Limits...
Periostin as a tissue and urinary biomarker of renal injury in type 2 diabetes mellitus.

Satirapoj B, Tassanasorn S, Charoenpitakchai M, Supasyndh O - PLoS ONE (2015)

Bottom Line: Improving the early detection of diabetic nephropathy remains a great challenge in disease management.Urine samples were obtained from 30 healthy volunteers and 328 type 2 diabetic patients with normoalbuminuria (n=114), microalbuminuria (n=100) and macroalbuminuria (n=114).The excretion levels of urinary periostin were quantified with enzyme-linked immunosorbent assay.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.

ABSTRACT

Background: Improving the early detection of diabetic nephropathy remains a great challenge in disease management. Periostin is a marker of renal tubular injury and related to progressive kidney injury in animal models of chronic kidney disease. The clinical implications of urinary periostin activities in patients with type 2 diabetes have not been evaluated.

Methods: Urine samples were obtained from 30 healthy volunteers and 328 type 2 diabetic patients with normoalbuminuria (n=114), microalbuminuria (n=100) and macroalbuminuria (n=114). The excretion levels of urinary periostin were quantified with enzyme-linked immunosorbent assay. Immunohistochemical periostin expression was determined in kidney tissues from overt diabetic nephropathy.

Results: Increased periostin expression in glomeruli and tubular epithelium in diabetic renal pathology was observed. Urinary periostin levels were significantly elevated in the patients of the normoalbuminuria [3.06 (IQR: 1.12, 6.77) ng/mgCr], microalbuminuria [8.71 (IQR: 5.09, 19.29) ng/mgCr] and macroalbuminuria [13.58 (IQR: 3.99, 16.19) ng/mgCr] compared with healthy controls [1.15 (IQR: 0.60, 1.63) ng/mgCr] (P<0.01).Increased urine periostin level significantly correlated with aging, high albuminuria and decline of GFR. Urine periostin ELISA also demonstrated high performance for the diagnosis of established normoalbuminuric, microalbuminuric and macroalbuminuric type 2 diabetes (AUC 0.78 (95%CI, 0.71 to 0.86), 0.99 (95%CI, 0.98 to 1.00) and 0.95 (95%CI, 0.91 to 0.98), respectively).

Conclusion: The study indicates that increased urine periostin levels can be detected in patients with type 2 diabetes before the onset of significant albuminuria. Urinary periostin is an associated renal derangement in patients with established diabetic nephropathy and it may be used as an early marker of diabetic renal injury.

No MeSH data available.


Related in: MedlinePlus

Renal periostin immunostaining in patients with diabetic nephropathy.Tissue sections were immunostained with a polyclonal rabbit anti-periostin antibody. Positive staining for periostin protein is shown in brown. All sections were counterstained with hematoxylin. Kidney tissues from patients with diabetic nephropathy display nodular glomerulosclerosis with arteriolar hyalinosis, interstitial fibrosis and tubular atrophy (A, B) and display diffuse periostin immunopositivity in glomerular and tubular compartments (C). Periostin staining was observed in the nodular sclerosis glomerulus with periglomerular and mesangial areas and also periostin staining in both atrophic and non-atrophic tubular epithelium (D). Periostin staining was found in the area of periglomerular fibrosis and collagen forming Bowman’s capsule within the ischemic type-change glomerulus (E). Global glomerulosclerosis showed periglomerular staining with periostin immunohistochemistry (F) (Original magnification: 400×).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4401767&req=5

pone.0124055.g001: Renal periostin immunostaining in patients with diabetic nephropathy.Tissue sections were immunostained with a polyclonal rabbit anti-periostin antibody. Positive staining for periostin protein is shown in brown. All sections were counterstained with hematoxylin. Kidney tissues from patients with diabetic nephropathy display nodular glomerulosclerosis with arteriolar hyalinosis, interstitial fibrosis and tubular atrophy (A, B) and display diffuse periostin immunopositivity in glomerular and tubular compartments (C). Periostin staining was observed in the nodular sclerosis glomerulus with periglomerular and mesangial areas and also periostin staining in both atrophic and non-atrophic tubular epithelium (D). Periostin staining was found in the area of periglomerular fibrosis and collagen forming Bowman’s capsule within the ischemic type-change glomerulus (E). Global glomerulosclerosis showed periglomerular staining with periostin immunohistochemistry (F) (Original magnification: 400×).

Mentions: Several kidney tissues from type 2 diabetic patients and controls were randomly collected for periostin immunostaining. Representative images of periostin immunostaining in patients with advanced diabetic nephropathy are shown in Fig 1. Representative sections of kidneys in the diabetic patients showed nodular glomerulosclerosis with arteriolar hyalinosis, interstitial fibrosis and tubular atrophy. In addition, they showed diffuse periostin immunopositivity in nodular sclerosis glomerulus and areas of periglomerular fibrosis and collagen forming Bowman’s capsule within the ischemic type-change glomerulus. Periostin also presented tubular cytoplasmic staining at both atrophic and nonatrophic tubular epithelium. In contrast, periostin was not detected in cortical control kidneys. Therefore, immunohistochemical analysis confirmed that increased periostin expression in pathologic glomeruli and tubules was observed after established diagnosis of diabetic nephropathy.


