Diffusion Tensor Imaging Magnetic Resonance Imaging Assessment in a Clinical Trial of Autologous Dendritic Cell Transfer for Diabetic Kidney Disease: A Molecular Approach

Abstract: Background: The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide, leading to a higher incidence of diabetic kidney disease (DKD). DKD has increased inflammation and decreased kidney function. Patients have not received op-timal therapy. This study aims to see the effect of autologous dendritic cell administra-tion on DTI MRI examination and biomarkers of Matrix Metalloproteinase-9 (MMP-9) and Intercellular Adhesion Molecule-1 (ICAM-1). Methods: An open-label clinical trial study was conducted on 25 DKD outpatients at Gatot Soebroto Army Hospital. Each subject received a one-time injection of Autologous Dendritic Cells, with evaluation conducted before and 1 month after administration. Parameters measured included Fractional Anisotropy (FA) using Diffuse Tensor Imaging in MRI sequences and in-flammatory biomarker MMP-9. Results: A significant increase shown in Fractional An-isotropy from 242.57 ± 63.97 at baseline to 305.61 ± 152.32 one month after DC injection, while MMP-9 and ICAM-1 showed no significant change. There was a negative corre-lation between FA and MMP-9 values (r = -0.324, p = 0.025). Conclusion: Autologous dendritic cell administration can significantly improve FA, which is associated with a decrease in the inflammatory biomarker MMP-9 and affects renal repair in DKD