Abstract
Diabetic nephropathy is one of the most common diseases leading to fibrosis and end-stage
renal disease (ESRD) world wide. Under normal conditions, a delicate equilibrium exists
between synthesis, composition, and removal of extracellular matrix (ECM). If this
is disturbed, ECM accumulation and fibrosis may result. The fragile balance between
synthesis and removal of ECM is crucial for the prognosis of glomerular as well as
interstitial pathological processes. Some features may favor ECM accumulation and
progression to ESRD (dialysis and transplantation), whereas other elements may favor
ECM removal and resolution (recovery). Pathogenetic mechanisms and the cellular sources
of ECM in the glomerular basement membrane as well as in the tubulointerstitial space
are still under investigation. Among several growth factors, transforming growth factor
β1 (TGF-β1) plays a major role. We consider the use of living animals necessary for
our understanding of the complex biological processes that occur during the development
of ESRD. The present review will discuss the glomerular as well as interstitial accumulation
of ECM and the use of transgenic animals in studying the pathogenetic mechanisms with
special emphasis on diabetic kidney disease and TGF-β1.
Key words
Transforming growth factor β1 - Extracellular matrix - Diabetes - Transgenic models
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Associate Professor Lise Wogensen Bach, D. M. Sci.
The Research Laboratory for Biochemical Pathology · Aarhus University Hospital
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