Potentiation of glucose-mediated glomerular injury by mechanical strain

1. The glomerular injury of diabetes is characterized by the progressive accumulation of extracellular matrix in the mesangial regions, ultimately resulting in glomerulosclerosis. 2. The excessive glomerular extracellular matrix formation associated with the haemodynamic alteration of diabetes is the result of mesangial mechanical strain. 3. The increased synthesis and deposition of extracellular matrix is augmented by the presence of high glucose concentrations. 4. Both mechanical strain and high glucose share many of the mechanisms mediating their metabolic effects, including the stimulation of prosclerotic growth factors. 5. Little is known about factors that may influence the long-term effects of mechanical strain, but the preservation of the F-actin cytoskeleton is likely an important modulator of the resulting injury.