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Article
Increased Urinary Angiotensin Converting Enzyme 2 and Neprilysin in Patients With Type 2 Diabetes
American Journal of Physiology - Renal Physiology
  • Sridevi Gutta, Wright State University - Main Campus
  • Nadja Grobe, Wright State University - Main Campus
  • Meenasri Kumbaji, Wright State University - Main Campus
  • Hassan Osman
  • Mohammad Saklayen, Wright State University - Main Campus
  • Gengxin Li, Wright State University - Main Campus
  • Khalid M. Elased, Wright State University - Main Campus
Document Type
Article
Publication Date
7-23-2018
Abstract

Angiotensin converting enzyme 2 (ACE2) and neprilysin (NEP) are metalloproteases that are highly expressed in the renal proximal tubules. ACE2 and NEP generate renoprotective angiotensin (1–7) from angiotensin II and angiotensin I, respectively, and therefore could have a major role in chronic kidney disease (CKD). Recent data demonstrated increased urinary ACE2 in patients with diabetes with CKD and kidney transplants. We tested the hypothesis that urinary ACE2, NEP, and a disintegrin and metalloproteinase 17 (ADAM17) are increased and could be risk predictors of CKD in patients with diabetes. ACE2, NEP, and ADAM17 were investigated in 20 nondiabetics (ND) and 40 patients with diabetes with normoalbuminuria (Dnormo), microalbuminuria (Dmicro), and macroalbuminuria (Dmacro) using ELISA, Western blot, and fluorogenic and mass spectrometric-based enzyme assays. Logistic regression model was applied to predict the risk prediction. Receiver operating characteristic curves were drawn, and prediction accuracies were calculated to explore the effectiveness of ACE2 and NEP in predicting diabetes and CKD. Results demonstrated that there is no evidence of urinary ACE2 and ADAM17 in ND subjects, but both enzymes were increased in patients with diabetes, including Dnormo. Although there was no detectable plasma ACE2 activity, there was evidence of urinary and plasma NEP in all the subjects, and urinary NEP was significantly increased in Dmicro patients. NEP and ACE2 showed significant correlations with metabolic and renal characteristics. In summary, urinary ACE2, NEP, and ADAM17 are increased in patients with diabetes and could be used as early biomarkers to predict the incidence or progression of CKD at early stages among individuals with type 2 diabetes.

DOI
10.1152/ajprenal.00565.2017
Citation Information
Sridevi Gutta, Nadja Grobe, Meenasri Kumbaji, Hassan Osman, et al.. "Increased Urinary Angiotensin Converting Enzyme 2 and Neprilysin in Patients With Type 2 Diabetes" American Journal of Physiology - Renal Physiology Vol. 315 Iss. 2 (2018) p. F263 - F274 ISSN: 1931-857X
Available at: http://works.bepress.com/khalid_elased/53/