Type 1 Diabetes Increases the Expression of Proinflammatory Cytokines and Adhesion Molecules in the Artery Wall of Candidate Patients for Kidney Transplantation
- Javier Triñanes, MSC1,
- Eduardo Salido, MD, PHD1,
- Julián Fernández, MD, PHD2,
- Margarita Rufino, MD, PHD3,
- José Manuel González-Posada, MD, PHD3,
- Armando Torres, MD, PHD3 and
- Domingo Hernández, MD, PHD4⇓
- 1Research Unit, University Hospital of the Canary Islands, Tenerife, Spain
- 2Radiology Department, University Hospital of the Canary Islands, Tenerife, Spain
- 3Nephrology Department, University Hospital of the Canary Islands, Tenerife, Spain
- 4Nephrology Department, University Hospital Carlos Haya, Málaga, Spain
- Corresponding author: Domingo Hernández, domingohernandez{at}gmail.com.
Abstract
OBJECTIVE Diabetes may accelerate atheromatosis in uremic patients. Our aim was to assess the influence of type 1 diabetes on the atheromatosis-related inflammation in patients with chronic kidney disease (CKD).
RESEARCH DESIGN AND METHODS We analyzed the expression of proinflammatory cytokines and adhesion molecules in the inferior epigastric artery walls of type 1 diabetic patients with CKD (n = 22) and compared it with nondiabetic uremic patients (n = 92) at the time of kidney transplantation. We evaluated the expression of interleukin (IL)-6, monocyte chemotractant protein (MCP)-1, vascular cell adhesion molecule (VCAM)-1, intercellular adhesion molecule-1, and the activation of nuclear factor-κβ p65 (NFkB-p65). Common carotid intima-media thickness (c-IMT) was determined by conventional echography.
RESULTS IL-6, MCP-1, and VCAM-1 proteins were elevated in type 1 diabetic patients compared with nondiabetic subjects (P < 0.05). The nuclear localization of NFkB-p65 was higher in type 1 diabetic patients (P < 0.01) and correlated with the levels of MCP-1 in this group (r = 0.726, P < 0.001). Arterial fibrosis correlated with IL-6 and MCP-1 levels (r = 0.411, P < 0.001 and r = 0.378, P = 0.001). A significant correlation was observed between VCAM-1 levels and both the degree of arterial narrowing and c-IMT.
CONCLUSIONS Type 1 diabetes produces a proinflammatory state in the arteries of end-stage CKD patients, with increased levels of IL-6, MCP-1, and VCAM-1, as well as a greater degree of p65 activation, which are associated with more severe vascular lesions and higher c-IMT. Although causality is not demonstrated, these findings support the major role of inflammation in type 1 diabetic patients with CKD.
Footnotes
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This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc11-1665/-/DC1.
- Received August 29, 2011.
- Accepted November 8, 2011.
- © 2012 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
