4.4 Article

Methylation pattern of urinary DNA as a marker of kidney function decline in diabetes

Journal

BMJ OPEN DIABETES RESEARCH & CARE
Volume 8, Issue 1, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bmjdrc-2020-001501

Keywords

diabetes complications; kidney diseases; renal insufficiency; chronic; urinalysis

Funding

  1. AMED-CREST
  2. Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus [JP18ek0210093]
  3. Translational Research program
  4. Strategic PRomotion for practical application of INnovative medical Technology, TR-SPRINT from Japan Agency for Medical Research and Development, AMED
  5. JSPS KAKENHI [25461230, 15H05788, 16K15466, 18K19533, 20K08627]
  6. Kidney Foundation, Japan [JFKB19-16]
  7. Okinaka Memorial Institute for Medical Research
  8. Grants-in-Aid for Scientific Research [16K15466, 18K19533, 15H05788, 25461230, 20K08627] Funding Source: KAKEN

Ask authors/readers for more resources

Introduction Renal tubular injury contributes to the decline in kidney function in patients with diabetes. Cell type-specific DNA methylation patterns have been used to calculate proportions of particular cell types. In this study, we developed a method to detect renal tubular injury in patients with diabetes by detecting exfoliated tubular cells shed into the urine based on tubular cell-specific DNA methylation patterns. Research design and methods We identified DNA methylation patterns specific for human renal proximal tubular cells through compartment-specific methylome analysis. We next determined the methylation levels of proximal tubule-specific loci in urine sediment of patients with diabetes and analyzed correlation with clinical variables. Results We identified genomic loci in SMTNL2 and G6PC to be selectively unmethylated in human proximal tubular cells. The methylation levels of SMTNL2 and G6PC in urine sediment, deemed to reflect the proportion of exfoliated proximal tubular cells due to injury, correlated well with each other. Methylation levels of SMTNL2 in urine sediment significantly correlated with the annual decline in estimated glomerular filtration rate. Moreover, addition of urinary SMTNL2 methylation to a model containing known risk factors significantly improved discrimination of patients with diabetes with faster estimated glomerular filtration rate decline. Conclusions This study demonstrates that patients with diabetes with continual loss in kidney function may be stratified by a specific DNA methylation signature through epigenetic urinalysis and provides further evidence at the level of exfoliated cells in the urine that injury of proximal tubular cells may contribute to pathogenesis of diabetic kidney disease.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.4
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

Article Biochemistry & Molecular Biology

Dialysis-related amyloidosis associated with a novel β2-microglobulin variant

Hiroki Mizuno, Junichi Hoshino, Masatomo So, Yuta Kogure, Takeshi Fujii, Yoshifumi Ubara, Kenmei Takaichi, Tetsuko Nakaniwa, Hideaki Tanaka, Genji Kurisu, Fuyuki Kametani, Mayuko Nakagawa, Tsuneaki Yoshinaga, Yoshiki Sekijima, Keiichi Higuchi, Yuji Goto, Masahide Yazaki

Summary: This study reported a rare case of DRA in a 41-year-old hemodialysis patient with a beta(2)-microglobulin variant (V27M) showing strong amyloidogenic propensity. The findings highlight the unique clinical manifestations and pathomechanical features of this variant compared to previously reported cases.

AMYLOID-JOURNAL OF PROTEIN FOLDING DISORDERS (2021)

Review Urology & Nephrology

Kidney and epigenetic mechanisms of salt-sensitive hypertension

Wakako Kawarazaki, Toshiro Fujita

Summary: This review discusses the impact of adverse environmental factors such as prenatal malnutrition, obesity, and aging on salt-sensitive hypertension, as well as the underlying mechanisms. Kidney mechanisms and aberrant DNA methylation of certain genes play crucial roles in the development of this condition.

