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Nephroprotective action of glycosaminoglycans: why the pharmacological properties of sulodexide might be reconsidered

A relatively large body of evidence supports the notion that glomerular capillary wall and mesangial alterations in diabetic nephropathy involve biochemical alterations of glycoproteins in these structures. Evidence in experimental animals rendered diabetic reveals that the administration of heparin...

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Detalles Bibliográficos
Autores principales: Gaddi, Antonio V, Cicero, Arrigo FG, Gambaro, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108767/
https://www.ncbi.nlm.nih.gov/pubmed/21694935
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author Gaddi, Antonio V
Cicero, Arrigo FG
Gambaro, Giovanni
author_facet Gaddi, Antonio V
Cicero, Arrigo FG
Gambaro, Giovanni
author_sort Gaddi, Antonio V
collection PubMed
description A relatively large body of evidence supports the notion that glomerular capillary wall and mesangial alterations in diabetic nephropathy involve biochemical alterations of glycoproteins in these structures. Evidence in experimental animals rendered diabetic reveals that the administration of heparin and other anionic glycoproteins can effectively prevent the biochemical alterations that promote albuminuria. Moreover, angiotensin II inhibits heparan sulfate synthesis, while heparins modulate angiotensin II signaling in glomerular cells, inhibiting aldosterone synthesis and lowering proteinuria in diabetes patients. Sulodexide, a mixture of heparin and dermatan sulfate, appears to be a promising treatment for diabetic proteinuria partially resistant to renin–angiotensin system blocking agents. Sulodexide prevents heparan sulfate degradation, thus allowing reconstruction of heparan sulfate content and restoration of glomerular basement membrane ionic permselectivity. The antiproteinuric effect appears to be mainly related to the basal proteinuria and consequently to the duration of treatment in a relatively large number of small clinical trials. On the other hand, several sulodexide pharmacodynamic properties could improve the prognosis of chronic kidney disease patients, also independently from its antiproteinuric effect. However, sulodexide development as an antiproteinuric drug needs to be continued, in order to define which kind of patients could better respond to this treatment.
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spelling pubmed-31087672011-06-21 Nephroprotective action of glycosaminoglycans: why the pharmacological properties of sulodexide might be reconsidered Gaddi, Antonio V Cicero, Arrigo FG Gambaro, Giovanni Int J Nephrol Renovasc Dis Review A relatively large body of evidence supports the notion that glomerular capillary wall and mesangial alterations in diabetic nephropathy involve biochemical alterations of glycoproteins in these structures. Evidence in experimental animals rendered diabetic reveals that the administration of heparin and other anionic glycoproteins can effectively prevent the biochemical alterations that promote albuminuria. Moreover, angiotensin II inhibits heparan sulfate synthesis, while heparins modulate angiotensin II signaling in glomerular cells, inhibiting aldosterone synthesis and lowering proteinuria in diabetes patients. Sulodexide, a mixture of heparin and dermatan sulfate, appears to be a promising treatment for diabetic proteinuria partially resistant to renin–angiotensin system blocking agents. Sulodexide prevents heparan sulfate degradation, thus allowing reconstruction of heparan sulfate content and restoration of glomerular basement membrane ionic permselectivity. The antiproteinuric effect appears to be mainly related to the basal proteinuria and consequently to the duration of treatment in a relatively large number of small clinical trials. On the other hand, several sulodexide pharmacodynamic properties could improve the prognosis of chronic kidney disease patients, also independently from its antiproteinuric effect. However, sulodexide development as an antiproteinuric drug needs to be continued, in order to define which kind of patients could better respond to this treatment. Dove Medical Press 2010-07-06 /pmc/articles/PMC3108767/ /pubmed/21694935 Text en © 2010 Gaddi et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Review
Gaddi, Antonio V
Cicero, Arrigo FG
Gambaro, Giovanni
Nephroprotective action of glycosaminoglycans: why the pharmacological properties of sulodexide might be reconsidered
title Nephroprotective action of glycosaminoglycans: why the pharmacological properties of sulodexide might be reconsidered
title_full Nephroprotective action of glycosaminoglycans: why the pharmacological properties of sulodexide might be reconsidered
title_fullStr Nephroprotective action of glycosaminoglycans: why the pharmacological properties of sulodexide might be reconsidered
title_full_unstemmed Nephroprotective action of glycosaminoglycans: why the pharmacological properties of sulodexide might be reconsidered
title_short Nephroprotective action of glycosaminoglycans: why the pharmacological properties of sulodexide might be reconsidered
title_sort nephroprotective action of glycosaminoglycans: why the pharmacological properties of sulodexide might be reconsidered
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108767/
https://www.ncbi.nlm.nih.gov/pubmed/21694935
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