Anti-inflammatory effects of C-peptide on kidney of type 1 diabetes mellitus animal model.

Type 1 diabetes mellitus (T1DM) is characterized by C-peptide deficiency and elevated levels of pro-inflammatory cytokines. The aim of this study was to investigate the role of C-peptide in renal and inflammatory complications in streptozotocin (STZ)-diabetic mice model of T1DM with kidney disease. The study was performed in 8-week old male C57BL/6 mice. Two streptozotocin-diabetic groups (a T1DM animal model), after 4 weeks of diabetes, were treated with subcutaneous infusion of either vehicle (n = 12) or C-peptide (n = 11). Two non-diabetic groups (vehicle, n = 10; C-peptide, n = 9) were treated using the same protocol as described for the diabetic mice. The treatment with C-peptide in the diabetic group reduced the urinary levels of IL17 and TNFα, as well as IL4 and IL10 (p < 0.05). Contrary, the diabetic + C-peptide group presented higher IL10 gene expression in kidney. Besides, it displayed a reduction of TNFα gene expression. The data suggest that C-peptide may modulate pro- and anti-inflammatory signalling pathways, resulting in attenuation of kidney inflammation in T1DM animal model.

Sickle cell disease nephropathy: an update on risk factors and potential biomarkers in pediatric patients.

One of the major chronic complications of sickle cell disease (SCD) is sickle cell nephropathy. The aim of this review is to discuss the pathophysiology, natural history, clinical manifestations, risk factors, biomarkers and therapeutic approaches for sickle cell nephropathy, focusing on studies with pediatric patients. The earliest manifestation of renal disease is an increase in the glomerular filtration rate. A finding that may also be observed in early childhood is microalbuminuria. Nephrin, KIM-1, VGFs, chemokines and renin-angiotensin system molecules have emerged as potential early markers of renal dysfunction in SCD. In regards to a therapeutic approach, renin-angiotensin system inhibitors and angiotensin receptor blockers seem to be effective for the control of albuminuria in adults with SCD, although new studies in children are needed. The precise moment to begin renoprotection in SCD patients who should be treated remains to be determined.