Plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus.

<h4>Objective</h4>To examine the association of bradykinin and related peptides with the development of diabetic nephropathy lesions in 243 participants with type 1 diabetes (T1D) from the Renin-Angiotensin System Study who, at baseline, were normoalbuminuric, normotensive and had normal...

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Main Authors: Kevin M Wheelock, Jian Cai, Helen C Looker, Michael L Merchant, Robert G Nelson, Gudeta D Fufaa, E Jennifer Weil, Harold I Feldman, Ramachandran S Vasan, Paul L Kimmel, Brad H Rovin, Michael Mauer, Jon B Klein, CKD Biomarkers Consortium
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0180964
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author Kevin M Wheelock
Jian Cai
Helen C Looker
Michael L Merchant
Robert G Nelson
Gudeta D Fufaa
E Jennifer Weil
Harold I Feldman
Ramachandran S Vasan
Paul L Kimmel
Brad H Rovin
Michael Mauer
Jon B Klein
CKD Biomarkers Consortium
author_facet Kevin M Wheelock
Jian Cai
Helen C Looker
Michael L Merchant
Robert G Nelson
Gudeta D Fufaa
E Jennifer Weil
Harold I Feldman
Ramachandran S Vasan
Paul L Kimmel
Brad H Rovin
Michael Mauer
Jon B Klein
CKD Biomarkers Consortium
author_sort Kevin M Wheelock
collection DOAJ
description <h4>Objective</h4>To examine the association of bradykinin and related peptides with the development of diabetic nephropathy lesions in 243 participants with type 1 diabetes (T1D) from the Renin-Angiotensin System Study who, at baseline, were normoalbuminuric, normotensive and had normal or increased glomerular filtration rate (GFR).<h4>Design</h4>Plasma concentrations of bradykinin and related peptides were measured at baseline by quantitative mass spectrometry. All participants were randomly assigned at baseline to receive placebo, enalapril or losartan during the 5 years between kidney biopsies. Kidney morphometric data were available from kidney biopsies at baseline and after 5 years. Relationships of peptides with changes in morphometric variables were assessed using multiple linear regression after adjustment for age, sex, diabetes duration, HbA1c, mean arterial pressure, treatment assignment and, for longitudinal analyses, baseline structure.<h4>Results</h4>Baseline median albumin excretion rate of study participants was 5.0 μg/min, and mean GFR was 128 mL/min/1.73 m2. After multivariable adjustment, higher plasma concentration of bradykinin (1-8) was associated with greater glomerular volume (partial r = 0.191, P = 0.019) and total filtration surface area (partial r = 0.211, P = 0.010), and higher bradykinin (1-7) and hyp3-bradykinin (1-7) were associated with lower cortical interstitial fractional volume (partial r = -0.189, P = 0.011; partial r = -0.164, P = 0.027 respectively). In longitudinal analyses, higher bradykinin was associated with preservation of surface density of the peripheral glomerular basement membrane (partial r = 0.162, P = 0.013), and for participants randomized to losartan, higher hyp3-bradykinin (1-8) was associated with more limited increase in cortical interstitial fractional volume (partial r = -0.291, P = 0.033).<h4>Conclusions</h4>Higher plasma bradykinin and related peptide concentrations measured before clinical onset of diabetic nephropathy in persons with T1D were associated with preservation of glomerular structures, suggesting that elevations of these kinin concentrations may reflect adaptive responses to early renal structural changes in diabetic nephropathy.
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spelling doaj.art-19eb20ea55884b679802c76a47f54cd12022-12-21T22:00:36ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01127e018096410.1371/journal.pone.0180964Plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus.Kevin M WheelockJian CaiHelen C LookerMichael L MerchantRobert G NelsonGudeta D FufaaE Jennifer WeilHarold I FeldmanRamachandran S VasanPaul L KimmelBrad H RovinMichael MauerJon B KleinCKD Biomarkers Consortium<h4>Objective</h4>To examine the association of bradykinin and related peptides with the development of diabetic nephropathy lesions in 243 participants with type 1 diabetes (T1D) from the Renin-Angiotensin System Study who, at baseline, were normoalbuminuric, normotensive and had normal or increased glomerular filtration rate (GFR).<h4>Design</h4>Plasma concentrations of bradykinin and related peptides were measured at baseline by quantitative mass spectrometry. All participants were randomly assigned at baseline to receive placebo, enalapril or losartan during the 5 years between kidney biopsies. Kidney morphometric data were available from kidney biopsies at baseline and after 5 years. Relationships of peptides with changes in morphometric variables were assessed using multiple linear regression after adjustment for age, sex, diabetes duration, HbA1c, mean arterial pressure, treatment assignment and, for longitudinal analyses, baseline structure.<h4>Results</h4>Baseline median albumin excretion rate of study participants was 5.0 μg/min, and mean GFR was 128 mL/min/1.73 m2. After multivariable adjustment, higher plasma concentration of bradykinin (1-8) was associated with greater glomerular volume (partial r = 0.191, P = 0.019) and total filtration surface area (partial r = 0.211, P = 0.010), and higher bradykinin (1-7) and hyp3-bradykinin (1-7) were associated with lower cortical interstitial fractional volume (partial r = -0.189, P = 0.011; partial r = -0.164, P = 0.027 respectively). In longitudinal analyses, higher bradykinin was associated with preservation of surface density of the peripheral glomerular basement membrane (partial r = 0.162, P = 0.013), and for participants randomized to losartan, higher hyp3-bradykinin (1-8) was associated with more limited increase in cortical interstitial fractional volume (partial r = -0.291, P = 0.033).<h4>Conclusions</h4>Higher plasma bradykinin and related peptide concentrations measured before clinical onset of diabetic nephropathy in persons with T1D were associated with preservation of glomerular structures, suggesting that elevations of these kinin concentrations may reflect adaptive responses to early renal structural changes in diabetic nephropathy.https://doi.org/10.1371/journal.pone.0180964
spellingShingle Kevin M Wheelock
Jian Cai
Helen C Looker
Michael L Merchant
Robert G Nelson
Gudeta D Fufaa
E Jennifer Weil
Harold I Feldman
Ramachandran S Vasan
Paul L Kimmel
Brad H Rovin
Michael Mauer
Jon B Klein
CKD Biomarkers Consortium
Plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus.
PLoS ONE
title Plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus.
title_full Plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus.
title_fullStr Plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus.
title_full_unstemmed Plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus.
title_short Plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus.
title_sort plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus
url https://doi.org/10.1371/journal.pone.0180964
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