Pharmacological basis of the antifibrotic effects of pirfenidone: Mechanistic insights from cardiac in-vitro and in-vivo models

Sartiani, Laura; Bartolucci, Gianluca; Pallecchi, Marco; Spinelli, Valentina; Cerbai, Elisabetta

doi:10.3389/fcvm.2022.751499

Cited by 13 publications

(14 citation statements)

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“…Although both human and animal studies have provided valuable insights into immune cell activation and cytokine production in neutrophil recruitment and activation, few biomarkers have been identified. The relevant immune cell populations, signaling pathways, and symptom control strategies are summarized in Table 1 [ 28 – 46 ] and Figure 1 .…”

Section: Na and Mga: Mechanisms And Therapeutic Targetsmentioning

confidence: 99%

“…In addition, TGF-β receptor blockers, such as galunisertib, have been found to restrict fibrosis in preclinical models and clinical trials that have investigated various fibrotic diseases [ 45 ]. Another potential therapeutic option is pirfenidone, an antifibrotic agent that can reduce collagen deposition and fibrosis in several lung diseases [ 46 ]. Further studies are needed to evaluate the potential of such inhibitors to alleviate TGF-β-mediated airway remodeling in patients with PGA.…”

Section: Pga: Mechanisms and Therapeutic Targetsmentioning

confidence: 99%

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New targets for type 2-low asthma

Quoc,

Choi,

Hur

et al. 2024

Korean J Intern Med

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Asthma is characterized by airway obstruction and inflammation, and presents significant diagnostic and treatment challenges. The concept of endotypes has improved understanding of the mechanisms of asthma and has stimulated the development of effective treatment strategies. Sputum profiles may be used to classify asthma into two major inflammatory types: type 2-high (T2H) and type 2-low (T2L) asthma. T2H, characterized by elevated type 2 inflammation, has been extensively studied and several effective biologic treatments have been developed. However, managing T2L is more difficult due to the lack of reliable biomarkers for accurate diagnosis and classification. Additionally, conventional anti-inflammatory therapy does not completely control the symptoms of T2L; therefore, further research is needed to identify effective biologic treatments. This review provides new insights into the clinical characteristics and underlying mechanisms of severe T2L and investigates potential therapeutic approaches to control the disease.

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Section: Na and Mga: Mechanisms And Therapeutic Targetsmentioning

confidence: 99%

Section: Pga: Mechanisms and Therapeutic Targetsmentioning

confidence: 99%

New targets for type 2-low asthma

Quoc,

Choi,

Hur

et al. 2024

Korean J Intern Med

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“…Pirfenidone is an antifibrotic drug whose mechanism of action is thought to involve inhibition of TGF-β [223]. In preclinical studies, pirfenidone blocked the expression of TGF-β and its subsequent downstream effects [224]. In cell culture experiments, the drug was able to inhibit the production and signaling of TGF-β as well as the downstream production of reactive oxygen species (ROS) [225].…”

Section: Pirfenidonementioning

confidence: 99%

Fibrosis in Chronic Kidney Disease: Pathophysiology and Therapeutic Targets

Reiss,

Jacob,

Zubair

et al. 2024

JCM

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Chronic kidney disease (CKD) is a slowly progressive condition characterized by decreased kidney function, tubular injury, oxidative stress, and inflammation. CKD is a leading global health burden that is asymptomatic in early stages but can ultimately cause kidney failure. Its etiology is complex and involves dysregulated signaling pathways that lead to fibrosis. Transforming growth factor (TGF)-β is a central mediator in promoting transdifferentiation of polarized renal tubular epithelial cells into mesenchymal cells, resulting in irreversible kidney injury. While current therapies are limited, the search for more effective diagnostic and treatment modalities is intensive. Although biopsy with histology is the most accurate method of diagnosis and staging, imaging techniques such as diffusion-weighted magnetic resonance imaging and shear wave elastography ultrasound are less invasive ways to stage fibrosis. Current therapies such as renin-angiotensin blockers, mineralocorticoid receptor antagonists, and sodium/glucose cotransporter 2 inhibitors aim to delay progression. Newer antifibrotic agents that suppress the downstream inflammatory mediators involved in the fibrotic process are in clinical trials, and potential therapeutic targets that interfere with TGF-β signaling are being explored. Small interfering RNAs and stem cell-based therapeutics are also being evaluated. Further research and clinical studies are necessary in order to avoid dialysis and kidney transplantation.

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“…It is also said to have several mechanisms that could be used to inhibit the progression of chronic diseases of both heart and kidney, as shown in Figure 4 [112,114]. The drug is mainly metabolized in the liver, by CYP1A2, and will therefore be contraindicated in patients with liver disease or liver failure [111].…”

Section: Pirfenidonementioning

confidence: 99%

Role of Uremic Toxins, Oxidative Stress, and Renal Fibrosis in Chronic Kidney Disease

Frąk,

Dąbek,

Balcerczyk-Lis

et al. 2024

Antioxidants

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Affecting millions of people worldwide, chronic kidney disease is a serious medical problem. It results in a decrease in glomerular filtration rate below 60 mL/min/1.73 m, albuminuria, abnormalities in urine sediment and pathologies detected by imaging studies lasting a minimum of 3 months. Patients with CKD develop uremia, and as a result of the accumulation of uremic toxins in the body, patients can be expected to suffer from a number of medical consequences such as progression of CKD with renal fibrosis, development of atherosclerosis or increased incidence of cardiovascular events. Another key element in the pathogenesis of CKD is oxidative stress, resulting from an imbalance between the production of antioxidants and the production of reactive oxygen species. Oxidative stress contributes to damage to cellular proteins, lipids and DNA and increases inflammation, perpetuating kidney dysfunction. Additionally, renal fibrogenesis involving the accumulation of fibrous tissue in the kidneys occurs. In our review, we also included examples of forms of therapy for CKD. To improve the condition of CKD patients, pharmacotherapy can be used, as described in our review. Among the drugs that improve the prognosis of patients with CKD, we can include: GLP-1 analogues, SGLT2 inhibitors, Finerenone monoclonal antibody—Canakinumab and Sacubitril/Valsartan.

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Pharmacological basis of the antifibrotic effects of pirfenidone: Mechanistic insights from cardiac in-vitro and in-vivo models

Cited by 13 publications

References 50 publications

New targets for type 2-low asthma

New targets for type 2-low asthma

Fibrosis in Chronic Kidney Disease: Pathophysiology and Therapeutic Targets

Role of Uremic Toxins, Oxidative Stress, and Renal Fibrosis in Chronic Kidney Disease

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