Relationship of Monocyte chemoattractant protein-1 with diabetic nephropathy in children with type-1 diabetes: effect of high dose vitamin E therapy

ABSTRACT

Monocyte chemoattractant protein-1 [MCP-1] is a specific chemokine that activates monocytes from the circulation to the inflammatory sites. In diabetic nephropathy, similar to other glomerulonephropathies, infiltration and activation of monocytes / macrophages in the glomeruli have been implicated in the development of glomerular injury. The aim of this study was to examine a possible relationship of the MCP-1 with the development of diabetic nephropathy in children with type-1 diabetes before and after treatment with high dose of vitamin E for eight weeks. This study was carried out on thirty diabetic children, group 1; fifteen children with type 1 diabetes mellitus with persistent microalbuminuria, and group 2; fifteen children without microalbuminuria. Fifteen healthy children served as control group. Albumin excretion rate [AER] and glycosylated hemoglobin [HbA[1C]] were measured, also plasma MCP-1 levels were measured by ELISA before and after treatment with vitamin E for eight weeks. The results proved that plasma levels of MCP-1 were significantly higher in children with diabetic nephropathy than diabetic children without nephropathy and the control group [P<0.05]. There was strong positive correlation between HbA[1C] level and AER and MCP-1 [P<0.0001]. After treatment with vitamin E, there was a significant decrease in the MCP-1 plasma levels in diabetic children with nephropathy. This study suggests that facilitated MCP-1 production by the mesangial cells in diabetic children contributes to the initiation and progression of diabetic nephropathy. High-dose vitamin E supplementation may provide an additional benefit, as adjuvant therapy to insulin treatment, in reducing the risks for the development of diabetic nephropathy