title: Pirfenidone is renoprotective in diabetic kidney disease.
abstract: Although several interventions slow the progression of diabetic nephropathy, current therapies do not halt progression completely. Recent preclinical studies suggested that pirfenidone (PFD) prevents fibrosis in various diseases, but the mechanisms underlying its antifibrotic action are incompletely understood. Here, we evaluated the role of PFD in regulation of the extracellular matrix. In mouse mesangial cells, PFD decreased TGF-beta promoter activity, reduced TGF-beta protein secretion, and inhibited TGF-beta-induced Smad2-phosphorylation, 3TP-lux promoter activity, and generation of reactive oxygen species. To explore the therapeutic potential of PFD, we administered PFD to 17-wk-old db/db mice for 4 wk. PFD treatment significantly reduced mesangial matrix expansion and expression of renal matrix genes but did not affect albuminuria. Using liquid chromatography with subsequent electrospray ionization tandem mass spectrometry, we identified 21 proteins unique to PFD-treated diabetic kidneys. Analysis of gene ontology and protein-protein interactions of these proteins suggested that PFD may regulate RNA processing. Immunoblotting demonstrated that PFD promotes dosage-dependent dephosphorylation of eukaryotic initiation factor, potentially inhibiting translation of mRNA. In conclusion, PFD is renoprotective in diabetic kidney disease and may exert its antifibrotic effects, in part, via inhibiting RNA processing.
authors: Center for Renal Translational Medicine, Division of Nephrology and Hypertension, Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA. satishrao@ucsd.edu
authors: Satish P
authors: SP
authors: RamachandraRao
authors: Yanqing
authors: Y
authors: Zhu
authors: Timothy
authors: T
authors: Ravasi
authors: Tracy A
authors: TA
authors: McGowan
authors: Irene
authors: I
authors: Toh
authors: Stephen R
authors: SR
authors: Dunn
authors: Shinichi
authors: S
authors: Okada
authors: Michael A
authors: MA
authors: Shaw
authors: Kumar
authors: K
authors: Sharma
mesh_terms: D000419:Albuminuria / Q000188:drug therapy; D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002460:Cell Line; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D039561:Eukaryotic Initiation Factor-4E / Q000187:drug effects* / Q000378:metabolism; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D015870:Gene Expression / Q000187:drug effects; D006801:Humans; D008297:Male; D050527:Mesangial Cells / Q000187:drug effects / Q000378:metabolism; D051379:Mice; D008810:Mice, Inbred C57BL; D010766:Phosphorylation / Q000187:drug effects; D040901:Proteomics; D011728:Pyridones / Q000494:pharmacology / Q000627:therapeutic use*; D012323:RNA Processing, Post-Transcriptional / Q000187:drug effects*; D017382:Reactive Oxygen Species / Q000378:metabolism; D015398:Signal Transduction / Q000187:drug effects; D053773:Transforming Growth Factor beta1 / Q000378:metabolism
chemical_list: D000970:Antineoplastic Agents; D039561:Eukaryotic Initiation Factor-4E; D016326:Extracellular Matrix Proteins; D011728:Pyridones; D017382:Reactive Oxygen Species; D053773:Transforming Growth Factor beta1; C093844:pirfenidone