E-Paper
Pune NCL-led study shows ASR test as early marker for kidney disease in Type 2 diabetics
Researchers from Chennai and Nimhans collaborated with city scientists to report important results
A study has identified urinary asymmetric to symmetric dimethylarginine ratio (ASR) as a potential biomarker for early prediction of diabetic nephropathy (DN).
This research, a multidisciplinary collaborative effort of scientists from the CSIR-National Chemical Laboratory (CSIR-NCL), Pune, and clinical researchers from the Madras Diabetes Research Foundation (MDRF), Chennai, and National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, has been published in a journal called Scientific Reports.
The research provides an insight into disease progression and timely prevention and management to reduce adverse outcomes of nephropathy in all patients with type 2 diabetes.
Dr Venkateswarlu Panchagnula (CSIR-NCL) and Dr Kuppan Gokulakrishnan (NIMHAMS and MDRF) are the lead scientists on this project. Dr V Mohan (MDRF) is the lead clinician on this study.
The researchers evaluated the efficiency of ASR using Matrix-Assisted Laser Desorption and Ionisation Mass Spectrometry (MALDI MS) from at least 500 people with varying levels of glucose intolerance as well as in patients with type 2 diabetes mellitus (T2DM), with or without DN.
The study found that the ASR profile is lower in Microalbuminuria (MIC) and macroalbuminuria (MAC) suggesting that it has the potential to be used as an early diagnostic marker.
The study was able to correctly identify 72 per cent of MIC and 91 per cent of MAC respectively among Asian Indians.
“Dimethylarginines (DMAs) are susceptible to protein binding, which may result in differential recovery for normal and proteinuric urine samples. Therefore, any quantitative estimation of these biomarkers and eventually meaningful clinical interpretations would have to take this into account as urine from patients with kidney disease has significant protein content.
“Estimation of their ratios using our approach offers a robust alternative to individual quantitative measurements. In this context, the decreased ASR in patients with MIC and MAC in our study is an important finding”, said Dr Panchagunula, principal scientist and associate professor from CSIR-NCL, also a lead author of this work.
Benefits
“Early diagnosis of DN using a sensitive biomarker such as ASR is beneficial, to detect the onset of DN and to prevent/delay the progression into overt nephropathy. Our work is a proof-of-concept that shows the use of ASR for assessing progressive DN and this could aid future studies to understand the biology of nephropathy and the search for new treatments,”
Dr Kuppan Gokulakrishnan, lead researcher , assistant professor, department of Neurochemistry, NIMHANS.
Diabetic nephropathy
Diabetic Nephropathy is among the most significant longer-term complications associated with type 2 diabetes mellitus (T2DM). The risk of End-Stage Renal Disease (ESRD) and resulting premature morbidity and mortality is estimated to increase by 12 fold with diabetes.
Microalbuminuria (MIC) is an early non-invasive marker of renal disease and its progression. However, it takes several years of diabetes for MIC to occur. Development of sensitive early stage disease markers and alternative diagnostic approaches are thus essential for the detection of DN.
