Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Feb 16:9:105.
doi: 10.3389/fphys.2018.00105. eCollection 2018.

Oxidative Stress and Renal Fibrosis: Recent Insights for the Development of Novel Therapeutic Strategies

Affiliations
Review

Oxidative Stress and Renal Fibrosis: Recent Insights for the Development of Novel Therapeutic Strategies

Wenshan Lv et al. Front Physiol. .

Abstract

Chronic kidney disease (CKD) is a significant worldwide healthcare problem. Regardless of the initial injury, renal fibrosis is the common final pathway leading to end stage renal disease. Although the underlying mechanisms are not fully defined, evidence indicates that besides inflammation, oxidative stress plays a crucial role in the etiology of renal fibrosis. Oxidative stress results from an imbalance between the production of free radicals that are often increased by inflammation and mitochondrial dysfunction, and reduced anti-oxidant defenses. Several studies have demonstrated that oxidative stress may occur secondary to activation of transforming growth factor β1 (TGF-β1) activity, consistent with its role to increase nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox) activity. A number of other oxidative stress-related signal pathways have also been identified, such as nuclear factor erythroid-2 related factor 2 (Nrf2), the nitric oxide (NO)-cyclic guanosine monophosphate (cGMP)-cGMP-dependent protein kinase 1-phosphodiesterase (cGMP-cGK1-PDE) signaling pathway, and the peroxisome proliferator-activated receptor gamma (PPARγ) pathway. Several antioxidant and renoprotective agents, including cysteamine bitartrate, epoxyeicosatrienoic acids (EETs), and cytoglobin (Cygb) have demonstrated ameliorative effects on renal fibrosis in preclinical or clinical studies. The mechanism of action of many traditional Chinese medicines used to treat renal disorders is based on their antioxidant properties, which could form the basis for new therapeutic approaches. This review focuses on the signaling pathways triggered by oxidative stress that lead to renal fibrosis and provides an update on the development of novel anti-oxidant therapies for CKD.

Keywords: antifibrotic therapy; chronic kidney disease; kidney function; oxidative stress; traditional Chinese medicines.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Renal fibrosis occurs downstream of TGF-β intracellular signaling and increased ROS generation. Through its cell surface receptors TGFR1 and TGFR2, TGF-β activates several signaling cascades (including AKT, Smad2/3, NF-κB, p38 MAPK, JNK, ERK1/2) that lead to formation of activated fibroblasts (directly from interstitial fibroblasts or by epithelial mesenchymal transition/EMT or endothelial to mesenchymal transition/EndMT). These myofibroblasts synthesize ECM components leading to fibrosis and express NOX2/4 that generates ROS, which can enhance fibrosis or induce anti-oxidant/cytoprotective genes by activating the transcription factor Nrf2. Activation of the nuclear receptor PPARγ also reduces ROS formation by improving mitochondrial function and defenses. The cell-surface chondroitin sulfate/heparan sulfate proteoglycan betaglycan facilitates the interaction of TGF-β with TGFR2, and a soluble truncated form of betaglycan (P144) can serve as a decoy receptor to attenuate TGF-β signaling. The hormone relaxin engages the G-protein receptor RXFP1 to induce NOS1 expression and generate NO, which can directly reduce ROS or indirectly reduce ROS via increased renal blood flow. The PDE5 inhibitors CTP-499 and Icariin enhance the beneficial effects of NO on the kidney. By increasing cAMP and PKA activity, the PDE inhibitor pentoxifylline interferes with Smad3/4-dependent CTGF transcription. CTGF enhances TGF-β signaling.
Figure 2
Figure 2
Recently identified constituents of Fufang Xue Shuan Tong (FXST) identified using liquid chromatography–tandem mass spectrometry (Zhou et al., 2015). (Capsule image adapted and reproduced with permission from the copyright holder http://servier.com/Powerpoint-image-bank).

References

    1. An L., Zhou M., Marikar F., Hu X. W., Miao Q. Y., Li P., et al. . (2017). Salvia miltiorrhiza lipophilic fraction attenuates oxidative stress in diabetic nephropathy through activation of nuclear factor erythroid 2-Related factor 2. Am. J. Chin. Med. 45, 1441–1457. 10.1142/S0192415X17500781 - DOI - PubMed
    1. Baltanas A., Miguel-Carrasco J. L., San Jose G., Cebrian C., Moreno M. U., Dotor J., et al. (2013). A synthetic peptide from transforming growth factor-beta(1) type III receptor inhibits NADPH oxidase and prevents oxidative stress in the kidney of spontaneously hypertensive rats. Antioxid. Redox Signal. 19, 1607–1618. 10.1089/ars.2012.4653 - DOI - PubMed
    1. Baylis C. (2008). Nitric oxide deficiency in chronic kidney disease. Am. J. Physiol. Renal Physiol. 294, F1–F9. 10.1152/ajprenal.00424.2007 - DOI - PubMed
    1. Bondi C. D., Manickam N., Lee D. Y., Block K., Gorin Y., Abboud H. E., et al. . (2010). NAD(P)H oxidase mediates TGF-beta1-induced activation of kidney myofibroblasts. J. Am. Soc. Nephrol. 21, 93–102. 10.1681/ASN.2009020146 - DOI - PMC - PubMed
    1. Chatuphonprasert W., Lao-Ong T., Jarukamjorn K. (2014). Improvement of superoxide dismutase and catalase in streptozotocin-nicotinamide-induced type 2-diabetes in mice by berberine and glibenclamide. Pharm. Biol. 52, 419–427. 10.3109/13880209.2013.839714 - DOI - PubMed

LinkOut - more resources