Hd. Humes et al., ACUTE-RENAL-FAILURE - GROWTH-FACTORS, CELL THERAPY, AND GENE-THERAPY, Proceedings of the Association of American Physicians, 109(6), 1997, pp. 547-557
The rapid understanding of the cellular and molecular basis of organ f
unction and disease will be translated during the next several decades
into new therapeutic approaches to a wide range of clinical disorders
, including acute renal failure (ARF). The development of the biotechn
ology for recombinant genetic engineering has led to the prospect of u
sing purified protein products for therapy. In this regard, the repair
of ischemic and toxic ARF is critically dependent on a redundant, int
eractive cytokine network of growth factors to return kidney function
to near normal baseline function. Recombinant growth factors are being
tested both experimentally and clinically to accelerate the repair of
kidney tissue in this disorder. A newer strategy in biotechnology is
the development of cell therapy derivatives. Cell therapy is based on
the ability to expand specific cells in tissue culture to perform diff
erentiated tasks and to introduce these cells into the patient either
in extracorporeal circuits or as implants as drug delivery vehicles of
a single protein or to provide physiological functions. Cell therapy
devices are being developed to replace components of renal function th
at are lost during ARF and chronic renal failure and are not replaced
with current hemodialysis or hemofiltration. These new approaches may
result in therapeutic modalities that diminish the degree of renal fai
lure and the time needed to recover renal function in acute tubular ne
crosis, This article examines the future prospects of these developing
therapies in the treatment of ARF.