Diabetic kidney disease Diabetic kidney disease (DKD) (or
diabetic nephropathy) is a progressive
microalbuminuria disease with a slight loss of albumin in the urine (30–300 mg per day); DKD has been viewed as a diabetic complication-related
microvascular disorder in a renal manifestation. In kidney biopsy, DKD is characterized by glomerular and tubular basement thickening,
mesangial expansion,
glomerulosclerosis,
podocyte effacement and nephron loss. DKD occurs in 30%-50% of the diabetic patient population and leads to kidney failures in up to 20% of the
type 1 diabetic patients. Especially, APOL1 is known to complex with APOA-I and HDL to facilitate cell
autophagy in response to injuries and to prevent glomerular diseases; however, an APOL1 risk variant specific to podocyte inhibits cell autophagy and can trigger kidney disease. FASN-mediated
de novo lipid synthesis accounts for more than 93% of
triglycerides in tumor cells. In prostate cancer cells and promyelocytic leukemia cells, USF1 activation also attains a high-level
of PAI-1 expression and inhibits spontaneous or
camptothecin-induced apoptosis. Among gastric cancer patients, 88% of the patients are diagnosed with
H. pylori infection, and half of the patients show lower USF1 expression in tumor tissues. Mechanistically,
H. pylori induces DNA hypermethylation in the promoter regions of USF1 and USF2 and inhibits expression. Decreased expression reduces the interaction between USF1 and p53 when DNA damage occurs, rendering p53 to associate more frequently with the E3-ubiquitin ligase HDM2 (also known as
MDM2) and increasing p53 instability in cancer cells. The core FCHL lipid profiles feature high serum cholesterol/triglyceride,
apolipoprotein B (APOB), and LDL levels. Genetic evidence has suggested a FCHL-related locus on the human chromosome 1q21-q23, which is linked to metabolic syndromes. Fine-mapping of those linked regions identifies USF1 as the first positionally cloned gene for FCHL and a target for FCHL treatment. In addition,
hepatocyte nuclear factor 4 alpha (HNF4A) is also implicated in high lipid levels and metabolic syndromes. Cooperative effects of USF1 and HNF4A have been shown to regulate the expression of
apolipoprotein A-II (APOA2) and
apolipoprotein C-III (APOC3). Mutations in USF1, HNF4A, and apolipoproteins also increase patients' susceptibility to FCHL. Additional genes subjected to USF1 regulation and involved in glucose/lipid metabolism include apolipoprotein A5 (
APOA5),
apolipoprotein E (APOE),
hormone-sensitive lipase (LIPE),
hepatic lipase (LIPC),
glucokinase (GCK), islet-specific glucose-6-phosphatase catalytic-subunit-related protein (IGRP), insulin,
glucagon receptor (GCGR) and ATP-binding cassette transporter A1 (
ABCA1). == Interactions ==