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he pathogenesis of chronic kidney disease (CKD) involves a complex interaction of hemodynamic and inflammatory
processes that leads to a final common pathway to renal fibrosis, which is characterized by activation of renal fibroblasts
and accumulation of excessive amounts of extracellular matrix (ECM) proteins. Activation of several tyrosien kinase receptors
including epidermal growth factor receptor (EGFR), platelet derived grwoth factor receptors (PDGFR) and vascular growth
factor receptors (VEGFR) has been reported to be involved in renal fibrogenesis. Recently, we demonstrated that treatment of
cultured renal interstitial fibroblasts with suramin, a compound that inhibits the interaction of several growth factors with their
receptors, inhibited their activation. In a mouse model of obstructive nephropathy, administration of a single dose of suramin
immediately after ureteral obstruction abolished the expression of fibronectin, largely suppressed expression of α-SMA and
type I collagen, and reduced the deposition of extracellular matrix proteins. Suramin also decreased the expression of multiple
cytokines including TGF-β1 and reduced the interstitial infiltration of leukocytes. Moreover, suramin blocked phosphorylation
of the EGF and PDGF receptors, and inactivated several signaling pathways associated with the progression of renal fibrosis.
In a rat model of CKD, suramin abrogated proteinuria, limited the decline of renal function, and prevented glomerular and
tubulointerstitial damage. Moreover, delayed administration of suramin also significantly attenuates progression of renal fibrosis.
These findings indicate that inhbition of tyrosine kinase receptors with suramin may have therapeutic potential for patients with
fibrotic kidney diseases.
Shougang Zhuang has completed his residency and renal fellowship in China and Ph.D. from Yokohama City University, and postdoctoral studies
from Harvard Medical School. He is an Associate Professor at Brown University and the director of Kidney Research at Rhode Island Hospital. He
has published 81 papers in peer?reviewed journals and has been serving as an editorial board member of three Journals.
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