Transforming growth factor-beta: a clinical target for the treatment of diabetic nephropathy.
Diabetic nephropathy is continuing to rise in incidence, despite awareness of tight glycemic control and blood pressure. The identification that matrix accumulation is driven by transforming growth factor-beta (TGF-beta) has led to a concerted effort to apply antifibrotic strategies for this disorder. Recent studies have not only demonstrated the beneficial effects of blocking TGF-beta on matrix accumulation but have also found that blocking TGF-beta may have important hemodynamic effects that are relevant to diabetic complications. In this article, we review the latest knowledge regarding the role of TGF-beta in diabetic kidney disease and discuss available and novel therapeutic approaches. The role of a novel antifibrotic drug, pirfenidone, may have important clinical relevance to diabetic nephropathy.
McGowan
Tracy A
TA
Dorrance Hamilton Research Laboratories, Division of Nephrology, Center for Diabetic Kidney Disease, Thomas Jefferson University Hospital, 1020 Locust Street, Suite 353, Philadelphia, PA 19107, USA.
Zhu
Yanqing
Y
Sharma
Kumar
K
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000503:physiopathology*; D004195:Disease Models, Animal; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000517:prevention & control; D011728:Pyridones / Q000627:therapeutic use*; D016212:Transforming Growth Factor beta / Q000037:antagonists & inhibitors* / Q000502:physiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D011728:Pyridones; D016212:Transforming Growth Factor beta; C093844:pirfenidone