Abstract

Renal fibrosis is a common irreversible process of chronic kidney disease (CKD) characterized by uncontrolled deposits of extracellular matrix, replacement of cellular parenchyma and progressive loss of renal function. Recent evidence suggests that a series of phenotypic transformations of resident renal cells are responsible for the formation of interstitial myofibroblasts, cells that play a key role in the fibrotic process. In the renal glomerulus transformation of mesangial cells to myofibroblasts is an event that orchestrates glomerulosclerosis and the participation of other cells types has also been suggested. Recent findings clarify the role of tubular epithelium in mediating the generation of ECM producing cells in the tubule interstitium. Also, crosstalk between injured cells and myofibroblasts for amplification of the fibrogenic cascade in CKD occurs. The crucial conductor of these changes in the kidney is the transforming growth factor-β (TGF-β). Thus, this review focuses on the control of this cytokines signaling mechanisms and their dysregulation in CKD. Further, some of the promising interventional alternatives targeting TGF-β are also discussed