PMID- 33442388
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210115
IS  - 1664-042X (Print)
IS  - 1664-042X (Electronic)
IS  - 1664-042X (Linking)
VI  - 11
DP  - 2020
TI  - Patterns of Toll-Like Receptor Expressions and Inflammatory Cytokine Levels and 
      Their Implications in the Progress of Insulin Resistance and Diabetic Nephropathy 
      in Type 2 Diabetic Patients.
PG  - 609223
LID - 10.3389/fphys.2020.609223 [doi]
LID - 609223
AB  - Background: Diabetic nephropathy (DNP) is a type 2 diabetes mellitus (T2DM) 
      chronic complication, which is the largest single cause of end-stage kidney 
      disease. There is an increasing evidence of the role of inflammation and 
      Toll-like receptors (TLRs) as part of innate immune system in its development and 
      progression. In addition, Toll-like receptor 2 (TLR2) and Toll-like receptor 4 
      (TLR4) downward signaling causes the production of proinflammatory cytokines, 
      which can induce insulin (INS) resistance in T2DM. Objective: The goal of this 
      study was to estimate the expression of TLRs (TLR2 and TLR4) in relation to 
      inflammation and INS resistance in nephrotic type 2 diabetic patients with or 
      without renal failure and to discuss the role of these TLRs in DNP progression. 
      Patients and Methods: In this study, blood samples were obtained from type 2 
      diabetic patients with or without renal failure, and patients with non-diabetic 
      renal failure were compared to healthy controls. All participants were tested for 
      analysis of fasting plasma glucose and serum insulin, kidney function tests, 
      C-reactive protein (CRP), and proinflammatory cytokines, including tumor necrosis 
      factor alpha (TNF-alpha), interferon gamma (IFN-gamma), and interleukin 6 (IL-6) as well 
      as expression of TLR2 and TLR4 in peripheral blood (PB). Statistical analysis of 
      data was done by using SPSS. Results: Diabetic patients with renal failure 
      exhibited significant increase in TLR2, TLR4 mRNA expression in PB in comparison 
      with normal subjects, diabetic patients without renal failure and non-diabetic 
      patients with renal failure. Both diabetic patients with or without kidney 
      failure and non-diabetic patients with renal failure had increased TLR2 and TLR4 
      mRNA expression in association with increased levels of proinflammatory cytokines 
      (TNF-alpha, IFN-gamma, and IL-6) compared to normal subjects. The diabetic patients with 
      kidney failure exhibited the highest elevation of TLRs, Th1 cytokines and CRP in 
      association the highest record of insulin resistance. Conclusion: Toll-like 
      receptor 2 and Toll-like receptor 4 increased expression and Th2 cytokines may 
      have an important role in the progression of DNP and deteriorations in insulin 
      resistance in type 2 diabetic patients. Therefore, TLR2 and TLR4 may be a 
      promising therapeutic target to prevent or retard DNP in type 2 diabetic 
      patients.
CI  - Copyright (c) 2020 Aly, Ahmed, Hozayen, Rabea, Ali, El Askary and Ahmed.
FAU - Aly, Rofyda H
AU  - Aly RH
AD  - Biotechnology and Life Sciences Department, Faculty of Postgraduate Studies for 
      Advanced Sciences, Beni-Suef University, Beni-Suef, Egypt.
FAU - Ahmed, Amr E
AU  - Ahmed AE
AD  - Biotechnology and Life Sciences Department, Faculty of Postgraduate Studies for 
      Advanced Sciences, Beni-Suef University, Beni-Suef, Egypt.
FAU - Hozayen, Walaa G
AU  - Hozayen WG
AD  - Biochemistry Department, Faculty of Science, Beni-Suef University, Beni-Suef, 
      Egypt.
FAU - Rabea, Alaa Mohamed
AU  - Rabea AM
AD  - Internal Medicine Department, Faculty of Medicine, Beni-Suef University, 
      Beni-Suef, Egypt.
FAU - Ali, Tarek M
AU  - Ali TM
AD  - Department of Physiology, College of Medicine, Taif University, Taif, Saudi 
      Arabia.
AD  - Department of Physiology, Faculty of Medicine, Beni-Suef University, Beni-Suef, 
      Egypt.
FAU - El Askary, Ahmad
AU  - El Askary A
AD  - Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, 
      Taif University, Taif, Saudi Arabia.
AD  - Department of Medical Biochemistry, Faculty of Medicine (New Damietta), Al Azhar 
      University, Cairo, Egypt.
FAU - Ahmed, Osama M
AU  - Ahmed OM
AD  - Physiology Division, Zoology Department, Faculty of Science, Beni-Suef 
      University, Beni-Suef, Egypt.
LA  - eng
PT  - Journal Article
DEP - 20201223
PL  - Switzerland
TA  - Front Physiol
JT  - Frontiers in physiology
JID - 101549006
PMC - PMC7798354
OTO - NOTNLM
OT  - Toll-like receptors
OT  - diabetes mellitus
OT  - inflammatory cytokines
OT  - insulin resistance
OT  - kidney failure
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/01/15 06:00
MHDA- 2021/01/15 06:01
PMCR- 2020/12/23
CRDT- 2021/01/14 05:47
PHST- 2020/09/22 00:00 [received]
PHST- 2020/12/04 00:00 [accepted]
PHST- 2021/01/14 05:47 [entrez]
PHST- 2021/01/15 06:00 [pubmed]
PHST- 2021/01/15 06:01 [medline]
PHST- 2020/12/23 00:00 [pmc-release]
AID - 10.3389/fphys.2020.609223 [doi]
PST - epublish
SO  - Front Physiol. 2020 Dec 23;11:609223. doi: 10.3389/fphys.2020.609223. eCollection 
      2020.