Periostin as a tissue and urinary biomarker of renal injury in type 2 diabetes mellitus.

Satirapoj B, Tassanasorn S, Charoenpitakchai M, Supasyndh O - PLoS ONE (2015)

Renal periostin immunostaining in patients with diabetic nephropathy.Tissue sections were immunostained with a polyclonal rabbit anti-periostin antibody. Positive staining for periostin protein is shown in brown. All sections were counterstained with hematoxylin. Kidney tissues from patients with diabetic nephropathy display nodular glomerulosclerosis with arteriolar hyalinosis, interstitial fibrosis and tubular atrophy (A, B) and display diffuse periostin immunopositivity in glomerular and tubular compartments (C). Periostin staining was observed in the nodular sclerosis glomerulus with periglomerular and mesangial areas and also periostin staining in both atrophic and non-atrophic tubular epithelium (D). Periostin staining was found in the area of periglomerular fibrosis and collagen forming Bowman’s capsule within the ischemic type-change glomerulus (E). Global glomerulosclerosis showed periglomerular staining with periostin immunohistochemistry (F) (Original magnification: 400×).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401767&req=5

pone.0124055.g001: Renal periostin immunostaining in patients with diabetic nephropathy.Tissue sections were immunostained with a polyclonal rabbit anti-periostin antibody. Positive staining for periostin protein is shown in brown. All sections were counterstained with hematoxylin. Kidney tissues from patients with diabetic nephropathy display nodular glomerulosclerosis with arteriolar hyalinosis, interstitial fibrosis and tubular atrophy (A, B) and display diffuse periostin immunopositivity in glomerular and tubular compartments (C). Periostin staining was observed in the nodular sclerosis glomerulus with periglomerular and mesangial areas and also periostin staining in both atrophic and non-atrophic tubular epithelium (D). Periostin staining was found in the area of periglomerular fibrosis and collagen forming Bowman’s capsule within the ischemic type-change glomerulus (E). Global glomerulosclerosis showed periglomerular staining with periostin immunohistochemistry (F) (Original magnification: 400×).
Mentions: Several kidney tissues from type 2 diabetic patients and controls were randomly collected for periostin immunostaining. Representative images of periostin immunostaining in patients with advanced diabetic nephropathy are shown in Fig 1. Representative sections of kidneys in the diabetic patients showed nodular glomerulosclerosis with arteriolar hyalinosis, interstitial fibrosis and tubular atrophy. In addition, they showed diffuse periostin immunopositivity in nodular sclerosis glomerulus and areas of periglomerular fibrosis and collagen forming Bowman’s capsule within the ischemic type-change glomerulus. Periostin also presented tubular cytoplasmic staining at both atrophic and nonatrophic tubular epithelium. In contrast, periostin was not detected in cortical control kidneys. Therefore, immunohistochemical analysis confirmed that increased periostin expression in pathologic glomeruli and tubules was observed after established diagnosis of diabetic nephropathy.

Bottom Line: Improving the early detection of diabetic nephropathy remains a great challenge in disease management.Urine samples were obtained from 30 healthy volunteers and 328 type 2 diabetic patients with normoalbuminuria (n=114), microalbuminuria (n=100) and macroalbuminuria (n=114).The excretion levels of urinary periostin were quantified with enzyme-linked immunosorbent assay.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.

ABSTRACT

Background: Improving the early detection of diabetic nephropathy remains a great challenge in disease management. Periostin is a marker of renal tubular injury and related to progressive kidney injury in animal models of chronic kidney disease. The clinical implications of urinary periostin activities in patients with type 2 diabetes have not been evaluated.

Methods: Urine samples were obtained from 30 healthy volunteers and 328 type 2 diabetic patients with normoalbuminuria (n=114), microalbuminuria (n=100) and macroalbuminuria (n=114). The excretion levels of urinary periostin were quantified with enzyme-linked immunosorbent assay. Immunohistochemical periostin expression was determined in kidney tissues from overt diabetic nephropathy.

Results: Increased periostin expression in glomeruli and tubular epithelium in diabetic renal pathology was observed. Urinary periostin levels were significantly elevated in the patients of the normoalbuminuria [3.06 (IQR: 1.12, 6.77) ng/mgCr], microalbuminuria [8.71 (IQR: 5.09, 19.29) ng/mgCr] and macroalbuminuria [13.58 (IQR: 3.99, 16.19) ng/mgCr] compared with healthy controls [1.15 (IQR: 0.60, 1.63) ng/mgCr] (P<0.01).Increased urine periostin level significantly correlated with aging, high albuminuria and decline of GFR. Urine periostin ELISA also demonstrated high performance for the diagnosis of established normoalbuminuric, microalbuminuric and macroalbuminuric type 2 diabetes (AUC 0.78 (95%CI, 0.71 to 0.86), 0.99 (95%CI, 0.98 to 1.00) and 0.95 (95%CI, 0.91 to 0.98), respectively).

Conclusion: The study indicates that increased urine periostin levels can be detected in patients with type 2 diabetes before the onset of significant albuminuria. Urinary periostin is an associated renal derangement in patients with established diabetic nephropathy and it may be used as an early marker of diabetic renal injury.

No MeSH data available.


Related in: MedlinePlus