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Transcription factors in the pathogenesis of diabetic nephropathy

Published online by Cambridge University Press:  28 April 2009

Amber Paratore Sanchez
Affiliation:
Division of Nephrology, University of California San Diego, La Jolla, CA 92093-0711, USA. Center for Renal Translational Medicine, University of California San Diego/VA Medical System, La Jolla, CA 92093-0711, USA.
Kumar Sharma*
Affiliation:
Division of Nephrology, University of California San Diego, La Jolla, CA 92093-0711, USA. Center for Renal Translational Medicine, University of California San Diego/VA Medical System, La Jolla, CA 92093-0711, USA.
*
*Corresponding author: Kumar Sharma, Center for Renal Translational Medicine, University of California San Diego/VA Medical System, 9500 Gilman Drive, MC 0711, La Jolla, CA 92093-0711, USA. Tel: +1 858 822 0870; Fax: +1 858 822 7483; E-mail: kusharma@ucsd.edu

Abstract

Approximately a third of patients with diabetes develop diabetic kidney disease, and diabetes is the leading cause of end-stage renal disease in most developed countries. Hyperglycaemia is known to activate genes that ultimately lead to extracellular matrix accumulation, the hallmark of diabetic nephropathy. Several transcription factors have been implicated in glucose-mediated expression of genes involved in diabetic nephropathy. This review focuses on the transcription factors upstream stimulatory factors 1 and 2 (USF1 and 2), activator protein 1 (AP-1), nuclear factor (NF)-κB, cAMP-response-element-binding protein (CREB), nuclear factor of activated T cells (NFAT), and stimulating protein 1 (Sp1). In response to high glucose, several of these transcription factors regulate the gene encoding the profibrotic cytokine transforming growth factor β, as well as genes for a range of other proteins implicated in inflammation and extracellular matrix turnover, including thrombospondin 1, the chemokine CCL2, osteopontin, fibronectin, decorin, plasminogen activator inhibitor 1 and aldose reductase. Identifying the molecular mechanisms by which diabetic nephropathy occurs has important clinical implications as therapies can then be tailored to target those at risk. Strategies to specifically target transcription factor activation and function may be employed to halt the progression of diabetic nephropathy.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2009

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Further reading, resources and contacts

The Animal Models of Diabetic Complications Consortium website is a useful resource for investigators in this field:

Brivanlou, A.H. and Darnell, J.E. Jr (2002) Signal transduction and the control of gene expression. Science 295, 813-818CrossRefGoogle ScholarPubMed
Brownlee, M. (2001) Biochemistry and molecular cell biology of diabetic complications. Nature 414, 813-820CrossRefGoogle ScholarPubMed
Zhu, Y., Usui, H.K. and Sharma, K. (2007) Regulation of transforming growth factor beta in diabetic nephropathy: implications for treatment. Seminars in Nephrology 27, 153-160CrossRefGoogle ScholarPubMed
Zhu, Y. et al. (2005) Role of upstream stimulatory factors in regulation of renal transforming growth factor-beta1. Diabetes 54, 1976-1984CrossRefGoogle ScholarPubMed
Brivanlou, A.H. and Darnell, J.E. Jr (2002) Signal transduction and the control of gene expression. Science 295, 813-818CrossRefGoogle ScholarPubMed
Brownlee, M. (2001) Biochemistry and molecular cell biology of diabetic complications. Nature 414, 813-820CrossRefGoogle ScholarPubMed
Zhu, Y., Usui, H.K. and Sharma, K. (2007) Regulation of transforming growth factor beta in diabetic nephropathy: implications for treatment. Seminars in Nephrology 27, 153-160CrossRefGoogle ScholarPubMed
Zhu, Y. et al. (2005) Role of upstream stimulatory factors in regulation of renal transforming growth factor-beta1. Diabetes 54, 1976-1984CrossRefGoogle ScholarPubMed