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How Tubular Epithelial Cell Injury Contributes to Renal Fibrosis

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Renal Fibrosis: Mechanisms and Therapies

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1165))

Abstract

The renal tubules are the major component of the kidney and are vulnerable to a variety of injuries including ischemia, proteinuria, toxins, and metabolic disorders. It has long been believed that tubules are the victim of injury. In this review, we shift this concept to renal tubules as a driving force in the progression of kidney disease. In response to injury, tubular epithelial cells (TECs) can synthesize and secrete varieties of bioactive molecules that drive interstitial inflammation and fibrosis. Innate immune-sensing receptors on the TECs also aggravate immune responses. Necroinflammation, an auto-amplification loop between tubular cell death and interstitial inflammation, leads to the exacerbation of renal injury. Furthermore, TECs also play an active role in progressive renal injury via mechanisms associated with the conversion into collagen-producing fibroblast phenotype, cell cycle arrest at both G1/S and G2/M checkpoints, and metabolic disorder. Thus, a better understanding the mechanisms by which tubular injury drives AKI and CKD is necessary for the development of therapeutics to halt the progression of CKD.

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Acknowledgements

This chapter was modified from a paper reported by our group in Kidney Int (Liu et al. 2018). The related contents are reused with permission.

This study was supported by grants from the National Key Research and Development Program of China (2018YFC1314004), the National Natural Scientific Foundation (No. 81720108007, 81130010, 81470997, and 81670696), and the Clinic Research Center of Jiangsu Province (No. BL2014080).

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  1. Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China

    Bi-Cheng Liu, Tao-Tao Tang & Lin-Li Lv

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  1. Bi-Cheng Liu
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  2. Tao-Tao Tang
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Correspondence to Bi-Cheng Liu .

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  1. Zhongda Hospital, Southeast University School of Medicine, Southeast University, Nanjing, Jiangsu, China

    Bi-Cheng Liu

  2. Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, Hong Kong

    Hui-Yao Lan

  3. Zhongda Hospital, Southeast University School of Medicine, Southeast University, Nanjing, Jiangsu, China

    Lin-Li Lv

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Liu, BC., Tang, TT., Lv, LL. (2019). How Tubular Epithelial Cell Injury Contributes to Renal Fibrosis. In: Liu, BC., Lan, HY., Lv, LL. (eds) Renal Fibrosis: Mechanisms and Therapies. Advances in Experimental Medicine and Biology, vol 1165. Springer, Singapore. https://doi.org/10.1007/978-981-13-8871-2_11

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