NATURE REVIEWS NEPHROLOGY (2021)

Article Urology & Nephrology

A case of thrombotic microangiopathy associated with polymyositis

Makoto Fukuda, Hiroki Mizuno, Rikako Hiramatsu, Akinari Sekine, Masahiro Kawada, Eiko Hasegawa, Masayuki Yamanouchi, Tatsuya Suwabe, Junichi Hoshino, Naoki Sawa, Kenmei Takaichi, Keiichi Kinowaki, Kenichi Ohashi, Takeshi Fujii, Motoaki Miyazono, Yoshifumi Ubara

Summary: A 60-year-old Japanese woman with polymyositis developed hemolytic anemia, thrombocytopenia, and acute kidney injury after starting steroid therapy, leading to a diagnosis of hemolytic uremic syndrome with thrombotic microangiopathy. Despite hemodialysis and plasma exchange treatment, the patient passed away due to hemorrhagic respiratory failure. Renal involvement by polymyositis is rare, but clinicians should be aware of the potential serious renal complications such as HUS/TMA.

CLINICAL NEPHROLOGY (2021)

Article Medicine, General & Internal

Renal Squamous Cell Carcinoma-related Polymyositis in a Patient with Autosomal Dominant Polycystic Kidney Disease

Kanako Terakawa, Naoki Sawa, Hiroki Mizuno, Akinari Sekine, Noriko Hayami, Daisuke Ikuma, Masahiro Kawada, Rikako Hiramatsu, Keiichi Sumida, Masayuki Yamanouchi, Eiko Hasegawa, Tatsuya Suwabe, Junichi Hoshino, Keiichi Kinowaki, Kenichi Ohashi, Takeshi Fujii, Yoshifumi Ubara

Summary: This case demonstrates a close relationship between the occurrence of squamous cell carcinoma and the development of polymyositis in a patient with ADPKD. Diagnostic imaging showed an 8 cm mass lesion and a renal stone in the right kidney.

INTERNAL MEDICINE (2021)

Article Medicine, General & Internal

Fabry Disease on Peritoneal Dialysis with Cardiac Involvement

Sayako Koga-Kobori, Naoki Sawa, Ryo Kido, Akinari Sekine, Hiroki Mizuno, Masayuki Yamanouchi, Noriko Hayami, Tatsuya Suwabe, Junichi Hoshino, Keiichi Kinowaki, Kenichi Ohashi, Takeshi Fujii, Yoshifumi Ubara

Summary: Fabry disease is a genetic disorder caused by a lack of alpha-galactosidase A activity in lysosomes, leading to multi-organ involvement. Cardiac involvement is a key factor in prognosis, and peritoneal dialysis is the preferred treatment for long-term management.

INTERNAL MEDICINE (2021)

Review Biochemistry & Molecular Biology

Role of Rho in Salt-Sensitive Hypertension

Wakako Kawarazaki, Toshiro Fujita

Summary: High salt intake can result in increased blood pressure, especially in individuals with impaired renal sodium excretion, leading to salt-sensitive hypertension. Activation of Rho in the central nervous system and vascular smooth muscle cells plays a crucial role in this process, contributing to increased vascular resistance and tone, ultimately impacting blood pressure control.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2021)

Article Peripheral Vascular Disease

Activation of Rac1-Mineralocorticoid Receptor Pathway Contributes to Renal Injury in Salt-Loaded db/db Mice

Daigoro Hirohama, Mitsuhiro Nishimoto, Nobuhiro Ayuzawa, Wakako Kawarazaki, Wataru Fujii, Shigeyoshi Oba, Shigeru Shibata, Takeshi Marumo, Toshiro Fujita

Summary: The study revealed that the activation of the Rac1-MR pathway contributes to the progression of DKD by causing hypertension and podocyte injury, highlighting MR antagonism and Rac1 inhibition as a novel strategy for DKD treatment.

