Metabolomics as a tool for the early diagnosis and prognosis of diabetic kidney disease

Abstract

Diabetic kidney disease (DKD) is one of the most prevalent comorbidities of diabetes mellitus and the leading cause of the end‐stage renal disease (ESRD). DKD results from chronic exposure to hyperglycemia, leading to progressive alterations in kidney structure and function. The early development of DKD is clinically silent and when albuminuria is detected the lesions are often at advanced stages, leading to rapid kidney function decline towards ESRD. DKD progression can be arrested or substantially delayed if detected and addressed at early stages. A major limitation of current methods is the absence of albuminuria in non‐albuminuric phenotypes of diabetic nephropathy, which becomes increasingly prevalent and lacks focused therapy. Metabolomics is an ever‐evolving omics technology that enables the study of metabolites, downstream products of every biochemical event that occurs in an organism. Metabolomics disclosures complex metabolic networks and provide knowledge of the very foundation of several physiological or pathophysiological processes, ultimately leading to the identification of diseases' unique metabolic signatures. In this sense, metabolomics is a promising tool not only for the diagnosis but also for the identification of pre‐disease states which would confer a rapid and personalized clinical practice. Herein, the use of metabolomics as a tool to identify the DKD metabolic signature of tubule interstitial lesions to diagnose or predict the time‐course of DKD will be discussed. In addition, the proficiency and limitations of the currently available high‐throughput metabolomic techniques will be discussed.

Effects of Danggui Buxue decoction on host gut microbiota and metabolism in GK rats with type 2 diabetes

“…Metabolomics based on LC–MS technology can reveal the physiological and pathological changes of organisms by analyzing the metabolic composition and changes of endogenous and exogenous substances in biological samples, which are of great significance in clarifying the pathogenesis and the treatment of metabolic diseases involving digestion and absorption ( De Vos et al, 2022 ; Pereira et al, 2022 ). The result of this study shows that DBD can significantly reverse the abundance of 9-OxoODE, enterodiol, enterolactone, arachidonyl carnitine, 2,3-Dinor-6-keto-prostaglandin F1 alpha, 4-OH-Retinal, Nomega-Acetylhistamine, oxindole, pyroglutamylvaline, and other metabolites, which are also changed in model group rats compared to the control group.…”

Molecular Mechanisms of Diabetic Kidney Disease

“…These types of receptors are seen in many of the innate immune cells, including macrophages, dendritic cells, T cells, B cells, and natural killer (NK) cells, and in non-immune cells such as tubular epithelial cells, mesangial cells, endothelial cells, and podocytes [ 3 ]. The human genome codes about 10 TLRs [ 1 , 35 ]. In DKD, TLR2 and TLR4 have been implicated in the inflammatory aspect of the disease [ 36 ].…”

Current Strategies and Potential Prospects for Nanoparticle-Mediated Treatment of Diabetic Nephropathy

“…However, routine clinical examinations for DN, such as renal biopsy, are invasive and this histopathologic examination are considered for only patients with clinical presentation or disease progression. 127 Therefore, new NP-based methods may offer a new approach to the diagnosis of DN, such as the use of lox-1-targeted iron oxide NPs for non-invasive imaging of DN. Renal damage is often key for the early diagnosis of DN.…”