Diabetic kidney disease (DKD) develops in about a quarter of all diabetics, doing so unbeknownst to those patients and their primary care providers (Duru, Middleton, Tewari, & Norris, 2018). As this disease progresses silently, surprised patients may find that dialysis or a kidney transplant is necessary. Could earlier detection and better awareness be the key to stalking the stalker? Perhaps, but there are still debates about the value of testing healthy-looking people, particularly because the current biomarkers are not applicable to everyone (Duru et al., 2018). So, what if we had better biomarkers?

A team of researchers set out to answer that very question and to better understand DKD’s stealthy maneuvers (Niewczas et al., 2019). From previous work on this silent killer, the team knew that the body’s inflammation proteins were involved and sought to get a clearer view with SomaLogic® technology.

With proteomic cameras covering specific angles of DKD’s kidney hunt, the team made some remarkable discoveries. From the data, which included people of different ethnic backgrounds and populations with type 1 or type 2 diabetes, the researchers saw changes in a set of inflammatory proteins that appeared years before the onset of end-stage renal disease. But this “signature” did not originate from the kidneys! Furthermore, this signature was unique to DKD and not to other common diabetic complications, such as diabetic retinopathy (visual loss from abnormal retina blood vessel growth).

Do the signature proteins cause loss of kidney function? If so, existing drugs that target them directly (or the proteins that they interact with) might help prevent end-stage renal disease. The researchers found some evidence that this could work. For example, the administration of baricitinib (a drug used to treat rheumatoid arthritis) over six months reduced the levels of several proteins believed to be involved in causing DKD and may be more effective if treatment is extended. Although losartan (a high blood pressure medication also used to treat DKD) did not reduce protein levels, the researchers remain optimistic that other drugs in testing for the treatment of chronic inflammation disorders may prove beneficial to thwarting DKD.

Using the SOMAscan® platform, the team got a close-up view of DKD’s attack in action, well before the victim felt the assault. Knowing a predator’s method of attack is key to avoiding becoming the next victim.

 

References

Duru, O. K., Middleton, T., Tewari, M. K., & Norris, K. (2018). The Landscape of Diabetic Kidney Disease in the United States. Curr Diab Rep, 18(3), 14. doi:10.1007/s11892-018-0980-x

Niewczas, M. A., Pavkov, M. E., Skupien, J., Smiles, A., Md Dom, Z. I., Wilson, J. M., . . . Krolewski, A. S. (2019). A signature of circulating inflammatory proteins and development of end-stage renal disease in diabetes. Nat Med. doi:10.1038/s41591-019-0415-5