Higher urinary IgM excretion in type 2 diabetic nephropathy compared to type 1 diabetic nephropathy.
(2002) In Kidney International 61(1). p.203-208- Abstract
- BACKGROUND: Proteinuria, due to impairment of the charge- and/or size selectivity of the glomerular capillary wall (GCW) is the earliest clinical evidence of diabetic nephropathy (DN). To study the pathophysiological differences between patients with DN in type 1 diabetes mellitus (type 1 DN) and type 2 diabetes mellitus (type 2 DN), we compared the patterns of urinary proteins of different size and charge in the two entities of diabetic kidney disease. METHODS: Urine concentrations of albumin, IgG2, IgG4 and IgM were assessed in 22 (15 males and 7 females) patients with type 1 DN, and in 20 (18 males and 2 females) patients with type 2 DN. Comparisons with one control group of 13 (12 males and one female) patients with nephrosclerosis due... (More)
- BACKGROUND: Proteinuria, due to impairment of the charge- and/or size selectivity of the glomerular capillary wall (GCW) is the earliest clinical evidence of diabetic nephropathy (DN). To study the pathophysiological differences between patients with DN in type 1 diabetes mellitus (type 1 DN) and type 2 diabetes mellitus (type 2 DN), we compared the patterns of urinary proteins of different size and charge in the two entities of diabetic kidney disease. METHODS: Urine concentrations of albumin, IgG2, IgG4 and IgM were assessed in 22 (15 males and 7 females) patients with type 1 DN, and in 20 (18 males and 2 females) patients with type 2 DN. Comparisons with one control group of 13 (12 males and one female) patients with nephrosclerosis due to systemic hypertension and a second control group of 16 (14 males and 2 females) healthy controls were made. RESULTS: The urine excretion of IgG2 and IgM and the ratio of IgG2 to IgG4 (IgG2/IgG4), were significantly higher in type 2 DN compared to type 1 DN (P < 0.01). Patients with type 2 DN and patients with nephrosclerosis had significantly higher urine excretion of IgG and IgM compared to the age-matched healthy subjects (P < 0.001). The IgG2/IgG4 ratio was higher in type 2 DN compared to nephrosclerosis and healthy controls (P < 0.01). CONCLUSION: The increased urine excretion of IgG and IgM that accompanies albuminuria in type 2 DN suggests that the dominant pathophysiological mechanism of proteinuria in type 2 DN might be an alteration of the size selective properties of the glomerular capillary wall, including the occurrence of non-discriminatory "shunt pathways." The charge selective properties of the glomerular capillary wall seem to be intact in type 2 DN, as indicated by the high IgG2/IgG4 ratio. The mechanisms of proteinuria in type 1 DN seem to be merely a consequence of an impaired charge selectivity of the glomerular capillary wall. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/106740
- author
- Bakoush, Omran LU ; Tencer, Jan LU ; Tapia, Juan LU ; Rippe, Bengt LU and Torffvit, Ole LU
- organization
- publishing date
- 2002
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Diabetes Mellitus Non-Insulin-Dependent : immunology : urine, Adult, Comparative Study, Diabetes Mellitus Insulin-Dependent : immunology : urine, Immunoglobulin G : urine, Human, Female, Diabetic Nephropathies : immunology : urine, Male, Immunoglobulin M : urine, Support Non-U.S. Gov't, Middle Age
- in
- Kidney International
- volume
- 61
- issue
- 1
- pages
- 203 - 208
- publisher
- Nature Publishing Group
- external identifiers
-
- pmid:11786102
- wos:000172904900024
- scopus:0036145377
- ISSN
- 1523-1755
- DOI
- 10.1046/j.1523-1755.2002.00108.x
- language
- English
- LU publication?
- yes
- id
- 20cbdc77-161d-46b1-86db-8260c8fce8c6 (old id 106740)
- date added to LUP
- 2016-04-01 15:19:53
- date last changed
- 2024-01-10 13:50:57
@article{20cbdc77-161d-46b1-86db-8260c8fce8c6, abstract = {{BACKGROUND: Proteinuria, due to impairment of the charge- and/or size selectivity of the glomerular capillary wall (GCW) is the earliest clinical evidence of diabetic nephropathy (DN). To study the pathophysiological differences between patients with DN in type 1 diabetes mellitus (type 1 DN) and type 2 diabetes mellitus (type 2 DN), we compared the patterns of urinary proteins of different size and charge in the two entities of diabetic kidney disease. METHODS: Urine concentrations of albumin, IgG2, IgG4 and IgM were assessed in 22 (15 males and 7 females) patients with type 1 DN, and in 20 (18 males and 2 females) patients with type 2 DN. Comparisons with one control group of 13 (12 males and one female) patients with nephrosclerosis due to systemic hypertension and a second control group of 16 (14 males and 2 females) healthy controls were made. RESULTS: The urine excretion of IgG2 and IgM and the ratio of IgG2 to IgG4 (IgG2/IgG4), were significantly higher in type 2 DN compared to type 1 DN (P < 0.01). Patients with type 2 DN and patients with nephrosclerosis had significantly higher urine excretion of IgG and IgM compared to the age-matched healthy subjects (P < 0.001). The IgG2/IgG4 ratio was higher in type 2 DN compared to nephrosclerosis and healthy controls (P < 0.01). CONCLUSION: The increased urine excretion of IgG and IgM that accompanies albuminuria in type 2 DN suggests that the dominant pathophysiological mechanism of proteinuria in type 2 DN might be an alteration of the size selective properties of the glomerular capillary wall, including the occurrence of non-discriminatory "shunt pathways." The charge selective properties of the glomerular capillary wall seem to be intact in type 2 DN, as indicated by the high IgG2/IgG4 ratio. The mechanisms of proteinuria in type 1 DN seem to be merely a consequence of an impaired charge selectivity of the glomerular capillary wall.}}, author = {{Bakoush, Omran and Tencer, Jan and Tapia, Juan and Rippe, Bengt and Torffvit, Ole}}, issn = {{1523-1755}}, keywords = {{Diabetes Mellitus Non-Insulin-Dependent : immunology : urine; Adult; Comparative Study; Diabetes Mellitus Insulin-Dependent : immunology : urine; Immunoglobulin G : urine; Human; Female; Diabetic Nephropathies : immunology : urine; Male; Immunoglobulin M : urine; Support Non-U.S. Gov't; Middle Age}}, language = {{eng}}, number = {{1}}, pages = {{203--208}}, publisher = {{Nature Publishing Group}}, series = {{Kidney International}}, title = {{Higher urinary IgM excretion in type 2 diabetic nephropathy compared to type 1 diabetic nephropathy.}}, url = {{https://lup.lub.lu.se/search/files/4368941/623581.pdf}}, doi = {{10.1046/j.1523-1755.2002.00108.x}}, volume = {{61}}, year = {{2002}}, }