Profibrotic and antifibrotic growth factors in the development of diabetic nephropathy

Progressing glomerular and tubulointerstitium kidney fibrosis is the leading pathological process defining the development of chronic renal failure in diabetic nephropathy. The development of the kidneys fibrosis under hyperglycemic condition is associated with imbalance between profibrotic and antifibrotic growth factors that regulate the proliferation, differentiation, apoptosis and synthetic function of glomerular and tubular cells. In presence of the hyperglycemia the synthesis of profibrotic growth factors (including transforming growth factor β, tumor necrosis factor α, fibroblast growth factor, connective tissue growth factor, vascular endothelial growth factor) is activated in the kidneys and meanwhile production of antifibrotic growth factors (bone morphogenetic protein 7, hepatocyte growth factor) is suppressed. The imbalance in profibrotic and antifibrotic growth factors expression and activity is crucial for extracellular matrix metabolism disorders and development of glomerular and interstitial fibrosis in diabetic nephropathy. Growth factors can be considered as a prospective diagnostic markers and potential targets for nephroprotection in diabetic kidney disease.