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Role of the Immune System in Diabetic Kidney Disease

  • Microvascular Complications—Nephropathy (M Afkarian and B Roshanravan, Section Editors)
  • Published:
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Abstract

Purpose of Review

The purpose of this review is to examine the proposed role of immune modulation in the development and progression of diabetic kidney disease (DKD).

Recent Findings

Diabetic kidney disease has not historically been considered an immune-mediated disease; however, increasing evidence is emerging in support of an immune role in its pathophysiology. Both systemic and local renal inflammation have been associated with DKD. Infiltration of immune cells, predominantly macrophages, into the kidney has been reported in a number of both experimental and clinical studies. In addition, increased levels of circulating pro-inflammatory cytokines have been linked to disease progression. Consequently, a variety of therapeutic strategies involving modulation of the immune response are currently being investigated in diabetic kidney disease.

Summary

Although no current therapies for DKD are directly based on immune modulation many of the therapies in clinical use have anti-inflammatory effects along with their primary actions. Macrophages emerge as the most likely beneficial immune cell target and compounds which reduce macrophage infiltration to the kidney have shown potential in both animal models and clinical trials.

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Authors and Affiliations

  1. Department of Clinical Medicine, Trinity College Dublin, Tallaght Hospital, Dublin, Dublin 24, Ireland

    Fionnuala B. Hickey

  2. School of Biomolecular & Biomedical Science, UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland

    Finian Martin

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  1. Fionnuala B. Hickey
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This article is part of the Topical Collection on Microvascular Complications—Nephropathy

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Hickey, F.B., Martin, F. Role of the Immune System in Diabetic Kidney Disease. Curr Diab Rep 18, 20 (2018). https://doi.org/10.1007/s11892-018-0984-6

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