Reversal of renal disease: is it enough to inhibit the action of angiotensin II?
Over the last years, evidence emerged demonstrating that the progression of renal fibrosis is reversible in experimental models. The present review summarizes the new insights concerning the mechanisms of progression and regression of renal disease and examines this novel evidence under the light of feasibility and transfer to human nephropathies. The involved mechanisms are discussed with particular emphasis on the fibrotic role of vasoactive peptides such as angiotensin II and endothelin, and growth factors such as transforming growth factor beta (TGFbeta). The possibility of regression is introduced by presenting the in vivo efficiency of anti-hypertensive treatments and of systems that antagonize the fibrogenic action of TGFbeta such as bone morphogenic protein-7 (BMP-7) and hepatocyte growth factor. Finally, we provide a brief description of the promising future directions and clinical considerations about the applications of the experimental data to humans.
Dussaule
J-C
JC
INSERM, Unité 702 Paris F-75020, Paris, France. jean-claude.dussaule@sat.ap-hop-paris.fr
Chatziantoniou
C
C
D000804:Angiotensin II / Q000037:antagonists & inhibitors* / Q000378:metabolism; D000818:Animals; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000494:pharmacology / Q000627:therapeutic use; D016326:Extracellular Matrix Proteins / Q000037:antagonists & inhibitors / Q000378:metabolism; D005355:Fibrosis / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D017228:Hepatocyte Growth Factor / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology*; D007674:Kidney Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology*; D007678:Kidney Glomerulus / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D016212:Transforming Growth Factor beta / Q000037:antagonists & inhibitors* / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use
C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D016326:Extracellular Matrix Proteins; D016212:Transforming Growth Factor beta; D000804:Angiotensin II; D017228:Hepatocyte Growth Factor