Role of glycosaminoglycans in diabetic nephropathy

A number of abnormalities of glycosaminoglycan metabolism have been reported in diabetes mellitus. These include anomalous synthesis, catabolism and sulphation. In this review glycosaminoglycan metabolism in diabetes mellitus is discussed with reference to its possible impact on glomerular basement membrane permeability, and on the physiology and metabolism of glomerular resident cells, specifically of the mesangium. Experimental results demonstrating favourable therapeutic activities of some glycosaminoglycans in mesangioproliferative glomerulitis and diabetic nephropathy are reported. These pharmacological actions do not depend on the well-known anticoagulative activity of glycosaminoglycans, but most probably on their antiproliferative effect. A more complex role of glycosaminoglycans in the pathogenesis of diabetic nephropathy is suggested.