الفهرس 
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Abstract
Diabetic nephropathy is a leading cause to end stage renal disease. Pioglitazone has been used as treatment for patient with diabetic nephropathy because of its anti-inflammatory properties and protective effect on the kidney. In this study, we studied the effect of human umbilical cord blood mononuclear cell transplantation on diabetic rats, and its effect on prevention of diabetic nephropathy. We compared its effects with effects of pioglitazone on the kidney of diabetic rats.
Diabetes was induced by a single intraperitoneal injection of streptozotcin 65 mg/Kg of body weight in sodium citrate buffer (pH 4.5).
Study groups included: normal control group, mononuclear stem cells control group, Pioglitazone control group, Diabetic untreated control group, A group pretreated with pioglitazone started the day before induction of diabetes, Diabetic group treated with pioglitazone started one week after induction of diabetes, A group pretreated with mononuclear stem cells started the day before induction of diabetes and diabetic group treated with mononuclear stem cells after induction of diabetes.
By the end of eight weeks after induction of diabetes, rats of all groups were killed under ether anesthesia. Right Kidney was removed and weighed and fixed in formalin for histopathological studies, the left kidney was removed and fixed in formalin for immunohistochemical studies.
The following investigations were done at the beginning of the study, after one week, after 4 weeks, and after 8 weeks after induction of diabetes: The weights of the rats were recorded and fasting blood sugar was measured.
The following investigations were done at the beginning of the study, after 4 weeks and after 8 weeks: serum creatinine (Cr) and blood urea nitrogen, urine albumin/ creatinine ratio and systolic BP (SBP).
Glycosated haemogobin was measured at the beginning and end of the study. Kidney histopatholgy , kidney weight, ratio between kidney weight and body weight and laminin immunostain were done at the end of the study.
We found that diabetic control group showed significant higher level of blood sugar, glycosated hemoglobin, systolic blood pressure, serum creatinine, serum urea, UACR and ratio between kidney weight and body weight compared to normal control group.
It showed significant pathological changes including glomerular hypertrophy and scelrosis, tubular dilatation and atrophy, interstitial inflammation compared to normal control group. It showed increased intensity of laminin immunostain compared to normal control group.
Groups treated with pioglitazone showed significant decrease in the level of all previous parameters compared to diabetic control. Blood sugar and glycosated hemoglobin were significantly higher than normal control group but significantly lower than diabetic control group.
Groups treated with mononuclear cells showed non significant difference compared with pioglitazone treated groups in kidney function parameters indicating prevention of diabetic nephropathy in these groups. However blood sugar level and glycosated hemoglobin were significantly lower than pioglitazone treated groups indicating better control of diabetes.
There was positive correlation of all parameters with fasting blood sugar; this may suggest that mononuclear cells exert their effect by preventing hyperglycemia which is the triggering factor for nephropathy. However in pioglitazone treated groups, there was improvement of renal parameters inspite of high glucose status, which may suggest that pioglitazone exerts its effect via anti-inflammatory effect on the kidney.