Roles of interleukins (interleukin-18 and interleukin-17a) and transforming growth factor-beta markers in the pathogenesis of diabetic kidney diseases

In diabetes, microvascular damage often targets the kidney, making them the most crucial organ affected. Due to the disease itself or other accompanying health issues such as hypertension and nephron loss due to aging, a significant number of patients end up with kidney disease. The current research aimed to analyze the concentration of cytokines in the serum (Interleukin [IL]-18, IL-17a and transforming growth factor-beta (TGF-β) in Iraqi adult patients with diabetic kidney disease (DKD). The current investigation was carried out in Tikrit Teaching Hospital/Salahaddin governorate for the time from October 2022 to January 2023. Sixty blood specimens were obtained from patients with DKD. Serum levels of IL-18, IL-17a, and TGF-β markers in the samples were subjected to measurement by enzyme-linked immunosorbent assay. Results of the present study showed significant differences (P < 0.05) among different age categories of clinical populations with 51-60 and >60 years scoring highest (28% and 33%), whereas 21-30 and 31-40 years scored (8.3% and 13.3%). The concentration of IL-18, IL-17a, and TGF-β markers was high in patients (200.30 ± 59.50, 102.13 ± 50.82, and 57.15 ± 18.90) than in healthy individuals (104.50 ± 31.01, 42.90 ± 10.55, and 31.90 ± 8.83). Based on the Pearson's correlation results, IL-17a had a significant negative correlation with TGF-β (r = −0.270* Sig. =0.037). Moreover, the receiver operating characteristic curve showed the IL-18, IL-17a, and TGF-β markers scored the highest sensitivity (98%, 96%, and 87%) and specificity (94%, 97%, and 80%), respectively, in screening patients with DKD. Based on the analysis, it could be inferred that disease intensity generally tends to worsen with an increase in age. IL-18, IL-17a, and TGF-β are good prognostic markers in screening patients with DKD. These cytokines present a promising target for therapeutic interventions in DKD therapy.