Processes of Fibrogenesis in Glomerular Nephropathies

Progressive renal disease is associated with the development of fibrosing lesions in the glomerulusglomerulosclerosis, and in the interstitiuminterstitial fibrosis. The mechanisms involved in this processes are shared by the inflammatory cells and the resident cells: glomerular mesangial cell, interstitial fibroblast, tubular epithelial cell and vascular smooth muscle cell. These resident cells undergo phenotypic changes, which lead to proliferation and increased production of the extracellular matrix. An important role in fibrogenesis is played by various growth factors, such as TGFβ, CTGF, PDGF, FGF, BMP7. On the other hand, the renin-angiotensin system stimulates renal fibrogenesis, with actions that are beyond the well-known hemodynamic and salt/water homeostasis. Treatment strategies focused on any one of these mechanisms, could be beneficial in reducing the ongoing renal scarring that accompanies progressive renal