Kidney diseases and chemokines

Infiltrating inflammatory cells into the kidney mediate the initiation and progression of damage by direct cytotoxicity, the secretion of soluble factors such as cytokines and proteases, or by the subsequent induction of further immune response. Before leukocytes can exert their effects on renal damage or repair, they have to reach the site of injury. It has become clear in recent years that a group of small proteins called chemokines are the chemotactic cytokines considered to be the main regulators of directional leukocyte trafficking under homeostatic and inflammatory conditions. In this review, we summarize available in vivo studies on the neutralization of chemokines and chemokine receptors in renal inflammatory disease, and especially focus on the potential therapeutic effects of chemokine blockade in glomerulonephritis and renal transplantation. Although interference with chemokine expression holds great promises for the treatment of inflammatory renal diseases, it has been shown that such an approach may actually worsen in diseases under certain circumstances. This suggests that inhibition of chemokine expression and action must be time and compartment specific to provide therapeutic benefit for renal structure and function.