%0 Journal Article
%T Urinary proteome analysis enables assessment of renoprotective treatment in type 2 diabetic patients with microalbuminuria
%A Sten Andersen
%A Harald Mischak
%A Petra Zščrbig
%A Hans-Henrik Parving
%A Peter Rossing
%J BMC Nephrology
%D 2010
%I BioMed Central
%R 10.1186/1471-2369-11-29
%X High-resolution capillary-electrophoresis coupled to mass-spectrometry (CE-MS) was used to profile the low-molecular-weight proteome in urine of a subgroup of patients from a two year randomized irbesartan versus placebo therapy trial, which included hypertensive type 2 diabetic patients with microalbuminuria on ongoing antihypertensive medication (IRMA2-substudy).We demonstrate that the therapy with 300 mg Irbesartan daily over a period of two years results in significant changes of the urinary proteome. Both, a classifier developed previously that consists of urinary peptides indicative of chronic kidney disease, as well as several individual peptides changed significantly after treatment. These changes were not observed in the placebo-treated individuals. Most prominent are changes of urinary collagen fragments associated with progression of diabetic nephropathy, indicating normalization in urinary peptides.CE-MS analysis of urine enabled identification of peptides as potential surrogate markers for renoprotection in microalbuminuric type 2 diabetic patients, which show persistent improvement after longterm treatment with Irbesartan. The results suggest that a major benefit of treatment by Irbesartan may be improvement of collagen turnover, reduction of fibrosis. They further suggest that urinary proteome analysis could be utilized to assess potential benefit of therapeutic intervention, providing statistically significant results even on a small population.At present more than 170 million people worldwide have diabetes and the number is expected to double within the next 20 years mainly due to an epidemic increase in the prevalence of type 2 diabetes [1]. Type 2 diabetes is associated with an increased occurrence of cardiovascular disease and approximately 40% of all diabetic patients are at risk of developing diabetic nephropathy which has become the leading cause of end-stage renal disease (ESRD) in the Western world [2]. Therefore, the early identification an
%U http://www.biomedcentral.com/1471-2369/11/29