title: Novel targets of antifibrotic and anti-inflammatory treatment in CKD.
abstract: Chronic kidney disease (CKD) is becoming a worldwide epidemic, driven largely by the dramatic rise in the prevalence of diabetes and obesity. Novel targets and treatments for CKD are, therefore, desperately needed-to both mitigate the burden of this disease in the general population and reduce the necessity for renal replacement therapy in individual patients. This Review highlights new insights into the mechanisms that contribute to CKD, and approaches that might facilitate the development of disease-arresting therapies for CKD. Particular focus is given to therapeutic approaches using antifibrotic agents that target the transforming growth factor β superfamily. In addition, we discuss new insights regarding the roles of vascular calcification, the NADPH oxidase family, and inflammation in the pathogenesis of CKD. We also highlight a new understanding regarding kidney energy sensing pathways (AMPK, sirtuins, and mTOR) in a variety of kidney diseases and how they are linked to inflammation and fibrosis. Finally, exciting new insights have been made into the role of mitochondrial function and mitochondrial biogenesis in relation to progressive kidney disease. Prospective therapeutics based on these findings will hopefully renew hope for clinicians and patients in the near future.
authors.affiliation: Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), CP603, 808 Route de Lennik, 1070 Brussels, Belgium.
authors.forename: Anne-Emilie
authors.initials: AE
authors.lastname: Declèves
authors.affiliation: Center for Renal Translational Medicine, University of California, San Diego and Veterans Affairs San Diego Healthcare System, Stein Clinical Research Building, 4th Floor, 9500 Gilman Drive, La Jolla, CA 92093-0711, USA.
authors.forename: Kumar
authors.initials: K
authors.lastname: Sharma
mesh_terms: D055372:AMP-Activated Protein Kinases / Q000502:physiology; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D018450:Disease Progression; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000502:physiology; D005355:Fibrosis; D005966:Glucuronidase / Q000627:therapeutic use; D006801:Humans; D000090265:Klotho Proteins; D008928:Mitochondria / Q000502:physiology; D023421:Models, Animal; D019255:NADPH Oxidases / Q000037:antagonists & inhibitors / Q000502:physiology; D016328:NF-kappa B / Q000037:antagonists & inhibitors / Q000502:physiology; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*; D016212:Transforming Growth Factor beta / Q000037:antagonists & inhibitors / Q000276:immunology / Q000502:physiology; D061205:Vascular Calcification
chemical_list: D000893:Anti-Inflammatory Agents; D016328:NF-kappa B; D016212:Transforming Growth Factor beta; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D019255:NADPH Oxidases; D055372:AMP-Activated Protein Kinases; D005966:Glucuronidase; D000090265:Klotho Proteins