Targeting growth factors to the kidney: myth or reality?

Growth factors and cytokines play a crucial role in the progression of renal diseases. A growing body of evidence has been obtained from experimental studies, suggesting that manipulation of the activity of growth factors and cytokines is a potential form of therapy for renal diseases. To preserve the renal function structure in progressive renal diseases, this approach is achieved by inhibition of apoptosis of renal intrinsic cells and by decrease in the fibrotic signal. Inhibition of transforming growth factor beta, platelet-derived growth factor, interleukin-1 and tumor necrosis factor alpha, and supplementation of hepatocyte growth factor, vascular endothelial growth factor and bone morphogenic protein-7 may be beneficial. Recent progress in therapeutic implements including humanized antibodies, chimeric soluble receptors, aptamers, antisense oligonucleotides, and gene therapy allow us to target the causal molecules. Administration of a combination of growth factors and cytokines is a potential therapeutic approach. Targeting signal transduction molecules and their co-factors and regulators is another possibility because the signals from various growth factors use a common pathway. Thus, targeting growth factors and cytokines in renal diseases could be a promising therapeutic approach. Curr Opin Nephrol Hypertens 11:49-57. (C) 2002 Lippincott Williams & Wilkins.