NRF2 in kidney physiology and disease

The role of NRF2 in kidney biology has received considerable interest over the past decade. NRF2 transcriptionally controls genes responsible for cellular protection against oxidative and electrophilic stress and has anti-inflammatory functions. NRF2 is expressed throughout the kidney and plays a ro...

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Bibliographic Details
Published in:Physiological reports 2024-03, Vol.12 (5), p.e15961-e15961
Main Authors: Bondi, Corry D, Hartman, Hannah L, Tan, Roderick J
Format: Article
Language:English
Subjects:
Alport syndrome
Animals
Antioxidants
Atrophy
bardoxolone methyl
Blood pressure
chronic kidney disease
Creatinine
Dehydrogenases
Diabetes mellitus
Diabetic Nephropathies
electrophiles
Fibrosarcoma
Fibrosis
Genes
Glomerular filtration rate
Homeostasis
Humans
Inflammation
Invited Review
Invited Reviews
Kidney
Kidney diseases
Kinases
Metabolism
NF-E2-Related Factor 2 - genetics
Oleanolic Acid - analogs & derivatives
Oxidative stress
Physiology
Polycystic kidney
Proteins
Proteinuria
Transcription factors
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Summary:The role of NRF2 in kidney biology has received considerable interest over the past decade. NRF2 transcriptionally controls genes responsible for cellular protection against oxidative and electrophilic stress and has anti-inflammatory functions. NRF2 is expressed throughout the kidney and plays a role in salt and water handling. In disease, animal studies show that NRF2 protects against tubulointerstitial damage and reduces interstitial fibrosis and tubular atrophy, and may slow progression of polycystic kidney disease. However, the role of NRF2 in proteinuric glomerular diseases is controversial. Although the NRF2 inducer, bardoxolone methyl (CDDO-Me), increases glomerular filtration rate in humans, it has not been shown to slow disease progression in diabetic kidney disease and Alport syndrome. Furthermore, bardoxolone methyl was associated with negative effects on fluid retention, proteinuria, and blood pressure. Several animal studies replicate findings of worsened proteinuria and a more rapid progression of kidney disease, although considerable controversy exists. It is clear that further study is needed to better understand the effects of NRF2 in the kidney. This review summarizes the available data to clarify the promise and risks associated with targeting NRF2 activity in the kidney.
ISSN:2051-817X
DOI:10.14814/phy2.15961