Diabetic nephropathy (DN) increases podocyte cyclooxygenase-2 (COX-2) expression, and COX-2 inhibition reduces proteinuria and glomerular injury in animal models of diabetes. To investigate the role of podocyte COX-2 in development of diabetic nephropathy, we employed a streptozotocin model of diabetic mellitus in wild-type and transgenic mice expressing COX-2 selectively in podocytes. Progressive albuminuria developed only in diabetic COX-2 transgenic mice despite hyperglycemia, BP, and GFR being similar to those in wild-type mice. Transgenic mice also manifested significant foot-process effacement, moderate mesangial expansion, and segmental thickening of the glomerular basement membrane. In cultured podocytes overexpressing COX-2, high glucose induced cell injury and increased both expression of the pro(renin) receptor and activation of the renin-angiotensin system. Downregulation of the (pro)renin receptor attenuated the injury induced by high glucose. In vivo, podocyte pro(renin) receptor expression increased in diabetic COX-2-transgenic mice, and treatment with a COX-2 inhibitor abrogated the upregulation of (pro)renin receptor and reduced albuminuria, footprocess effacement, and mesangial matrix expansion. In summary, these results demonstrate that increased expression of podocyte COX-2 predisposes to diabetic glomerular injury and that the (pro)-renin receptor may be one mediator for this increased susceptibility to injury. Hyperglycemia-mediated metabolic abnormalities, hemodynamic abnormalities, and oxidative stress have all been implicated in the pathogenesis of diabetic nephropathy. 1 Diabetes can affect numerous cell types in the kidney, including glomerular podocytes, mesangial and endothelial cells, tubular epithelia, interstitial fibroblasts, and vascular endothelia. 2 Altered podocyte function occurs early in the development of diabetic nephropathy and can affect cell-cell interactions, attachment to the glomerular basement membrane, and apoptosis. [2][3][4][5][6][7][8][9][10] In humans, COX-2 expression is readily detectable in glomerular podocytes of adults, 11,12 and expression levels have been reported to increase during acute renal allograft rejection. 13,14 Occasional COX-2-positive podocytes are also detectable in adult rats, 15,16 and we have previously reported that in rat models of diabetes there is increased COX-2 expression in podocytes, and also in mesangial cells and macula densa cells, and have shown that COX-2 inhibition can attenuate proteinuria and retard diabetic nephropathy progression. 15 In this study, we investigated the role of increased COX-2 in diabetes-induced podocyte injury. Our results indicate that increased podocyte expression of COX-2 increases susceptibility