Mechanism-based therapeutics for autosomal dominant polycystic kidney disease: recent progress and future prospects.
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease, accounting for up to 10% of patients on renal replacement therapy. There are presently no proven treatments for ADPKD and an effective disease-modifying drug would have significant implications for patients and their families. Since the identification of PKD1 and PKD2, there has been an explosion in knowledge identifying new disease mechanisms and testing new drugs. Currently, the three major treatment strategies are to: (1) reduce cAMP levels; (2) inhibit cell proliferation, and (3) reduce fluid secretion. Several compounds shown to be effective in preclinical models have already undergone clinical trials and more are planned. In addition, a whole raft of other compounds have been developed from preclinical studies. The purpose of this paper is to evaluate the results of recent published trials, review current trials and highlight the most promising compounds in the pipeline. There appears to be no shortage of potential candidates, but several key issues need to be addressed to facilitate clinical translation.
Kidney Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Ming-Yang
MY
Chang
Albert C M
AC
Ong
D000814:Aniline Compounds / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D000242:Cyclic AMP / Q000502:physiology; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000037:antagonists & inhibitors; D003864:Depression, Chemical; D019468:Disease Management; D004311:Double-Blind Method; D015507:Drugs, Investigational / Q000627:therapeutic use*; D005544:Forecasting; D056572:Histone Deacetylase Inhibitors / Q000627:therapeutic use; D006801:Humans; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009570:Nitriles / Q000627:therapeutic use; D016891:Polycystic Kidney, Autosomal Dominant / Q000188:drug therapy* / Q000503:physiopathology; D011687:Purines / Q000627:therapeutic use; D011804:Quinolines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000077546:Roscovitine; D015398:Signal Transduction / Q000187:drug effects*; D013004:Somatostatin / Q000627:therapeutic use; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D000077602:Tolvaptan; D057170:Translational Research, Biomedical
D000814:Aniline Compounds; D000959:Antihypertensive Agents; D001552:Benzazepines; C505032:CFTR protein, human; D015507:Drugs, Investigational; D056572:Histone Deacetylase Inhibitors; D009570:Nitriles; D011687:Purines; D011804:Quinolines; D000077546:Roscovitine; D019005:Cystic Fibrosis Transmembrane Conductance Regulator; D000077602:Tolvaptan; C471992:bosutinib; D013004:Somatostatin; D000242:Cyclic AMP; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases