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NGAL and SMAD1 gene expression in the early detection of diabetic nephropathy by liquid biopsy
  1. Glaucia Veiga1,
  2. Beatriz Alves1,
  3. Matheus Perez1,
  4. Luiz Vinicius Alcantara1,
  5. Joyce Raimundo1,
  6. Lysien Zambrano2,
  7. Jessica Encina1,
  8. Edimar Cristiano Pereira3,
  9. Marcelo Bacci1,
  10. Neif Murad1,
  11. Fernando Fonseca1,3
  1. 1 Centro Universitário Saúde ABC/Faculdade de Medicina do ABC, Santo Andre, Brazil
  2. 2 Universidad Nacional Autónoma de Honduras, Tegucigalpa, Francisco Morazán, Honduras
  3. 3 Pharmaceutical Sciences Department, Universidade Federal de São Paulo, Diadema, São Paulo, Brazil
  1. Correspondence to Dr Glaucia Veiga, Faculdade de Medicina do ABC, Santo Andre 09060-870, Brazil; grlveiga{at}


Introduction Diabetic nephropathy (DN) is a disease that progresses with the slow and progressive decline of the glomerular filtration rate (GFR); the installation of this pathology is silent and one of the major causes of death in patients with diabetes.

Aims To identify new molecular biomarkers for early identification of the onset of DN in patients with type II diabetes mellitus (DM2). We studied the expression profile of the genes; suppressor of mothers against decapentaplegic type 1 (SMAD1), neutrophil gelatinase-associated lipocalin (NGAL) and type IV collagen (COLIV1A) in peripheral blood and urine sediment samples.

Methods Ninety volunteers, 51 with DM2 and 39 healthy, were recruited from the Faculdade de Medicina do ABC outpatient clinic. We conducted an interview and collected anthropometric data, as well as blood and urine samples for biochemical evaluation and real-time PCR amplification of the genes of interest.

Results Gene expression data: peripheral blood NGAL (DM2 0.09758±0.1914 vs CTL 0.02293±0.04578), SMAD1 (blood: DM2 0.01102±0.04059* vs CTL 0.0001317±0.0003609; urine: DM2 0.7195±2.344* vs CTL 0.09812±0.4755), there was no significant expression of COLIV1A. These genes demonstrated good sensitivity and specificity in the receiving operating characteristic curve evaluation.

Conclusion Our data suggest the potential use of NGAL and SMAD1 gene expression in peripheral blood and urine samples as early biomarkers of DN.

  • diabetes
  • molecular biology
  • nephrology

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  • Handling editor Runjan Chetty.

  • Contributors GV and FF: formal analysis, data curation, writing the main manuscript, preparation of the figures, review and editing. BA: data curation, writing, review and editing. MP, LVA and JR: data curation, formal analysis, preparation of the figures, review and editing. LZ, JE, ECP and MB: data curation. NM: data curation and editing. All authors reviewed the manuscript.

  • Funding This study was funded by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brazil, Case no. 1738522 and Fundação de Amparo a Pesquisa do Estado de São Paulo, Brazil, Case no. 2018/24808-0.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Institutional Research Ethics Committee of Faculdade de Medicina do ABC under protocol 2.302.284. The present study was carried out in accordance with the relevant guidelines and regulations/ethical principles of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.