Research Description
Urine is easily obtained without any invasive procedures, it is a high yield fluid and its composition reflects the activity of the kidney. Therefore, urine has all the requisites to provide precious information about kidney health. The practice to analyze urine has dramatically improved with new technological discoveries and the use of modern tools revealed its extraordinary complexity. Scientists have recently identified in urine specialized particles released by all the cells forming the kidney. These particles are 10,000 smaller than a millimeter or 1/32 of an inch (nano-particle) in size and they contain molecules specific to the cell of origin. The analysis of such structures can precisely determine what type of cell in the kidney release them into the forming urine and they can be used to identify signs of cell injury. Diabetic kidney disease (DKD) is one of the major complications of diabetes. It is silent at an early stage and when it manifests with symptoms it is already too late because organ damage has already happened. The aim of this proposal is to use 132 urine samples collected from participants enrolled in the Simultaneous Risk Factor Control Using Telehealth to slow Progression of DKD Trial (STOP-DKD). The analysis of urinary nanoparticles with state-of-the-art instruments will help in the identification of different types of DKDs injuries, to be able to monitor the kidney function of each individual in the clinic, and treat patients with tailored pharmacological therapy to successfully manage diabetes and prevent its complications.Research Profile
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?This grant will analyze novel biomarkers of kidney damage in patients with diabetes. These markers are called extracellular vesicles and are submicron blebs released from various kidney cells into the urine. We will detect markers from different parts (glomeruli/filter and tubular system) of the kidney in urine of a large patient group with known early onset diabetic kidney disease. We will associate the novel biomarkers with clinical information from the patients. This proposal will help to optimize diagnosis of different forms of diabetic kidney disease and hopefully will lead to more personalization and targeted drug therapy in the future. A second outcome of this study is to test also a customized-capture microchip to identify these markers in these small blebs/vesicles using small volumes of urine which can open up new investigations of other existing biobanks of diabetic kidney disease.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?This project will help to describe the different forms of diabetic kidney disease in a safe and easy way by developing novel biomarkers from urine. These novel markers are capable to describe the damage caused by diabetes to different parts of the kidney. Therefore, these markers can potentially help to better strategize treatment according to location of the damage. Currently only an invasive procedure like a kidney biopsy can pinpoint the sites of damage in the diabetic kidney.
Why important for you, personally, to become involved in diabetes research? What role will this award play?As a kidney doctor I like to slow down and even prevent any kidney damage caused by diabetes. Diabetes is the number one reason that people have failed kidneys and need to start dialysis. I like to prevent this and optimize and personalize treatment for my patients with diabetes. During the recent years more and more novel treatments for diabetic kidney disease are available, but we still need to understand which combination of drugs is the best for individual patients.
In what direction do you see the future of diabetes research going?We are currently experiencing an exciting era of novel diabetic treatment options which will change the way we have treated patients. However, there are still many open clinical questions, in particular in regards to which drugs are the best option for the individual patients so that patients can be treated without extra risk or insufficiently. We need to continue to understand mechanism of diabetic complications, in particular microvascular and macrovascular ones, and need to better describe diabetic disease phenotypes so that we can optimize treatment and avoid development of complications or at least slow down progression of complications. As a kidney doctor I like to better early detect diabetic kidney disease, develop prognostic markers and slow down disease progression of the kidney so that people do not need to be started on dialysis.