**Author details**

Irina Sarvilina

All changes in patients with DN are associated with a higher expression of urine proteins in the progression of epithelial-to-mesenchymal transition (EMT) and changes in the extracellular matrix (ECM) in kidneys in T2DM patients with DN (**Table 1**). Proteomic analysis helps in the detection of differences in the component composition of the urine proteins in patients with DN of varying stages compared with the control group. Molecules interact among themselves and with other molecules as participants in universal pathways in T2DM patients with DN, which are the key elements for EMT formation and changes in ECM: Smad, p38 MAPK, TLRs, Wnt, mTOR, Notch, small GTPase and Hedgehog and PI3K/AKT-signaling pathways. Each protein molecule in the functional group interacts with other protein molecules. For example, the molecular interactions of NGAL are presented in **Figure 3**. The concentration of NGAL increases in the urine of T2DM patients with DN. The study identified the biomarkers of tubular damage that have a key role in the development and progression of DN. The research into signaling pathways and molecules that are involved in ECM formation may help in developing strategies to prevent DN. Molecular pathways for the development of DN constitute a model for the study of molecular pathways in the development of

**Figure 3.** Molecular interactions of NGAL (STRING 10.0 database). LCN2, lipocalin-2; MMP-9, matrix metallopeptidase 9; LRP2, low density lipoprotein-related protein 2; ERBB2, erythroblastic leukemia viral oncogene homolog 2 (neuro/ glioblastoma derived oncogene homolog); IL3, interleukin 3 (colony-stimulating factor, multiple); HMOX1, heme oxygenase (decycling) 1; IL-17A, interleukin 17A; LEP, leptin; INS, insulin; TLR2, toll-like receptor 2 and CDH1, cadherin

aging of kidney tissue.

156 Diabetes and Its Complications

1, type 1, E-cadherin (epithelial cadherin).

Address all correspondence to: isarvilina@mail.ru

Medical Centre "Novomeditsina,"Rostov State Medical University, Rostov-on-Don, Russia
