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      Molecular Mechanisms of Epigallocatechin-3-Gallate for Prevention of Chronic Kidney Disease and Renal Fibrosis: Preclinical Evidence

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          ABSTRACT

          Chronic kidney disease (CKD) is a common public health problem worldwide characterized by gradual decline of renal function over months/years accompanied by renal fibrosis and failure in tissue wound healing after sustained injury. Patients with CKD frequently present with profound signs/symptoms that require medical treatment, mostly culminating in hemodialysis and renal transplantation. To prevent CKD more efficiently, there is an urgent need for better understanding of the pathogenic mechanisms and molecular pathways of the disease pathogenesis and progression, and for developing novel therapeutic targets. Recently, several lines of evidence have shown that epigallocatechin-3-gallate (EGCG), an abundant phytochemical polyphenol derived from Camellia sinensis, might be a promising bioactive compound for prevention of CKD development/progression. This review summarizes current knowledge of molecular mechanisms underlying renoprotective roles of EGCG in CKD based on available preclinical evidence (from both in vitro and in vivo animal studies), particularly its antioxidant property through preservation of mitochondrial function and activation of Nrf2 (nuclear factor erythroid 2-related factor 2)/HO-1 (heme oxygenase-1) signaling, anti-inflammatory activity, and protective effect against epithelial mesenchymal transition. Finally, future perspectives, challenges, and concerns regarding its clinical use in CKD and renal fibrosis are discussed.

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          Origin and function of myofibroblasts in kidney fibrosis.

          Myofibroblasts are associated with organ fibrosis, but their precise origin and functional role remain unknown. We used multiple genetically engineered mice to track, fate map and ablate cells to determine the source and function of myofibroblasts in kidney fibrosis. Through this comprehensive analysis, we identified that the total pool of myofibroblasts is split, with 50% arising from local resident fibroblasts through proliferation. The nonproliferating myofibroblasts derive through differentiation from bone marrow (35%), the endothelial-to-mesenchymal transition program (10%) and the epithelial-to-mesenchymal transition program (5%). Specific deletion of Tgfbr2 in α-smooth muscle actin (αSMA)(+) cells revealed the importance of this pathway in the recruitment of myofibroblasts through differentiation. Using genetic mouse models and a fate-mapping strategy, we determined that vascular pericytes probably do not contribute to the emergence of myofibroblasts or fibrosis. Our data suggest that targeting diverse pathways is required to substantially inhibit the composite accumulation of myofibroblasts in kidney fibrosis.
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            Fibrosis--a common pathway to organ injury and failure.

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              Mitochondrial energetics in the kidney

              Mitochondria provide the kidney with energy to remove waste from the blood and regulate fluid and electrolyte balance. This Review discusses how mitochondrial homeostasis is maintained, the changes in mitochondrial energetics that occur in acute kidney injury and diabetic nephropathy, and how targeting mitochondrial energetics might aid the treatment of renal disease.
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                Author and article information

                Contributors
                Journal
                Curr Dev Nutr
                Curr Dev Nutr
                cdn
                Current Developments in Nutrition
                Oxford University Press
                2475-2991
                29 August 2019
                September 2019
                29 August 2019
                : 3
                : 9
                : nzz101
                Affiliations
                [1] Medical Proteomics Unit, Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok, Thailand
                Author notes
                Address correspondence to VT (e-mail: thongboonkerd@ 123456dr.com ; vthongbo@ 123456yahoo.com )
                Author information
                http://orcid.org/0000-0001-7865-0765
                Article
                nzz101
                10.1093/cdn/nzz101
                6752729
                31555758
                d84f19ae-b038-4e8f-a1e9-68fbdd6cd0ba
                Copyright © American Society for Nutrition 2019.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@ 123456oup.com

                History
                : 02 July 2019
                : 28 August 2019
                Page count
                Pages: 10
                Funding
                Funded by: Thailand Research Fund 10.13039/501100004396
                Award ID: IRN60W0004
                Award ID: IRG5980006
                Funded by: Medicine Siriraj Hospital
                Categories
                Review

                camellia sinensis,ckd,diabetic nephropathy,egcg,glomerulonephritis,lupus nephritis,renoprotection,tea

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