title: Pentoxifylline for Diabetic Nephropathy: an Important Opportunity to Re-purpose an Old Drug?
abstract: Diabetic nephropathy, or diabetic kidney disease (DKD), is the most serious complication of diabetes mellitus (DM). Despite recent advances in therapy, DKD still often progresses to end-stage renal disease (ESRD). Recent studies have suggested that pentoxifylline (PTX) may be efficacious in the treatment of DKD. PTX is a rheologic modifier approved for use in the USA for the symptomatic relief of claudication. It competitively inhibits phosphodiesterase (PDE), resulting in increased intracellular cyclic AMP (cAMP), activation of protein kinase A (PKA), inhibition of interleukin (IL) and tumor necrosis factor (TNF) synthesis, and reduced inflammation. PTX improves red blood cell deformability, reduces blood viscosity, and decreases platelet aggregation. In combination with renin-angiotensin-aldosterone (RAAS) blockers, PTX may help prevent progression to ESRD in patients with DKD. This review focuses on the possible mechanisms of action of PTX in DKD and studies suggesting possible efficacy of this old drug for a new indication.
authors.affiliation: George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Shelly
authors.initials: S
authors.lastname: Bhanot
authors.affiliation: Loyola University Stritch School of Medicine, Maywood, IL, USA. david.leehey@va.gov.|Hines VA Hospital, 111L, Hines, IL, 60141, USA. david.leehey@va.gov.
authors.forename: David J
authors.initials: DJ
authors.lastname: Leehey
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D018450:Disease Progression; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000209:etiology; D010431:Pentoxifylline / Q000627:therapeutic use*
chemical_list: D010431:Pentoxifylline
keywords: Diabetic nephropathy; Inflammation; Pentoxifylline; Phosphodiesterase (PDE) inhibitor renin-angiotensin-aldosterone (RAAS) blockers; Renal progression