Role of TGF-alpha in the progression of diabetic kidney disease

Am J Physiol Renal Physiol. 2017 Jun 1;312(6):F951-F962. doi: 10.1152/ajprenal.00443.2016. Epub 2017 Mar 1.

Abstract

Transforming growth factor-alpha (TGFA) has been shown to play a role in experimental chronic kidney disease associated with nephron reduction, while its role in diabetic kidney disease (DKD) is unknown. We show here that intrarenal TGFA mRNA expression, as well as urine and serum TGFA, are increased in human DKD. We used a TGFA neutralizing antibody to determine the role of TGFA in two models of renal disease, the remnant surgical reduction model and the uninephrectomized (uniNx) db/db DKD model. In addition, the contribution of TGFA to DKD progression was examined using an adeno-associated virus approach to increase circulating TGFA in experimental DKD. In vivo blockade of TGFA attenuated kidney disease progression in both nondiabetic 129S6 nephron reduction and Type 2 diabetic uniNx db/db models, whereas overexpression of TGFA in uniNx db/db model accelerated renal disease. Therapeutic activity of the TGFA antibody was enhanced with renin angiotensin system inhibition with further improvement in renal parameters. These findings suggest a pathologic contribution of TGFA in DKD and support the possibility that therapeutic administration of neutralizing antibodies could provide a novel treatment for the disease.

Keywords: TGFa; diabetic kidney disease.

MeSH terms

  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / pharmacology
  • Animals
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Neutralizing / pharmacology
  • Blood Pressure
  • Cells, Cultured
  • Dependovirus / genetics
  • Diabetes Mellitus, Type 2 / complications
  • Diabetic Nephropathies / drug therapy
  • Diabetic Nephropathies / genetics
  • Diabetic Nephropathies / metabolism*
  • Diabetic Nephropathies / physiopathology
  • Disease Models, Animal
  • Disease Progression
  • ErbB Receptors / metabolism
  • Extracellular Matrix / metabolism
  • Female
  • Gene Transfer Techniques
  • Genetic Vectors
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / complications
  • Hypertension / physiopathology
  • Kidney / drug effects
  • Kidney / metabolism*
  • Kidney / physiopathology
  • Kidney / surgery
  • Male
  • Mice, 129 Strain
  • Mice, Knockout
  • Middle Aged
  • Nephrectomy
  • Phosphorylation
  • Renin-Angiotensin System
  • Signal Transduction
  • Time Factors
  • Transforming Growth Factor alpha / antagonists & inhibitors
  • Transforming Growth Factor alpha / deficiency
  • Transforming Growth Factor alpha / genetics
  • Transforming Growth Factor alpha / metabolism*

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Neutralizing
  • Transforming Growth Factor alpha
  • EGFR protein, mouse
  • ErbB Receptors