Delrue Charlotte, Eisenga Michele F, Delanghe Joris R, Speeckaert Marijn M
Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium.
Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands.
J Pers Med. 2024 Dec 5;14(12):1141. doi: 10.3390/jpm14121141.
Chronic kidney disease (CKD) is a chronic disorder characterized by kidney fibrosis and extracellular matrix accumulation that can lead to end-stage kidney disease. Epithelial-to-mesenchymal transition, inflammatory cytokines, the TGF-β pathway, Wnt/β-catenin signaling, the Notch pathway, and the NF-κB pathway all play crucial roles in the progression of fibrosis. Current medications, such as renin-angiotensin-aldosterone system inhibitors, try to delay disease development but do not stop or reverse fibrosis. This review emphasizes the growing need for tailored antifibrotic medications for CKD treatment. Precision medicine, which combines proteomic, metabolomic, and genetic data, provides a practical way to personalize treatment regimens. Proteomic signatures, such as CKD273, and genetic markers, such as and , help in patient stratification and focused therapy development. Two recently developed antifibrotic medications, nintedanib and pirfenidone, have been proven to diminish fibrosis in preclinical animals. Additionally, research is being conducted on the efficacy of investigational drugs targeting CTGF and galectin-3 in the treatment of kidney fibrosis.
慢性肾脏病（CKD）是一种以肾纤维化和细胞外基质积聚为特征的慢性疾病，可导致终末期肾病。上皮-间质转化、炎性细胞因子、转化生长因子-β（TGF-β）通路、Wnt/β-连环蛋白信号传导、Notch通路和核因子-κB（NF-κB）通路在纤维化进展中均起关键作用。目前的药物，如肾素-血管紧张素-醛固酮系统抑制剂，试图延缓疾病发展，但不能阻止或逆转纤维化。本综述强调了为CKD治疗量身定制抗纤维化药物的需求日益增长。精准医学结合了蛋白质组学、代谢组学和基因数据，为个性化治疗方案提供了一种实用方法。蛋白质组学特征，如CKD273，以及基因标志物，如 和 ，有助于患者分层和针对性治疗方案的制定。最近开发的两种抗纤维化药物，尼达尼布和吡非尼酮，已被证实在临床前动物模型中可减轻纤维化。此外，针对结缔组织生长因子（CTGF）和半乳糖凝集素-3的研究性药物治疗肾纤维化的疗效也在进行研究。
