The goal of this study is to develop low-dose radiation (LDR) as a new tool to prevent and treat diabetic nephropathy. Currently no effective preventive or therapeutic approaches are available to treat diabetic nephropathy, which is the most common cause of renal failure. We have been investigating the biological effects of LDR, including its hormesis and adaptive response, in vitro and in vivo. A major advantage of LDR is that it activates many genes in antioxidant and anti-inflammatory pathways, rather than just single protective gene, potentially making LDR a very potent and novel therapeutic approach. This was borne out by our preliminary studies that show that LDR at 25 mGy decreases diabetic nephropathy, by significantly reducing diabetes-induced renal oxidative damage and inflammation. Our latest preliminary data show up-regulation of nuclear factor erythroid 2-related factor 2 (Nrf2) expression and protein kinase B (also called Akt) phosphorylation in the kidney of diabetic mice, also exposed to LDR at 25 mGy. NRF2 is a transcription factor involved in expression of a broad range of protective genes. Therefore our central hypothesis is that exposure of diabetic animals to LDR can prevent and treat diabetic nephropathy by activation of many protective genes through stimulation of the Nrf2 pathway. This hypothesis will be tested through three specific Aims: (1) LDR at the optimal condition not only prevents, but also delay diabetic nephropathy;(2) the optimal LDR is safe for diabetic subjects;(3) the renal protection by the optimal LDR is predominantly mediated by up- regulating Nrf2-mediated multiple antioxidant components. The great advantage of LDR is that it offers a highly controllable, non-invasive method for eliciting endogenous, synergistic tissue protection and repair mechanisms. This innovative approach will be particularly valuable for the diabetic patient who already has significantly decreased renal function that increases the toxicity of invasive drugs. Therefore, this project will open a new avenue for the prevention and treatment of diabetic complications.

Public Health Relevance

The objective of this study is to apply low-dose radiation (LDR) as a new and non-invasive tool to prevent and treat diabetic nephropathy through stimulation of renal multiple protective mechanisms against oxidative damage and inflammation. We will firstly define the optimal condition of LDR to prevent and treat diabetic nephropathy with type 1 and type 2 diabetic mouse models, and then determine the safety for diabetic subjects to expose to LDR and underlying mechanisms for the renal protection from diabetes by LDR. This project represents a unique approach to apply LDR to activate multiple protective pathways unlike most currently- used drugs only working on a single pathway.

National Institute of Health (NIH)
Research Project (R01)
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Radiation Therapeutics and Biology Study Section (RTB)
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Flessner, Michael Francis
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University of Louisville
Schools of Medicine
United States
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