Thomas, H. Y. | Search bioRxiv

bioRxiv2023

A Mathematical Model of Glomerular Fibrosis in Diabetic Kidney Disease to Predict Therapeutic Efficacy

1BackgroundGlomerular fibrosis is a tissue damage that occurs within the kidneys of chronic and diabetic kidney disease patients. Effective treatments are lacking, and the mechanism of glomerular damage reversal is poorly understood. MethodA mathematical model suitable for hypothesis-driven systems pharmacology of glomerular fibrosis in diabetes was developed from a previous model of interstitial fibrosis. The adapted model consists of a system of ordinary differential equations that models the complex disease etiology and progression of glomerular fibrosis in diabetes. ResultsWithin the scope of the mechanism incorporated, advanced glycation end products (AGE)--matrix proteins that are modified due to high blood glucose--were identified as major contributors to the delay in the recovery from glomerular fibrosis after glucose control. The model predicted that inhibition of AGE production is not an effective approach for accelerating the recovery from glomerular fibrosis. Further, the model predicted that treatments breaking down accumulated AGE is the most productive at reversing glomerular fibrosis. The use of the model led to the identification that glucose control and aminoguanidine are ineffective treatments for reversing advanced glomerular fibrosis because they do not remove accumulated AGE. Additionally, using the model, a potential explanation was generated for the lack of efficacy of alagebrium in treating advanced glomerular fibrosis, which is due to the inability of alagebrium to reduce TGF-{beta}. ImpactUsing the mathematical model, a mechanistic understanding of disease etiology and complexity of glomerular fibrosis in diabetes was illuminated, and then hypothesis-driven explanations for the lack of efficacy of different pharmacological agents for treating glomerular fibrosis were provided. This understanding can enable the development of more efficacious therapeutics for treating kidney damage in diabetes.

systems biology↗

bioRxiv2021

Collagen Deposition in Diabetic Kidney Disease Boosts Intercellular Signaling: A Mathematical Model

Diabetic kidney disease is a health burden that is becoming more prevalent in the US and worldwide. The limited options for treating and preventing diabetic kidney disease are in part due to gaps in our understanding of the progression of diabetic kidney damage and its impacts on cellular function. An important cellular function in the kidney glomerulus is intercellular communication via the release and uptake of soluble cytokines and growth factors. In diabetic kidney disease, excess collagen deposition alters the mesangial matrix properties, which, we hypothesize, diminishes the intercellular signaling between key glomerular cells. To test our hypothesis, we utilized established mathematical models of transport to study the impact of pathological deposition on the ability of cells to communicate via intercellular signaling. Our analysis reveals that pathological collagen deposition can enhance the signaling range of the glomerular cells rather than diminishing it. SIGNIFICANCEThe incidence of diabetes is expected to rise to over 600 million by the year 2040, one third of whom are expected to develop diabetic kidney disease. Our lack of understanding of how diabetic kidney disease progresses and affects cellular and tissue function has led to our inability to mitigate the rapidly rising burden of diabetic kidney disease. A hallmark of diabetic kidney damage is collagen deposition, yet its impact on cellular and tissue function is still not well understood. The elucidation of the impact of collagen deposition on cellular and tissue function will enable the identification of mechanisms that exacerbate the progression of diabetic kidney damage and thus provide novel avenues for preventing or slowing the progression of diabetic kidney damage.

systems biology↗