Previous in vitro studies suggest that the p38 MAPK pathway may be involved in the pathogenesis of diabetic nephropathy, but the consequences of the inhibition of the p38 MAPK pathway have not been well elucidated in diabetic (DM) glomeruli. This study was undertaken to investigate the effect of p38 MAPK inhibitor, FR167653, on fibronectin expression and apoptosis in DM glomeruli and in high-glucose-stimulated mesangial cells (MC). In vivo, 32 Sprague-Dawley rats were injected with diluent (control, N ϭ 16) or streptozotocin intraperitoneally (DM, N ϭ 16). Eight rats from each group were treated with FR167653 for 3 mo. In vitro, rat MC were exposed to medium containing 5.6 mM glucose or 30 mM glucose [high glucose (HG)] with or without 10 Ϫ6 M FR167653 for 24 h. Fibronectin mRNA and protein expression were determined by real-time PCR and Western blot, respectively. Western blot for apoptosis-related molecules, terminal deoxynucleotidyl transferase dUTP-mediated nick-end labeling assay, and Hoechst 33342 staining were performed to determine apoptosis. FR167653 ameliorated the increases in fibronectin-to-GAPDH mRNA ratio and protein expression in DM glomeruli by 89 and 79% and in HGstimulated MC by 70 and 91%, respectively (P Ͻ 0.05). Under diabetic conditions, Bcl-2 protein expression was decreased, whereas cleaved caspase-3 protein expression was increased (P Ͻ 0.05), and these changes were inhibited by FR167653 treatment. Apoptotic cells were also significantly increased in DM glomeruli and in HG-stimulated MC (P Ͻ 0.05), and FR167653 ameliorated these increases in apoptotic cells, both in vivo and in vitro. In conclusion, these findings suggest that the inhibition of the p38 MAPK pathway has a beneficial effect on the development of diabetic nephropathy by inhibiting the increase in fibronectin expression and apoptosis. p38 mitogen-activated protein kinase; fibrosis; apoptosis; diabetic nephropathy THE MOLECULAR AND CELLULAR mechanisms responsible for diabetic nephropathy remain incompletely resolved. While studies indicate involvement of hyperglycemia via the stimulation of growth factor-induced cellular hypertrophy (48), increased production of extracellular matrix (ECM) protein (2), and decreased production of matrix-degrading proteinases (20), the underlying signal transduction mechanisms mediating these processes have been less well explored.Numerous studies reveal protein kinase C (PKC) activation in diabetic glomeruli (5) and in mesangial cells cultured under high-glucose conditions (42). PKC propagates the physiological responses of receptor-ligand interactions via an array of downstream signals, such as mitogen-activated protein kinases (MAPKs). p38 MAPK, a member of the MAPK family, is known to be activated in response to stress signals, such as proinflammatory cytokines (28, 34), ultraviolet irradiation (34), osmolality changes (28, 34), and oxidative stress (4, 28), leading to apoptosis (43), prostanoid production (22), and other cellular dysfunctions (8). Since hyperosmolality and oxidant stress c...