caa a22 4500 445882506 CHVBK 20180317145548.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s10157-010-0357-1 doi (NATIONALLICENCE)springer-10.1007/s10157-010-0357-1 Renoprotective effects of clarithromycin via reduction of urinary MCP-1 levels in type 2 diabetic patients [Elektronische Daten] [Atsuhito Tone, Kenichi Shikata, Koichi Nakagawa, Masaaki Hashimoto, Hirofumi Makino] Background: Recent studies have shown the involvement of microinflammation in the pathogenesis of diabetic nephropathy. We previously demonstrated that erythromycin, one of the macrolides, ameliorated renal injury via anti-inflammatory effects in experimental diabetic rats. We conducted an open randomized controlled pilot study to investigate the renoprotective effect of clarithromycin for diabetic nephropathy in type 2 diabetic patients manifesting albuminuria. Methods: Sixteen patients were randomly assigned to the control (n=8) or the CAM group in which they received 200mg/day of clarithromycin (n=8). At the beginning of the study and after 3months of investigation, the following parameters were assessed: urinary albumin creatinine ratio (ACR), the levels of serum MCP-1, soluble ICAM-1, IL-18, IL-6 and hs-CRP, and the levels of urinary MCP-1 and IL-18. Results: The changes in urinary ACR were significantly improved (P=0.039), and serum creatinine levels showed a decreasing trend (P=0.053) in the CAM group compared with the control group. Urinary MCP-1 levels were significantly reduced in the clarithromycin-administrated group (P=0.009). However, there was no significant difference in other proinflammatory markers. A significant positive correlation was obtained between the post-to-pre-urinary ACR and the post-to-pre-urinary MCP-1 ratio(r=0.526, P=0.043). In the CAM group, the changes of serum creatinine also showed a significant positive correlation with those of urinary ACR, urinary MCP-1, urinary IL-18 and serum levels of soluble ICAM-1. Conclusion: The results from our study suggest that clarithromycin may attenuate the production of renal MCP-1 in type 2 diabetic patients, resulting in amelioration of urinary ACR via anti-inflammatory effects. Modulation of microinflammation with clarithromycin may provide a new approach for diabetic nephropathy. Japanese Society of Nephrology, 2010 Diabetic nephropathy nationallicence Clarithromycin nationallicence MCP-1 nationallicence Microinflammation nationallicence Macrolide nationallicence Tone Atsuhito Department of Diabetes and Metabolism, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, 701-1192, Okayama, Japan aut Shikata Kenichi Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan aut Nakagawa Koichi Department of Surgery, Fukuyama Daiichi Hospital, Fukuyama, Japan aut Hashimoto Masaaki Department of Surgery, Fukuyama Daiichi Hospital, Fukuyama, Japan aut Makino Hirofumi Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan aut Clinical and Experimental Nephrology Springer Japan 15/1(2011-02-01), 79-85 1342-1751 15:1<79 2011 15 10157 https://doi.org/10.1007/s10157-010-0357-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-010-0357-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tone Atsuhito Department of Diabetes and Metabolism, National Hospital Organization, Okayama Medical Center, 1711-1 Tamasu, Kita-ku, 701-1192, Okayama, Japan aut NATIONALLICENCE 700 1- Shikata Kenichi Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan aut NATIONALLICENCE 700 1- Nakagawa Koichi Department of Surgery, Fukuyama Daiichi Hospital, Fukuyama, Japan aut NATIONALLICENCE 700 1- Hashimoto Masaaki Department of Surgery, Fukuyama Daiichi Hospital, Fukuyama, Japan aut NATIONALLICENCE 700 1- Makino Hirofumi Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/1(2011-02-01), 79-85 1342-1751 15:1<79 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer