MRes in Translational Medicine (2014-2015) Research Project Summary Project Title Measuring changes in circulating Gremlin levels as a diagnostic marker of diabetic kidney injury Supervisor(s) Dr. Derek Brazil/Prof. Tim Lyons/Dr. Jeremy Yu Research Centre Centre for Experimental Medicine Principal Supervisor’s Contact Details Background information: Email: [email protected] Aims / objectives 1. To measure levels of Gremlin using ELISA in plasma and urine from pregnant control and preeclampsia patients in a prospective cohort of pregnant women with type 1 diabetes. We will use existing samples collected prospectively at all trimesters of gestation. Tel: 9063-2572 Gremlin is a secreted antagonist of the bone morphogenetic protein (BMP) family that regulates multiple processes in development and disease. Gremlin levels are increased in renal biopsies of patients suffering from diabetic kidney disease, and strategies that target Gremlin attenuate the severity of fibrosis in diabetes and other kidney diseases. Apart from its role as a BMP antagonist, recent data have identified Gremlin as a proangiogenic factor that signals via the VEGFR2 in endothelial cells. Preeclampsia is a serious complication of pregnancy, especially in women with diabetes. Preeclampsia is characterised by high blood pressure and proteinuria, attributed to endothelial dysfunction caused by placental factors released into the maternal circulation. Recent evidence suggests that altered angiogenic/anti-angiogenic balance is involved in the development of maternal symptoms. Such alterations include increased levels of soluble Flt1 and soluble Endoglin (sEng1) in plasma, antagonizing the normal function of VEGF, TGF-β1 and PlGF. As a factor that modulates angiogenesis, we hypothesize that Gremlin is likely to play a role in preeclampsia. 2. To correlate changes of Gremlin in plasma and/or urine with clinical characteristics, blood pressure, HbA1c,degree of proteinuria, lipid profiles, and other established preeclampsia markers such as sFlt1, sEng1, and PlGF 3. To measure levels of serum and urinary Gremlin in mouse models of diabetic nephropathy and/or unilateral ureteral obstruction (UUO) 4. To examine Gremlin signalling in a placental trophoblast cell line using VEGFR2 receptor activation and BMP-9 inhibition as readouts Successful completion of this project by the MRes student will define whether changes in Gremlin are associated with increased risk of preeclampsia in human patients, as well as Gremlin levels in mouse models of diabetic nephropathy and acute obstructive fibrosis. Techniques employed: ELISA Real time PCR Histology Western blotting Statistical correlation analysis Cell Culture
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