Boffa Jean-Jacques, Dussaule Jean-Claude, Ronco Pierre, Chatziantoniou Christos
Unité Inserm 702, Paris, F-75020.
Rev Prat. 2012 Jan;62(1):72-5.
Despite the use of angiotensin blockers, chronic kidney diseases still progress. New therapeutic approaches aim to strengthen and to complete angiotensin blocker effects. Endothelin receptor antagonists, in addition to angiotensin blockers reduce blood pressure and urinary albumin excretion in diabetic nephropathies but can induce fluid overload. A second therapeutic approach consists in preventing the development of interstitial renal fibrosis which is a prognostic factor of CKD. Transforming growth factor-beta (TGF-beta) plays a major role in this process. Several molecules such as pirfenidone, microARN are in development to block TGF-beta or its downstream signaling pathways. Another approach aims to promote resolution of inflammation and renal repair Interesting experimental results were obtained with tyrosine kinase inhibitors and with methyl of bardoxolone in humans.
尽管使用了血管紧张素阻滞剂，但慢性肾脏病仍在进展。新的治疗方法旨在增强并完善血管紧张素阻滞剂的作用。内皮素受体拮抗剂除血管紧张素阻滞剂外，还可降低糖尿病肾病患者的血压和尿白蛋白排泄，但可导致液体超负荷。第二种治疗方法是预防肾间质纤维化的发生，肾间质纤维化是慢性肾脏病的一个预后因素。转化生长因子-β（TGF-β）在这一过程中起主要作用。几种分子如吡非尼酮、微小RNA正在研发中，以阻断TGF-β或其下游信号通路。另一种方法旨在促进炎症消退和肾脏修复。酪氨酸激酶抑制剂和巴多昔芬甲基酯在人体试验中获得了有趣的实验结果。