HYPERTENSION (2021)

Article Urology & Nephrology

Development of osmotic vacuolization of proximal tubular epithelial cells following treatment with sodium-glucose transport protein 2 inhibitors in type II diabetes mellitus patients-3 case reports

Shun Watanabe, Naoki Sawa, Hiroki Mizuno, Masayuki Yamanouchi, Tatsuya Suwabe, Junichi Hoshino, Keiichi Kinowaki, Kenichi Ohashi, Takeshi Fujii, Yutaka Yamaguchi, Yoshifumi Ubara

Summary: Three cases of acute kidney injury were observed after treatment with a SGLT2 inhibitor, showing osmotic vacuolization in tubules and positive staining for CD138 and CD10 indicating proximal tubules. Patients who are obese and have a body mass index over 30 are at higher risk for AKI due to overdose of sugar in urine and dehydration caused by SGLT2 inhibitor treatment, especially in individuals with type II diabetes mellitus.

CEN CASE REPORTS (2021)

Article Medicine, Research & Experimental

Idiopathic retroperitoneal fibrosis mimicking infiltrative malignancy: a case report

Miho Akabane, Shusuke Haruta, Takeshi Fujii, Masayuki Urabe, Yu Ohkura, Masaki Ueno, Harushi Udagawa

Summary: The treatment strategy for idiopathic retroperitoneal mass is still unclear, while distinguishing between benign and malignant is challenging. This report presents a case of idiopathic retroperitoneal fibrosis that mimicked malignancy, in which partial resection of the mass was performed, and the final pathological findings revealed non-tumorous tissue. The patient had a good postoperative course and remained free of recurrence after 8 years.

JOURNAL OF INTERNATIONAL MEDICAL RESEARCH (2022)

Editorial Material Urology & Nephrology

From mapping kidney function to mechanism and prediction

Daigoro Hirohama, Katalin Susztak

Summary: In 2021, significant progress was made in understanding the genetics of kidney function and disease, with key advances in genome-wide association studies and multi-omics methods identifying key genes and cell types involved in disease development.

NATURE REVIEWS NEPHROLOGY (2022)

Review Peripheral Vascular Disease

Clinical effect of nonsteroidal mineralocorticoid receptor (MR) antagonists in the treatment of diabetic kidney disease: expectations as a new therapeutic strategy

Atsuhisa Sato, Mitsuhiro Nishimoto

Summary: This article summarizes the latest evidence on the use of nonsteroidal MR antagonists in the treatment of diabetic kidney disease (DKD). It highlights the effectiveness of MR antagonists and suggests measures for managing hyperkalemia. The study emphasizes the importance of continuous use of MR antagonists in DKD treatment.

HYPERTENSION RESEARCH (2022)

Article Urology & Nephrology

Unbiased Human Kidney Tissue Proteomics Identifies Matrix Metalloproteinase 7 as a Kidney Disease Biomarker

Daigoro Hirohama, Amin Abedini, Salina Moon, Aditya Surapaneni, Simon T. Dillon, Allison Vassalotti, Hongbo Liu, Tomohito Doke, Victor Martinez, Zaipul Md Dom, Anil Karihaloo, Matthew B. Palmer, Josef Coresh, Morgan E. Grams, Monika A. Niewczas, Katalin Susztak

Summary: In this study, unbiased proteomics analysis was performed to identify diagnostic markers for kidney fibrosis and future kidney function decline in patients with diabetic kidney disease (DKD). It was found that matrix metalloprotease 7 (MMP7) is significantly associated with both fibrosis in renal tissue and decline in kidney function. Additionally, plasma levels of MMP7 were found to correlate with future kidney function decline.

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2023)

Article Cardiac & Cardiovascular Systems

Outcomes of Video-Assisted Thoracic Surgical Lung Biopsy for Interstitial Lung Diseases

Masaaki Nagano, Atsushi Miyamoto, Shinichiro Kikunaga, Souichiro Suzuki, Hisashi Takaya, Takeshi Fujii, Sakashi Fujimori

Summary: Surgical lung biopsy is a safe approach for interstitial lung disease, and an accurate diagnosis of idiopathic pulmonary fibrosis through SLB can aid in appropriate patient management.

ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY (2021)

No Data Available