Inhibition and restimulation by insulin of cellular autophagy in distal tubular cells of the kidney in early diabetic rats.

Cellular autophagy in the cells of distal tubular segments (DT cells) of the kidney cortex in streptozotocin-diabetic rats was evaluated by quantitative electron microscopy. Five days after streptozotocin administration, volume and numerical densities of autophagic vacuoles (AVs) in DT cells were reduced by 56 and 57%, respectively. The correction of the diabetic state by insulin injection reversed the inhibition of cellular autophagy. Volume and numerical densities of AVs increased by 97 and 53%, respectively. Endogenous insulin replacement by islet transplantation showed the same effect on cellular autophagy. Volume and numerical densities of AVs increased by 82 and 34%, respectively, as compared with sham-operated diabetic animals. The data show that, during diabetic kidney hypertrophy, the cellular autophagy is inhibited in DT cells to the same extent as in proximal tubular cells, suggesting that DT cells contribute in a balanced manner to hypertrophic growth of the kidney cortex. Similarly, DT cells are involved in the catabolic reaction, i.e., stimulation of autophagy, after metabolic correction of the diabetic state by insulin.