Noninvasive evaluation of diabetic nephropathy using magnetization transfer MRI
Diabetic nephropathy (DN) is a major diabetic complication that determines the morbidity and mortality of the diabetic patients. However, currently available clinical tests or risk factors do not reliably assess its severity or progression in individual patients, making it difficult to do the targeted and intensified treatment to high-risk patient populations. One of the major limitations of current tests is their inability to reliably assess the extent of renal fibrosis in the affected kidney, even though renal fibrosis is the most important pathological change to evaluate or predict the long-term outcome of the patient. Although renal biopsy can diagnose fibrosis, it is invasive and prone to sampling errors, and does not reliably measure renal fibrosis in the affected kidney. Thus, a non-invasive test that better evaluate renal fibrosis in diabetic kidney should greatly improve the assessment of this disease, enabling better treatment protocol and prognosis.In recent decade, a variety of magnetic resonance imaging (MRI) methods have been developed andapplied to human disease including cancer and brain disorders. These techniques have enabled us toassess the pathological changes in disease organ at molecular and cellular levels. Magnetization transfer(MT) imaging is a MRI technique that evaluates large and immobile macromolecules distributed within thetissue and could provide a means to evaluate the pathological events that are accompanied by the changes of macromolecular components, such as fibrosis and apoptosis. However, this method is poorly applied to kidney disease including DN. Therefore, here we will evaluate the utility of MT imaging in measuring renal fibrosis in diabetic kidney using a mouse model of progressive DN (db/db eNOS -/- mice). The aims of thisstudy are: 1) To optimize and establish the MT protocol for mouse kidney imaging; 2) To examine the correlation between MT data and histological or biochemical measures of renal fibrosis. Thus, thisapplication explores a new MRI test to assess renal fibrosis in DN. Given the fact that this MRI technique can be translated to clinics, the present work should efficiently improve the outcome of the patients with DN.

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