Related Experiment Video
Updated: Mar 17, 2026
Phenotypic Characterization of Macrophages from Rat Kidney by Flow Cytometry
Published on: October 18, 2016
Macrophages in diabetic nephropathy in patients with type 2 diabetes
Celine Q F Klessens1, Malu Zandbergen1, Ron Wolterbeek2
1Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Background:
Inflammation plays a role in the development of diabetic nephropathy (DN) in type 2 diabetes. Although macrophages have been found in experimental models of DN, little is known regarding the presence of macrophages in patients with DN. Therefore, we investigated the presence and phenotype of glomerular and interstitial macrophages in relation to clinical and histopathological parameters in patients with DN.
Methods:
Renal autopsy samples were obtained from 88 type 2 diabetic patients with histologically proven DN and stained for CD68 and CD163 as general and M2/anti-inflammatory markers of macrophages. Renal damage was scored based on histopathological classification of DN. Control renal autopsy samples were obtained from patients without renal abnormalities and from diabetic patients without DN. Positive cells per glomerulus were counted. Interstitial macrophages were counted semi-quantitatively.
Results:
Macrophages were present in all groups. In the DN group, the mean number of CD68+ cells per glomerulus and CD163+ cells per glomerulus was 4.2 (range 0-19) and 2.1 (range 0-14.47), respectively. The distribution was similar between all histopathological classes. Glomerular CD163+ macrophages were positively associated with DN class, interstitial fibrosis and tubular atrophy, and glomerulosclerosis. Interstitial CD68+ macrophages were correlated with glomerular filtration rate stage and albuminuria.
Conclusions:
Our results demonstrate that macrophages are present in the glomeruli and interstitium of type 2 diabetic patients with DN and of controls. Although patients and controls had similar numbers of glomerular macrophages, glomerular anti-inflammatory CD163+ macrophages were associated with pathological lesions in DN. Taken together with the correlation between interstitial macrophages and interstitial fibrosis and tubular atrophy, DN class, and renal function, this finding suggests that macrophages may play a role in DN progression. Therefore, targeting macrophages may be a promising new therapy for inhibiting the progression of DN.
Insights
Macrophages are present in diabetic kidney disease (DN) kidneys. Anti-inflammatory macrophages correlate with kidney damage, suggesting they may drive DN progression and represent a therapeutic target.
Area of Science:
- Nephrology
- Immunology
- Pathology
Background:
- Inflammation is implicated in type 2 diabetes-related kidney disease (DN).
- While macrophages are observed in DN models, their role in human DN patients is unclear.
- This study investigated macrophage presence and phenotype in human DN kidneys.
Purpose of the Study:
- To determine the presence and phenotype of glomerular and interstitial macrophages in patients with DN.
- To correlate macrophage markers with clinical and histopathological parameters of DN.
Main Methods:
- Analysis of renal autopsy samples from 88 type 2 diabetic patients with DN and controls.
- Staining for CD68 (general) and CD163 (M2/anti-inflammatory) macrophage markers.
- Histopathological scoring of renal damage and semi-quantitative counting of macrophages.
Main Results:
- Macrophages were detected in glomeruli and interstitium of all groups.
- Glomerular CD163+ macrophages correlated with DN severity, fibrosis, and glomerulosclerosis.
- Interstitial CD68+ macrophages correlated with kidney function (GFR stage) and albuminuria.
Conclusions:
- Macrophages are present in human DN kidneys, with specific phenotypes associated with disease severity.
- The association of macrophages with pathological lesions and declining renal function suggests a role in DN progression.
- Targeting macrophages presents a potential therapeutic strategy for DN.
Related Concept Videos
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:36Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
01:22Diabetes Mellitus: Type 2 and Gestational
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:24Chronic Kidney Disease II: Clinical Manifestations
01:20Renal Corpuscle
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...