Targeting CTGF, EGF and PDGF pathways to prevent progression of kidney disease

Nat Rev Nephrol. 2014 Dec;10(12):700-11. doi: 10.1038/nrneph.2014.184. Epub 2014 Oct 14.


Chronic kidney disease (CKD) is a major health and economic burden with a rising incidence. During progression of CKD, the sustained release of proinflammatory and profibrotic cytokines and growth factors leads to an excessive accumulation of extracellular matrix. Transforming growth factor β (TGF-β) and angiotensin II are considered to be the two main driving forces in fibrotic development. Blockade of the renin-angiotensin-aldosterone system has become the mainstay therapy for preservation of kidney function, but this treatment is not sufficient to prevent progression of fibrosis and CKD. Several factors that induce fibrosis have been identified, not only by TGF-β-dependent mechanisms, but also by TGF-β-independent mechanisms. Among these factors are the (partially) TGF-β-independent profibrotic pathways involving connective tissue growth factor, epidermal growth factor and platelet-derived growth factor and their receptors. In this Review, we discuss the specific roles of these pathways, their interactions and preclinical evidence supporting their qualification as additional targets for novel antifibrotic therapies.

Publication types

  • Review

MeSH terms

  • Connective Tissue Growth Factor / genetics*
  • Connective Tissue Growth Factor / metabolism
  • Disease Progression
  • EGF Family of Proteins / genetics*
  • EGF Family of Proteins / metabolism
  • Female
  • Humans
  • Male
  • Molecular Targeted Therapy / methods
  • Platelet-Derived Growth Factor / genetics*
  • Platelet-Derived Growth Factor / metabolism
  • Prognosis
  • Renal Insufficiency, Chronic / drug therapy*
  • Renal Insufficiency, Chronic / genetics*
  • Renal Insufficiency, Chronic / physiopathology
  • Signal Transduction / drug effects*
  • Treatment Outcome


  • EGF Family of Proteins
  • Platelet-Derived Growth Factor
  • Connective Tissue Growth Factor