Chatziantoniou Christos, Dussaule Jean-Claude
INSERM U702, Université Pierre et Marie Curie, Paris, France.
Curr Opin Nephrol Hypertens. 2008 Jan;17(1):76-81. doi: 10.1097/MNH.0b013e3282f1bb69.
Recent evidence indicates that the progression of renal fibrosis is a reversible process in experimental models. This review summarizes the new insights concerning the mechanisms of progression and regression of renal disease and examines this novel evidence in the light of feasibility and transfer to human nephropathies.
Most of the studies investigated prevention rather than reversal of renal disease. Interesting results have been obtained using agents antagonizing the signaling pathway of transforming growth factor-beta, by blockers of the tyrosine kinase growth factor receptors and by kinin receptor activation.
The future for therapy belongs to systems that mediate simultaneously proliferation, fibrosis and inflammation. Inhibitors of this kind of mediator will provide valuable assistance to 'classical' therapy with angiotensin II blockers, in order to achieve regression of renal fibrosis and reversal of renal failure.
最近的证据表明，在实验模型中肾纤维化的进展是一个可逆过程。本综述总结了有关肾脏疾病进展和逆转机制的新见解，并根据可行性以及向人类肾病转化的情况来审视这一新证据。
大多数研究调查的是肾脏疾病的预防而非逆转。使用拮抗转化生长因子-β信号通路的药物、酪氨酸激酶生长因子受体阻滞剂以及激肽受体激活剂已获得了有趣的结果。
未来的治疗方法属于能够同时调节增殖、纤维化和炎症的系统。这类介质的抑制剂将为使用血管紧张素II阻滞剂的“经典”治疗提供有价值的辅助，以实现肾纤维化的消退和肾衰竭的逆转。
