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Epigenetic strategies for mitigating kidney fibrosis

molecular-biology
nephrology
pharmacology

Abstract

Renal fibrosis is the irreversible pathological core of chronic kidney disease (CKD), and current treatments can only slow down the progression of the disease but cannot cure it. Epigenetic regulatory mechanisms provide a new perspective for understanding and intervening in this process. This review summarizes the core epigenetic regulatory networks in renal fibrosis: Firstly, abnormal DNA methylation can silence anti-fibrotic genes. Secondly, histone modifications dynamically regulate chromatin state and affect the transcription of fibrosis-related genes. Moreover, non-coding RNAs regulate fibrosis signals through complex networks. Preclinical studies have verified the effectiveness of DNMT inhibitors, subtype-specific histone deacetylase inhibitors, miRNA-based therapies, and natural products in reversing the fibrotic phenotype by restoring epigenetic homeostasis. However, there are still obstacles from clinical success to practical application. Future development depends on precision medicine. Optimizing targeted therapy, designing rational combination therapies, and establishing a strict and systematic long-term safety assessment system will be the key to translating epigenetic research results into effective treatments for renal fibrosis.
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