of cells and tissue samples. Importance: The use of proteomic technologies of urine proteins in patients and healthy controls gives a new data for the identification of diagnostic and prognostic markers of kidney damage. This study shows the presence of significant differences in the proteins of the respondents, which can be used as diagnostic and differential diagnostic parameters. Study of toxic effects of aristolochic acid 1 and ochratoxin A permited a better understanding of the mechanisms of kidney disease, but first of all, a better expanation of molecular pathway in the initiation and during development of endemic nephropathy and associated urothelial cancer