Xie P, Sun L, Oates PJ, Srivastava SK, Kanwar YS. Pathobiology of renal-specific oxidoreductase/myo-inositol oxygenase in diabetic nephropathy: its implications in tubulointerstitial fibrosis. Am J Physiol Renal Physiol 298: F1393-F1404, 2010. First published March 24, 2010 doi:10.1152/ajprenal.00137.2010.-Renal-specific oxido-reductase/myoinositol oxygenase (RSOR/MIOX) is expressed in renal tubules. It catabolizes myo-inositol and its expression is increased in diabetic mice and in LLC-PK 1 cells under high-glucose ambience. Aldose reductase (AR) is another aldo-keto reducase that is expressed in renal tubules. It regulates the polyol pathway and plays an important role in glucose metabolism, osmolyte regulation, and ECM pathobiology via the generation of advanced glycation end products, reactive oxygen species, and activation of transforming growth factor (TGF)-. In view of the similarities between AR and RSOR/MIOX, the pathobiology of RSOR/MIOX and some of the cellular pathways affected by its overexpression were investigated. An increased expression of fibronectin was noted by transfection of LLC-PK 1 cells with pcDNA3.1-RSOR/MIOX. Similar changes were observed in LLC-PK 1 cells under high-glucose ambience, and they were notably lessened by RSOR/MIOX-small interfering (si) RNA treatment. The changes in tubulointerstitial fibronectin expression were also observed in the kidneys of db/db mice having high levels of RSOR. The pcDNA3.1-RSOR/MIOX transfectants had an increased NADH/NAD ϩ ratio, PKC and TGF- activity, Raf1:Ras association, and p-ERK phosphorylation. These changes were significantly reduced by the inhibitors of PKC, aldose reductase, Ras farnesylation, and MEK1. Similar increases in various the above-noted parameters were observed under high-glucose ambience. Such changes were partially reversed with RSOR-siRNA treatment. Expression of Ecadherin and vimentin paralleled in cells overexpressing RSOR/ MIOX or subjected to high-glucose ambience. These studies suggest that RSOR/MIOX modulates various downstream pathways affected by high-glucose ambience, and conceivably it plays a role in the pathobiology of tubulointerstitium in diabetic nephropathy.fibronectin; db/db mice; sorbinil DIABETES MELLITUS IS A COMMON metabolic disorder in which hyperglycemia afflicts injury on multiple organ systems in humans, and frequent lesions that have been well described include diabetic microangiopathy, neuropathy, retinopathy, and nephropathy (6,33,47,54). The changes in the kidney occur in more than one-third of the patients with diabetes mellitus, and they have been exhaustively described in the literature (27,46,51,53,57,62). The hyperglycemia-induced renal changes may be acute and reversible or chronic and irreversible in nature, and these kidney lesions may serve as a prototypical example that would be applicable to other mammalian organ systems. The acute metabolic changes include increased activity of the polyol pathway, altered redox state of pyridine nucleotides (NADPH:NADP ϩ and NADH:NAD ϩ ratios), pert...