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AGEs–RAGE overexpression in a patient with smoking-related idiopathic nodular glomerulosclerosis

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Abstract

We report a case of smoking-related idiopathic nodular glomerulosclerosis (ING) with overexpression of glomerular advanced glycation end products (AGEs) and their receptor (RAGE). A 59-year-old Japanese man with nephrotic syndrome, who had a smoking history of one pack of cigarettes per day for approximately 40 years, presented with a 3-year history of urinalysis abnormalities without clinical evidence of diabetic mellitus. The patient’s leg edema progressively worsened over the previous 2 years, and he was admitted to our hospital. Renal biopsy showed mesangial expansion with diabetic Kimmelstiel–Wilson-like nodular lesions, glomerular basement thickening, and arteriosclerosis. No electron-dense deposits, fibrils, or microtubule deposits were seen in the glomeruli on electron microscopy. Skin AGE level measured using AGE reader was higher in this case than the average level in age-matched Caucasians. In addition, immunohistochemical analysis revealed that N-carboxymethyl lysine, one of the major AGEs, and RAGE were overexpressed and podocin expression was decreased in the peripheral area of the glomerular nodular lesions. These observations suggest that AGEs–RAGE system may be activated in smoking-related ING, possibly leading to the progression of renal dysfunction.

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Acknowledgements

The authors would like to thank the members of the Kyusyu Okinawa Kidney Biopsy forum for their useful discussion. The authors also would like to thank Enago (http://www.enago.jp) for English language review.

Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Nao Nakamura, Kensei Taguchi, Yuka Kurokawa, Yosuke Nakayama, Yusuke Kaida, Ryo Shibata & Kei Fukami

  2. Division of Microscopic and Developmental Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan

    Yoshihiro Miyazono & Keiichiro Uemura

  3. Division of Nephrology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi, Japan

    Kiyomi Koike

  4. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Akihiro Tsuchimoto

  5. Department of Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan

    Katsuhiko Asanuma

Authors
  1. Nao Nakamura
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  2. Kensei Taguchi
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  3. Yoshihiro Miyazono
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  9. Ryo Shibata
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  10. Akihiro Tsuchimoto
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  11. Katsuhiko Asanuma
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  12. Kei Fukami
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Corresponding author

Correspondence to Kensei Taguchi.

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Informed consent was obtained from the patient in this study.

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The authors declare that no conflict of interest exists.

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Nakamura, N., Taguchi, K., Miyazono, Y. et al. AGEs–RAGE overexpression in a patient with smoking-related idiopathic nodular glomerulosclerosis. CEN Case Rep 7, 48–54 (2018). https://doi.org/10.1007/s13730-017-0290-1

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  • DOI: https://doi.org/10.1007/s13730-017-0290-1

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