Diabetic nephropathy is a leading cause of end-stage renal disease, but molecular indicators may aid in early detection. A study published in the Journal of Diabetes & Metabolic Disorders explored the relationship between ERAP1, toll-like receptor 4 (TLR4), and Ang II in patients with type 2 diabetes mellitus (T2DM).

The study analyzed 80 T2DM patients with nephropathy, 80 without nephropathy, and 60 healthy controls. ERAP1 and TLR4 gene expression were assessed using real-time polymerase chain reaction, while serum Ang II was measured by enzyme-linked immunosorbent assay.

Results showed that patients with nephropathy had markedly higher Ang II and ERAP1 expression compared with both other groups (p < 0.05). The rs30187 TT polymorphism was also significantly more prevalent among these patients (p = 0.021). Elevated TLR4 expression was noted in all diabetic participants versus controls (p < 0.01).

These findings indicate that enhanced ERAP1 activity and increased Ang II levels may contribute to renal injury in diabetes and serve as potential early biomarkers for diabetic nephropathy risk stratification.