This article comments on Varatharajan et al recent article,highlighting the role of tubulointerstitial damage mechanisms in diabetic nephropathy progression.Evidence suggests a bidirectional interaction between the in...This article comments on Varatharajan et al recent article,highlighting the role of tubulointerstitial damage mechanisms in diabetic nephropathy progression.Evidence suggests a bidirectional interaction between the interstitium,tubular cells,and glomeruli.Renal tubules are highly susceptible to proteinuria,metabolic disorders,and toxins.Since diabetic nephropathy persistently activates inflammatory and fibrotic pathways,epithelial-to-mesenchymal transition mechanisms present promising targets for risk assessment.Periostin,a cellular matrix protein,plays a key role in modulating extracellular interactions.Increased periostin expression in tissue,serum,and urine correlates with type 2 diabetes,making it a valuable biomarker alongside neutrophil gelatinase-associated lipocalin and kidney injury molecule-1.While periostin and neutrophil gelatinase-associated lipocalin reflect distal tubular damage,kidney injury molecule-1 serves as a marker for proximal tubular injury.Combining these biomarkers enhances diagnostic precision.展开更多
文摘This article comments on Varatharajan et al recent article,highlighting the role of tubulointerstitial damage mechanisms in diabetic nephropathy progression.Evidence suggests a bidirectional interaction between the interstitium,tubular cells,and glomeruli.Renal tubules are highly susceptible to proteinuria,metabolic disorders,and toxins.Since diabetic nephropathy persistently activates inflammatory and fibrotic pathways,epithelial-to-mesenchymal transition mechanisms present promising targets for risk assessment.Periostin,a cellular matrix protein,plays a key role in modulating extracellular interactions.Increased periostin expression in tissue,serum,and urine correlates with type 2 diabetes,making it a valuable biomarker alongside neutrophil gelatinase-associated lipocalin and kidney injury molecule-1.While periostin and neutrophil gelatinase-associated lipocalin reflect distal tubular damage,kidney injury molecule-1 serves as a marker for proximal tubular injury.Combining these biomarkers enhances diagnostic precision.
