There has been an explosion of new genetic, biochemical, and cell biologic techniques. Appropriate systems biology tools are needed to facilitate integration of genotyping information, mRNA expression, microRNA expression, promoter analysis, proteome expression, and metabolome profiles in order to identify key biological processes and their interactions. In addition to better computational tools, a deeper understanding is needed of the control mechanisms of mRNA and protein expression levels in the diabetic state, such as ubiquitination, sumoylation, DNA methylation, histone modifications, and non-coding RNAs. Ultimately, this knowledge needs to be applied to clinical diabetes through better access and techniques for understanding pathobiology in individuals with DN. Large scale, longitudinal collection of CKD patients’ genetic, serum, tissue, and urine samples are required to allow use of these technologies to define the relationships between phenotype and multiple biomarkers. What is the best way to acquire tissue samples for these types of studies? Is their value in applying these approaches to human cadaveric tissue or from patients with End Stage Renal Disease?
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